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British Columbia Harm-reduction drug programs may get OK under new Liberal government

An employee prepares injection equipment at Vancouver’s Insite, the legal supervised drug injection site, which was the first of its kind in North America.

Rafal Gerszak/The Globe and Mail

Health and legal experts are cautiously optimistic that a newly elected Liberal government will clear roadblocks to harm-reduction programs, such as supervised injection sites and prescription heroin, which clashed with Conservative ideals and were stymied by Stephen Harper's government.

Despite international research that has shown these measures reduce crime and other associated harms, the outgoing Conservative government denounced such programs, maintaining that "harm elimination" should be the goal. In 2013, it banned doctors from prescribing heroin and last year introduced legislation that made it much more difficult for a community service provider to open a harm-reduction site.

Since then, courts have sided with both harm-reduction measures – most notably Vancouver's Insite supervised injection site, which was the first of its kind in North America. A constitutional challenge to the prescription heroin issue is ongoing.

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Evan Wood, co-director of the Urban Health Research Initiative at the B.C. Centre for Excellence in HIV/AIDS, described the relationship with the outgoing government as "frustrating."

"I think they did have a sincere interest in trying to reduce the harms of addiction, but there was clearly a disconnect between science and decision-making in this area," Dr. Wood said.

Bill C-2, which received royal assent over the summer and imposed a host of new regulations on prospective supervised injection sites, has stalled plans for facilities in such cities as Victoria, Montreal and Ottawa, while also raising concerns that Insite could run into problems staying open, despite its previous court wins. Vancouver's Dr. Peter Centre, which quietly offered supervised injection services even before Insite's opening, applied in February for the federal exemption needed to operate legitimately, but it never heard back.

Dr. Wood added that heavy-handed criminal justice measures introduced under the Conservative government, such as mandatory minimum sentences for growing as few as six marijuana plants, actually result in adverse effects.

"There is very excellent literature … showing how people initiate serious, hard drug use in prison," he said.

Meanwhile, the Liberals campaigned on a promise of "evidence-based decision-making," and prime-minister-designate Justin Trudeau has spoken in support of Insite.

Hedy Fry, a long-time MP who was most recently Liberal health critic, said her party will revisit Bill C-2, also called the Respect for Communities Act.

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"I have never, as a physician, understood how you could ignore good, solid scientific evidence and data and successful outcomes in other parts of the world," said Ms. Fry, who is also a medical doctor.

"For me, this is clear evidence. Addiction is a public-health issue, so what is it that we're doing here? Surely if you care about the lives of all Canadians, you don't separate Canadians into a group of people whose lives are worthless and a group of people whose lives are worthy."

Mr. Trudeau has also expressed support for an ambitious made-in-B.C. HIV/AIDS target that was dismissed by the Conservative Party.

Adrienne Smith, a health and drug policy lawyer with the Pivot Legal Society, which is representing addicts receiving prescription heroin, said a new health minister could simply "allow prescription heroin to be used as medicine, as it should be."

She added that the minister could also make widely available naloxone, a drug that reverses heroin and other opioid overdoses within minutes with no abuse potential, and repeal other Conservative-legislated mandatory minimum sentences, in particular those for non-violent drug offences.

"I would be thrilled if that happened," Ms. Smith said, "but until there is a clear shift in Canadian drug policy by a newly appointed minister of health, all of Pivot's litigation will continue."

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A B.C. Supreme Court judge last year granted an injunction to a group of severe heroin addicts exiting a clinical trial, allowing them to continue receiving prescription heroin while the larger constitutional challenge is before the courts.

There are currently 104 people receiving the drug in a clinical setting.

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