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Safe-injection site in B.C. wins court protection

lilnick

TRIBE Member
Safe-injection site in B.C. wins court protection
ROD MICKLEBURGH

From Wednesday's Globe and Mail

May 27, 2008 at 10:18 PM EDT

VANCOUVER — North America's only sanctioned safe-injection site for drug addicts won a major court victory Tuesday, thwarting any chance of the federal Conservative government closing it down.

Mr. Justice Ian Pitfield of the B.C. Supreme Court granted users and staff at the popular but controversial facility known as Insite a permanent constitutional exemption from prosecution under federal drug laws.

Allowing addicts to inject their illegal drugs in a safe, medically supervised environment is a matter of sensible health care and they should not be under threat of being busted by police, the judge ruled.

In so doing, Judge Pitfield also declared that sections of Canada's drug laws against possession and trafficking in illegal narcotics were unconstitutional.

However, he gave the government until the end of June next year to redraft them in accordance with the Canadian Charter of Rights and Freedoms. The ruling is narrow in scope and not expected to lead to widespread loosening of the laws against heroin, cocaine, marijuana and other illegal drugs.

But it was clearly a stunning reprieve for Insite.

The fate of the facility in the heart of Vancouver's drug-ravaged Downtown Eastside had been up in the air over fears that federal Health Minister Tony Clement would withdraw its legal exemption at the end of June.

Critics have accused the Tories of having an ideological bias against allowing the injection of illegal drugs such as heroin and cocaine despite numerous scientific reports extolling the positive benefits of Insite.

But Judge Pitfield stripped the decision from Mr. Clement's hands, calling drug addiction an illness and applauding Insite's philosophy of harm reduction aimed at saving lives and curbing the spread of infectious diseases.

“While there is nothing to be said in favour of the injection of controlled substances that leads to addiction, there is much to be said against denying health care services that will ameliorate the effects of their condition,” said Judge Pitfield in his landmark, 59-page decision.

He rejected arguments from the federal lawyers that drug use was a matter of individual choice and it was up to the government whether addicts at Insite should be immune from prosecution.

“Society cannot condone addiction, but in the face of its presence, it cannot fail to manage it, hopefully with ultimate success reflected in the cure of the addicted individual and abstinence,” Judge Pitfield said.

“Simply stated, I cannot agree with Canada's submission that an addict must feed his addiction in an unsafe environment when a safe environment that may lead to rehabilitation is the alternative.”

Supporters of Insite, which enjoys strong backing among politicians, police and health-care providers in the city, were overjoyed by the judgment.

“It's very exciting, and a great relief for the staff,” said Mark Townsend of the Portland Hotel Society, which helps operate Insite and brought the case before the courts.

“This means they can now go about their business without some monkey on their back, stemming from some weird ideology in Ottawa.”

The addicts who crowd the facility every day now have one less thing to worry about, Mr. Townsend said.

“This means we can stay open and hopefully there will be no more of this silliness from [the federal government]. It's all very exciting.”

Lawyer Monique Pongracic-Speier, who argued the case on behalf of several drug addicts and the Portland Hotel Society, said the ruling has the potential to be a real watershed in treating injection drug users.

“Clearly, Canada has lost on this issue. The court accepted evidence that Insite provides a vital health care service to people who need it,” Ms. Pongracic-Speier said.

“To the best of my knowledge, this is the first ruling of its kind, certainly with respect to the use of heroin and cocaine.”

She added that the bold judgment by the court may open the door to similar facilities elsewhere in the country.

Essentially, Judge Pitfield decided that applying federal drug laws to Insite users while they are at the facility interferes with their constitutional right to life, liberty or security.

He outlined a litany of problems addicts face, including drug overdoses, HIV infection, syphilis and prostitution, all of which Insite attempts to curb.

Once an individual is addicted to injection drugs, they are no longer using them for recreation, Judge Pitfield said. Their addiction becomes an illness that needs treatment.

He compared their plight to alcoholics and those hooked on cigarettes, problems recognized by society even though the substances are legal.

“Society neither condemns the individual who chooses to drink or smoke to excess, nor deprives that individual of a range of health care services,” Judge Pitfield reasoned.

“I cannot see any rational or logical reason why the approach should be different when dealing with the addiction to narcotics.”

A spokesman for Mr. Clement said the federal Health Minister is studying the decision and would have no immediate comment.

Provincial Health Minister George Abbott welcomed the ruling, and quickly speculated that it could lead to more such facilities in the province.

“We are strongly supportive of Insite and we look forward to continue our funding of it.”

However, drug addict Jason Reimer, who described himself as an intermittent user of the centre, was equivocal about the ruling.

“I think Insite should be able to stay open, but I also think there should be more resources available … for people wanting to get clean,” he said. “There's free everything down here, so why would anyone feel the need to leave, if everything is here?” Since Insite opened in 2003, more than a million injections have taken place at its 12 cubicles.

The facility is open 18 hours a day, and staff describe it as the busiest such clinic in the world.

With reports from Sunny Dhillon, Cathryn Atkinson and Gloria Galloway.

:D
 
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Michlerish

Well-Known TRIBEr
So stupid, they should have just closed down.

It's a huge waste of money. They calculate that they save ONE person per year. At the cost of millions of dollars.

I could see that money being spent on more useful means of disease and overdose prevention.
 
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Ditto Much

TRIBE Member
Michlerish said:
So stupid, they should have just closed down.

It's a huge waste of money. They calculate that they save ONE person per year. At the cost of millions of dollars.

I could see that money being spent on more useful means of disease and overdose prevention.


I'm actually with you on this. Now for all we spend on illegal drugs cross the board the same argument holds. We spend some hefty numbers dealing with a tiny percentage of the actual population.

Then again if they propose opening a safe injection clinic on the other side of the city from me I'd probably support it, anything to get the real junkies out of my hood and into someone elses is alright with me.
 

Michlerish

Well-Known TRIBEr
Flashy_McFlash said:
Like what?

Well, I'm not so sure....
Better education, minus all the lies/exaggerations. De-criminalizing it so addicts aren't jailed, but rather sent to treatment centres. Public funding of treatment centres, so more addicts and their families can afford it.

???

I'm not an expert, I just don't think the huge cost of this "safe injection site" is justified in any way.
 

MissBlu

TRIBE Member
Michlerish said:
Well, I'm not so sure....
Better education, minus all the lies/exaggerations. De-criminalizing it so addicts aren't jailed, but rather sent to treatment centres. Public funding of treatment centres, so more addicts and their families can afford it.

???

I'm not an expert, I just don't think the huge cost of this "safe injection site" is justified in any way.


do you have any idea how much it would cost to send addicts to treatment centres?

you can't force people to get help, they must want to receive it. as society we have a choice - we can give addicts a clean, supervised area to shoot up, saving money for the health care system and spots for health care. a spot for them to do this also prevents it from happening on the street.

or we can pretend the problem doesn't exist, and say it's not justified.
 

Michlerish

Well-Known TRIBEr
MissBlu said:
or we can pretend the problem doesn't exist, and say it's not justified.

I'm not pretending the problem doesn't exist. I used to fully support the safe injection sites, and was angry when I heard they wanted to close it down.

But then I read a few articles on it, and listened to a very lengthy discussion on the radio about it that featured various experts and people involved.

After looking into it more, I came to the conclusion that I would rather see that money spent elsewhere.
 
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WestsideWax

TRIBE Promoter
Michlerish said:
Well, I'm not so sure....
Better education, minus all the lies/exaggerations. De-criminalizing it so addicts aren't jailed, but rather sent to treatment centres. Public funding of treatment centres, so more addicts and their families can afford it.

???

I'm not an expert, I just don't think the huge cost of this "safe injection site" is justified in any way.

Something that is bucking current societal mores so drastically is going to incur considerable expense in simply trying to operate. That's the only justification required.
 

Ditto Much

TRIBE Member
MissBlu said:
you can't force people to get help, they must want to receive it. as society we have a choice - we can give addicts a clean, supervised area to shoot up, saving money for the health care system and spots for health care. a spot for them to do this also prevents it from happening on the street.

or we can pretend the problem doesn't exist, and say it's not justified.


Alright and a calm cool level hearted person is going to be assumed to select option A as it does appear to make a lot of sense.

However there are a few opinions and reasons why some people (myself included) aren't such big fans of the model. Although safe injection sites do allow for a reduction in risk they do not have a significant impact on risk. We have not seen a decrease in hep-c or hiv transmission and we have not seen a significant difference in users between groups who have access and those who don't.

Turns out they use the site when its available but if it isn't and they need a fix they use whatever space they can find. We can see this clearly at many of the washrooms in Toronto that have been used to shoot up and have the burn marks to prove it. At best a safe injection clinic may server a user %20 of the time and thus the health benefits are almost zero.

Then we move on to the more tacky issue of 'not in my neighborhood' where owners of homes ask the valid question of why are we treating junkies down the street from my child's school or my home or my place of work and not somewhere else. nobody is a fan of this argument however having watched the lineup at the shoppers at queen and carlaw many mornings (methadone program) I can understand how this is a serious roadblock to any community improvements.

There are some solid questions that we should be able to ask and discuss without sounding cold.

Ignoring the approach of 'its either this or nothing' and instead asking the question 'does this actually accomplish anything'
 

Bumbaclat

TRIBE Member
Michlerish said:
Public funding of treatment centres, so more addicts and their families can afford it.

They already offer this, at least in Ontario OHIP will cover many treatment programs.




MissBlu said:
do you have any idea how much it would cost to send addicts to treatment centres?

lots but getting addicts cleaned up and reintegrating with society has to be a net gain, financially and other.
 

MissBlu

TRIBE Member
Ditto Much said:
Alright and a calm cool level hearted person is going to be assumed to select option A as it does appear to make a lot of sense.

However there are a few opinions and reasons why some people (myself included) aren't such big fans of the model. Although safe injection sites do allow for a reduction in risk they do not have a significant impact on risk. We have not seen a decrease in hep-c or hiv transmission and we have not seen a significant difference in users between groups who have access and those who don't.

Turns out they use the site when its available but if it isn't and they need a fix they use whatever space they can find. We can see this clearly at many of the washrooms in Toronto that have been used to shoot up and have the burn marks to prove it. At best a safe injection clinic may server a user %20 of the time and thus the health benefits are almost zero.

Then we move on to the more tacky issue of 'not in my neighborhood' where owners of homes ask the valid question of why are we treating junkies down the street from my child's school or my home or my place of work and not somewhere else. nobody is a fan of this argument however having watched the lineup at the shoppers at queen and carlaw many mornings (methadone program) I can understand how this is a serious roadblock to any community improvements.

There are some solid questions that we should be able to ask and discuss without sounding cold.

Ignoring the approach of 'its either this or nothing' and instead asking the question 'does this actually accomplish anything'

what? who is saying it's either this or nothing?

also, source. let's focus on the clinic specific to the article, and what is option a?
 
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MissBlu

TRIBE Member
Bumbaclat said:
lots but getting addicts cleaned up and reintegrating with society has to be a net gain, financially and other.

i totally agree with this, however i stand by my point that the addict needs to want the help, or we are making futile attempts.
 

spaboy

TRIBE Member
I think Ditto Much makes a great point. The availability of such a center will be limited & junkies aren't going to wait around until something becomes available. So for every time they do have a 'clean' environment to do it in, they probably do it 5 times in a 'unclean' environment which makes the whole thing pointless
 

WestsideWax

TRIBE Promoter
So if the concept and subsequent experimentation with are pointless, what's your alternate suggestion?

Ventures like these are not a fixed point - they're a work in progress, and it's highly possible that a more refined method of care/treatment could emerge from the current model, as ineffective as it might be.

That, or just give 'em some acid.
 

Flashy_McFlash

Well-Known TRIBEr
spaboy said:
I think Ditto Much makes a great point. The availability of such a center will be limited & junkies aren't going to wait around until something becomes available. So for every time they do have a 'clean' environment to do it in, they probably do it 5 times in a 'unclean' environment which makes the whole thing pointless

That's why this is a landmark decision. Basically it's like saying if there's only one hospital in Toronto, there's no point in employing doctors at all because that one hospital can't treat everyone.

What we need is not to shut down this safe injection site because it can't serve more people - what we need is more of them so that they can. I hope this decision opens the door for more sites like these so that more addicts can be helped and the option to shoot up in an unclean space looks less attractive.

I mean, if there's only one such centre and it's across town are you, the heroin addict, going to drop money on bus fare to get there or are you going to drop that money on heroin and shoot up in the first place you can find?
 
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Bumbaclat

TRIBE Member
The Comfort Zone should apply for status as a safe-injection site, then they wouldn't be having all their problems.
 

Ditto Much

TRIBE Member
MissBlu said:
what? who is saying it's either this or nothing?

also, source. let's focus on the clinic specific to the article, and what is option a?


More than fair but I think the issue steps beyond just a single example. Making this injection site free of federal laws regarding possession and prosecution of laws related to possession we must see this as applying elsewhere.

Now in regards to this specific clinic which is very much a unique circumstance we have a very strong backing from residents and from specific politicians as well. So this becomes a question of jurisdiction and federal/provincial and who gets to say what. We had an interesting circumstance occur in Ottawa where the city said no to a harm reduction kit being handed out and the province did it anyway. In this case we have the inverse where a larger government body is acting in a non harm reduction fashion against the wishes of the city and province (or at least as it is presented in the article).

Where do we draw lines? Do we have regions or areas where federal drug laws don't apply?
 

spaboy

TRIBE Member
Flashy_McFlash said:
That's why this is a landmark decision. Basically it's like saying if there's only one hospital in Toronto, there's no point in employing doctors at all because that one hospital can't treat everyone.

What we need is not to shut down this safe injection site because it can't serve more people - what we need is more of them so that they can. I hope this decision opens the door for more sites like these so that more addicts can be helped and the option to shoot up in an unclean space looks less attractive.

I mean, if there's only one such centre and it's across town are you, the heroin addict, going to drop money on bus fare to get there or are you going to drop that money on heroin and shoot up in the first place you can find?

Understood but it would cost a lot of money to have numerous sites dispersed across a metropolitan area. The question is, is that money better spent elsewhere?

There's tons of homeless shelters & yet ppl still sleep on the street because they just can't accommodate. If they did open numerous 'safe centres' you'd still have a similar problem with availability.

& unless a junkie is shooting up in the safe center EVERY time it's not effective
 

praktik

TRIBE Member
spaboy said:
& unless a junkie is shooting up in the safe center EVERY time it's not effective

I'm not sure this is a valid criticism of the project. The idea that an addict must inject every time at a safe-injection site is just not feasible: are you suggesting that the addicts live there as well? What kind of costs would that entail?

The main idea is that by offering a safe-injection site you're exposing addicts to staff and resources to help them become safer with their drug use, to give them tips that they will employ even when not there.

The nature of an intravenous cocaine user, injecting anywhere from 5-20x a day, makes it nigh impossible for them to be there every time.

Instead we hope that use of the center results in safer use even when not there, and in the best case scenarios, results in an addict seeking treatment based on resources they found when they visited the center.

let's say an addict has secured a good supply of clean needles, and then runs out - they go to the safe injection site, get a clean needle to tide them over before they get more. That user would not have been there every time they shot up, but the center was there when they needed it... how is that not effective?
 
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