Closing Insite would violate Charter: Supreme Court

Montreal, Toronto and Victoria could establish similar services

Brian Howell/Maclean's

A crowd gathered on the gritty streets of Vancouver’s Downtown Eastside burst into cheers Friday morning at news the Supreme Court of Canada ruled unanimously that Insite, the supervised injection site for drug addicts can remain open. The ruling is a stinging defeat for Stephen Harper’s Conservative government, which claimed the site fostered addictions, encouraged crime and violated the federal criminal code by facilitating the use of illegal drugs.

The court ordered the federal health minister to immediately issue an exemption at the site from laws prohibiting drug possession and trafficking to allow the facility to operate. The ruling almost certainly assures that similar sites will open across Canada. Montreal, Toronto and Victoria are among the communities that have expressed interest in establishing similar services.

The judges upheld rulings by the provincial supreme court and court of appeal, which found the federal government acted in an arbitrary manner, in violation of guarantees in the Charter of Rights and Freedoms protecting life, liberty and security of the person. During the Supreme Court hearing in May, several high court judges hammered home the point to federal lawyers that the site was, in fact, saving lives.

The news was greeted by cheers and tears at 6:45 a.m. Vancouver time, by a crowd watching the ruling on a big-screen television set up outside the store front facility.

Insite opened in 2003, after receiving an exemption from the federal Liberal government of the day that allowed staff and addicts to use the street-front facility without fear of prosecution. Since opening more than 1.8 million injections have been done at the facility on East Hastings Street, which is staffed by nurses, social workers and addiction counsellors. In that time not a single overdose death occurred at the facility. It also reduced the open injection of drugs in the streets and alleys near the site, and reduced the sharing of needles and the spread of disease.

While the site was initially controversial in Vancouver, its record of success in limiting drug overdose deaths, as well as the spread of HIV and hepatitis C, recorded in dozens of peer-reviewed studies in medical journals, soon gained it strong support. It now has the backing of the Vancouver Police Department, provincial and local health authorities, the provincial government as well as the general public, according to several public opinion polls.

Those findings factored heavily in the Supreme Court’s ruling, which curbs federal criminal law when it comes in conflict with provincial responsibility to deliver safe, effective health care.

“Addiction-related drug use is a health issue and not a criminal justice issue,” said Debra Lynkowski, CEO of the Canadian Public Health Association, after the ruling was handed down. The results of more than 50 peer-reviewed scientific articles provide irrefutable evidence that Insite has a positive impact on the health of the people who use its services, and a positive impact on the surrounding community,” the CPHA said in a news release. “Given the thoughtful consideration of the court, we trust that the [health] minister will take the appropriate action.”

Insite’s future was cast in doubt when the Conservative government of Stephen Harper came to power in 2006. Tony Clement, health minister at the time, condemned the site as a public menace. In 2008, he enraged Canada’s doctors by questioning the medical ethics of those who backed the site. “The supervised injection site undercuts the ethic of medical practice and sets a debilitation example for all physicians and nurses, both present and future in Canada, who might begin to question whether it’s all right to allow someone to overdose under their care,” he said during a speech to the Canadian Medical Association.

A day later, 130 doctors signed a declaring of support for the site and condemned Clement’s “potentially deadly” misrepresentation of the “harm reduction” strategy embodied by the site.

The site had also run afoul of the U.S. government of George Bush, which said the site—one of the first such facilities in North America—undermined its war on drugs. Real Women of Canada and the Drug Prevention Network of Canada strongly opposed Insite, and said the claims of its health benefits were exaggerated.

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