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Health authority weighs adding more supervised injection sites

Health officials are talking to potential partners in the medical community about a new way to provide the harm-reduction service.


Vancouver Coastal Health is looking at offering supervised injection services for heroin addicts at several of its clinics.

Health officials are talking to potential partners in the medical community about a new way to provide the harm-reduction service, Chief Medical Officer Patricia Daly said Monday in an interview.

The health authority has no plans in place at this time, she said, but offering supervised injection services at several facilities is the direction the health authority wants to go.

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"We want to really normalize it, so it becomes just another one of the harm-reduction services that you can offer to this group," she said. "We need to be able to provide services throughout the region, wherever injection drug users may live."

Any expansion of supervised injection services would be a challenge to the law-and-order agenda of the federal Conservative government, which last fall lost a protracted battle against Insite, Vancouver Coastal Health's supervised injection centre in the heart of the Downtown Eastside.

Insite was opened in 2003 as a research project on intravenous drug users under a special federal exemption issued by the Liberal government. The Harper government in 2008 refused to extend the exemption, prompting a court case. The Supreme Court of Canada issued its decision in September, ruling that the clinic saved lives, and medical staff and drug users could not be prosecuted.

Health Canada spokesman Gary Holub said the court case did not clear the way for additional supervised injection sites to be opened. The Supreme Court of Canada decision clearly stated that a federal exemption was necessary for supervised injection activities to take place in Canada, he said in an interview.

The federal health department has not received any requests for additional exemptions to create new sites anywhere in Canada since the court ruling, he added. Any request to operate a supervised injection site "would be reviewed and given proper, careful consideration on a case-by-case basis," Mr. Holub said.

Dr. Daly said officials have been talking with health-care workers who might provide services to injection drug users. They were also looking into the exemption that would be required to allow illegal drugs to be brought into government-run health clinics.

"You cannot just say tomorrow this is our new policy and we are going to offer it anywhere," she said. "So, that is some of the work we are doing now, to look at what that might mean."

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She said she envisions the health authority offering services to drug users similar to those provided at the Dr. Peter Centre in downtown Vancouver. The facility has a room where users can do a supervised injection as part of the nursing care provided to people with HIV/AIDS.

Dr. Daly said she has been in discussions with senior staff at the Dr. Peter Centre and her staff has been looking at what has been done at the facility. "That's an intriguing model because it becomes simpler to think about doing it in other places," she said.

Dr. Daly added that Vancouver Coastal Health followed a similar approach with its needle exchanges for injection drug users. Initially, the needle exchange was operated out of one depot in Vancouver's Downtown Eastside. The health authority now offers a needle exchange at several locations where health workers interact with drug users.

Insite, which does not provide any drugs, has more than 12,000 registered users. Last year, an average of 587 injection drug users came to the clinic daily. Drug users at Insite have access to addiction counsellors, nurses, community workers and mental-health staff. A detox treatment facility called Onsite is located adjacent to Insite.

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