Canada's Health Minister says Ottawa has no plans to repeal Conservative government legislation that harm-reduction advocates say makes opening new supervised-consumption sites unduly onerous – if not impossible.
British Columbia's Health Minister, provincial health officer and others say the Respect for Communities Act puts unnecessary obstacles in the way of a proven health intervention.
Overdose deaths are at a record high in B.C., having surpassed 433 as of July 31 – a 74-per-cent increase over the same period last year.
Asked about the legislation in Vancouver on Tuesday, federal Health Minister Jane Philpott reiterated that the Liberal government supports harm reduction, and supervised-consumption sites specifically.
However, it does not plan to revisit the legislation immediately.
"There are other communities that are using the mechanisms in place to be able to apply to open similar sites," Dr. Philpott said.
"We have made statements in the past to say that we are continuing to follow how that is evolving under the current legislation, and if there is a requirement for changing the legislation, we'll certainly be looking at that possibility."
The minister acknowledged that opioid-related deaths are an "escalating problem in a number of provinces" and said she has corresponded with B.C. Health Minister Terry Lake about the matter.
"We have already indicated some of the measures that we are going to take as a federal government.
"We introduced a five-point plan that I announced a couple of months ago that talks about better public-health education, better support for providers, addressing access to unnecessary opioids, expanding treatment options, including harm reduction."
Critics have called the act, which received royal assent in June, 2016, a deliberate effort by Stephen Harper's government to block facilities where people can ingest their own drugs using sterile equipment and under the supervision of medical staff.
The Conservative government had fought Insite, the only public supervised injection site in North America, all the way to the Supreme Court of Canada, which in 2011 ordered it to stop interfering.
The legislation contains more than 27 conditions for those seeking approval of sites, including holding extensive community consultations; collecting data and other information on crime, public nuisance and inappropriately discarded drug paraphernalia in the vicinity of the site; and conducting criminal-record checks for every staff member going back 10 years, which can prevent recovered addicts from being peer-support workers.
Vancouver Coastal Health's application package for renewal of Insite's permission to operate used to be about an inch thick, and its application under the act is four inches thick. Completing the application used to take several weeks; it now takes several months. The health authority spent about $15,000 preparing its most recent renewal application, and paying staff to do the work to complete the new requirements added another $15,000 to the cost.
Perry Kendall, B.C. provincial health officer, said the requirements build a case for denying permission to such sites.
"The Supreme Court judgment basically said that you would expect, as a rule, that [approval] would be granted by the minister of health if there was evidence that there was a health problem, and there would be no social harms from opening such a site," Dr. Kendall said in an interview on Tuesday.
"The Respect for Communities Act basically says that [approval] will only be granted in exceptional circumstances. So the act is designed to run against the spirit of the Supreme Court judgment."
Overdose deaths have surged in B.C., driven in large part by the growing prevalence of illicit fentanyl, a synthetic opioid, being cut into street drugs. Most recent figures from the B.C. Coroners Service show that fentanyl is detected in about 60 per cent of all illicit drug overdose deaths.