Ten years ago, North America's first and still only legal safe-injection site opened in Vancouver. Today, Insite in the troubled Downtown Eastside, is marking the milestone, and reflecting on a bumpy path over the last decade.
Insite, operated by the PHS Community Services Society and Vancouver Coastal Health Authority, provides users with a place to inject drugs under medical supervision. It does not provide drugs. Since 2003, there have been 1.8 million visits and no overdose deaths among clients.
Insite was launched with a temporary exemption to federal drug laws under a supportive federal Liberal government. However, the federal Conservative government, elected three years after Insite opened, has been opposed to the operation and went to court to try to shut it down. In 2011, the Supreme Court of Canada ruled the site could remain open. But Ottawa tabled legislation this year some critics say will make it tougher for Insite to eventually renew its licence.
Liz Evans, executive director of the PHS society, has been there since the beginning.
How do you celebrate the 10th anniversary of a safe-injection site? Is cake appropriate? Is a party appropriate?
We're going to have a street party for the community [on Friday]. We feel a street party is the appropriate mechanism for everybody to recognize their role is important, and it's a landmark victory. It's important people understand we're not celebrating that people are addicted, we're celebrating the fact that their lives matter, and we have had a victory in our attempt to shift the dialogue around the drug user and who they are in terms of their right to stay alive and access basic care. That's really the message Insite is sending. We're certainly not saying, 'We're so happy there are injection drug users.' We're saying, 'We're so happy the injection drug users' rights have been acknowledged.'
Do you think it can be taken for granted that Insite will make its 20th birthday?
No, sadly. I think we continue to be faced with a government that doesn't understand why it's so important. Without the federal government being onside, it's not a guarantee because we continue to rely on an exemption from the federal government.
Do you remember the opening day?
What I remember was sitting in a corner crying because I felt so emotionally overwhelmed that people were coming in out of the alleys. Sorry, I'm going to start crying … I felt overwhelmed. It felt like a sanctuary. People were walking into where they were treated with dignity and respect. It was clean and warm and welcoming and it just sent such a different message to people about them actually being valued, and it was overwhelming. My midwife came in and brought me flowers because she had a son who was addicted, and she said, 'Now I know where to come to find him instead of driving around the alleys at three in the morning.'
Do you see any likely changes in the short term on how Insite operates?
We're really maxed. It means some people won't wait to come in. They will go to an alley and inject because it's too long to wait and get into an injection room. It's not happening all the time, but there are days when it's so busy, people can't wait. Also, it's not open until 10 in the morning and it shuts at 4 a.m. Before 10 in the morning, you will see people using on the street. It would be really nice if we could be open 24 hours a day.
What's preventing that?
It's just a funding issue. We've asked and suggested that might be an important funding priority for the province, but it's a difficult time right now everywhere, so I am not sure how high on the list it is. It should be a standard of care that's provided.
What kind of increase in your funding would it take to go to 24-hour operation?
I don't have that number at the top of my head. It's $3-million a year to operate the whole site now. That includes the detox and the injection site. It would be another whole shift for however many people.
What would your Insite pitch be if you had a five-minute meeting with Prime Minister Stephen Harper?
I would want to appeal to his humanity and let him know that while I understand that he disagrees with the concept of harm reduction because he sees the suffering of drug users, we base our support for the concept on our first-hand experience of witnessing the suffering of drug addicts. Insite is a really important way to keep people alive long enough to help alleviate this suffering. Insite sends the message to drug users while they are still actively addicted that their lives matter. This provides hope.
Do you think you could have an impact on him?
I don't know. I would like to be able to have that chance.
This interview has been edited and condensed.