Skip to main content
The Globe and Mail
Support Quality Journalism.
The Globe and Mail
First Access to Latest
Investment News
Collection of curated
e-books and guides
Inform your decisions via
Globe Investor Tools
per week
for first 24 weeks

Enjoy unlimited digital access
Cancel Anytime
Enjoy Unlimited Digital Access
Get full access to
Just $1.99per week for the first 24weeks
Just $1.99per week for the first 24weeks
var select={root:".js-sub-pencil",control:".js-sub-pencil-control",open:"o-sub-pencil--open",closed:"o-sub-pencil--closed"},dom={},allowExpand=!0;function pencilInit(o){var e=arguments.length>1&&void 0!==arguments[1]&&arguments[1];select.root=o,dom.root=document.querySelector(select.root),dom.root&&(dom.control=document.querySelector(select.control),dom.control.addEventListener("click",onToggleClicked),setPanelState(e),window.addEventListener("scroll",onWindowScroll),dom.root.removeAttribute("hidden"))}function isPanelOpen(){return dom.root.classList.contains(}function setPanelState(o){dom.root.classList[o?"add":"remove"](,dom.root.classList[o?"remove":"add"](select.closed),dom.control.setAttribute("aria-expanded",o)}function onToggleClicked(){var l=!isPanelOpen();setPanelState(l)}function onWindowScroll(){window.requestAnimationFrame(function() {var l=isPanelOpen(),n=0===(document.body.scrollTop||document.documentElement.scrollTop);n||l||!allowExpand?n&&l&&(allowExpand=!0,setPanelState(!1)):(allowExpand=!1,setPanelState(!0))});}pencilInit(".js-sub-pencil",!1); // via darwin-bg var slideIndex = 0; carousel(); function carousel() { var i; var x = document.getElementsByClassName("subs_valueprop"); for (i = 0; i < x.length; i++) { x[i].style.display = "none"; } slideIndex++; if (slideIndex> x.length) { slideIndex = 1; } x[slideIndex - 1].style.display = "block"; setTimeout(carousel, 2500); } //

Richard Chenery prepares heroin he bought on the street to be injected at the Insite safe injection clinic in Vancouver May 11, 2011. Insite is North America's first and only legal injection site.

John Lehmann/The Globe and Mail

When the Supreme Court of Canada convenes Thursday to consider Vancouver's supervised injection site, it will hear detailed arguments that hinge on the fine print of the Canadian Constitution.

But besides being a landmark showdown between federal and provincial powers, the hearing also sets the stage for a ruling expected to affect not only the daily lives of injection drug users on Vancouver's Downtown Eastside but drug policy across the country and potentially farther afield.

In cities including Victoria and Montreal, groups that have lobbied for supervised injection sites along the lines of Vancouver's Insite facility will be waiting to see whether their proposals could proceed without breaking the law.

Story continues below advertisement

Across the country, researchers and health-care workers are looking to the Supreme Court decision as a signal that could shape future health care policy, ranging from needle exchange programs in prisons to inhalation rooms for crack-cocaine smokers.

Internationally, health researchers will be monitoring the case as a bare-knuckle brawl between political ideology and evidence-based research, of which a small mountain has accumulated to back Insite and which supporters repeatedly cite in their long-running fight to keep the clinic open.

At home and abroad, policy makers are watching the case in the context of Prime Minister Stephen Harper's newly-minted majority and tough-on-crime agenda.

A lightning rod for controversy, Insite attracts support and detractors along several main lines.

Supporters say:

It saves lives:

There have been no overdose deaths at Insite since it opened in 2003. On average, nearly 600 injections occur daily at the site and last year alone there were more than 200 "overdose interventions" by Insite staff who provide oxygen or drugs to users who are in danger of overdosing. A paper published in the Lancet in April of this year found fatal overdoses within 500 metres of Insite decreased by 35 per cent after the facility opened compared to a decrease of nine per cent in the rest of Vancouver.

Story continues below advertisement

Earlier this month, the B.C. Coroners' Service warned of a spike in overdose deaths resulting from potent heroin being sold throughout the province and urged drug users to use community services such as Insite "where possible." B.C. public-health officials and the British Columbia Nurses' Union support the facility.

It serves as a bridge to detox and treatment:

Insite was conceived of as part of a four-pillars approach – those being harm reduction, prevention, treatment and enforcement – modelled on similar programs that jurisdictions such as Switzerland and Germany pursued in the 1990s.

By offering a clean, safe, non-judgmental environment to shoot up, the reasoning goes, Insite allows drug users to connect with other services, whether that be treatment for a drug-related abscess or dental care.

Last year, Insite staff made more than 5,000 referrals to other social and health agencies, including 458 admissions to Onsite, a neighbouring detox facility that opened in 2007 and recorded a "program completion rate" of 43 per cent in 2010.

Supporters say supervised injection facilities should be seen as just one piece of a bigger puzzle in treating drug addiction and its related toll on society.

Story continues below advertisement

It benefits public health and the broader community:

Among the many studies published on Insite are papers that conclude the clinic has not led to an increase in drug-related crime, is not a negative influence of those seeking to stop drug use and has resulted in a drop in public injections in back alleys and doorways.

Studies have also reported declines in dangerous behaviour, such as sharing needles, and a related decrease in HIV infections. The Vancouver Police Department supports the facility, which studies have shown has resulted in fewer discarded needles in neighbourhood streets.

In fighting to keep Insite open, the provincial government argues that the health benefits of the facility should trump jurisdictional issues, saying in written submissions to the court that British Columbians have a "visceral" memory of hundreds of addicts dying needlessly in flophouses and on the street before Insite was opened.

Those who want to see the site closed maintain:

Insite's operation is an affront to federal control:

Story continues below advertisement

When Insite opened, it obtained a three-year exemption from Canada's Controlled Drugs and Substances Act from Health Canada. That exemption was extended twice, until June 30, 2008. When the federal government declined to extend the exemption, Insite supporters launched a court challenge. The B.C. Supreme Court and the B.C. Court of Appeal supported B.C.'s right to run the clinic on health grounds. The federal government appealed.

Federal prosecutors say Ottawa needs to maintain control over drug policy and that giving B.C. control over Insite would open the door to a fragmented, patchwork of rules and regulations across the country.

The legal wrangle will zero in on the constitutional conundrum posed by Insite – the federal government has authority over criminal law and the promotion of health and safety, but provinces decide how health care can be delivered.

Governments should not facilitate drug use:

Despite the research studies backing Insite and its harm-reduction approach, there is still profound discomfort for many with any facility that gives addicts a green light to inject illegal drugs and flout the law. Governments, they argue, should not be facilitating illegal, dangerous activities. "The state has no constitutional obligation to facilitate drug use at a specific location by hardcore addicts, the mildly addicted, frequent users or occasional users," federal prosecutors Robert Frater and W. Paul Riley said in written submissions to the court.

There have been arguments that money spent on Insite would be better spent on services such as treatment and that government's support of supervised injection sites sends a mixed message to young people who might be considering illicit drug use.

Story continues below advertisement

Supervised injection sites do nothing to deter drug use or help drug addicts:

Part of the federal government's argument is that drug laws are not an unreasonable restriction on individuals' liberty. "Unsafe injection or, for that matter, consumption by injection at all, is a choice made by the consumer," the federal prosecutors say in their brief to the Supreme Court.

There are also arguments that supervised injection sites are a magnet for drug dealers and predators, and that public safety demands that illegal drugs be tightly controlled.

Your Globe

Build your personal news feed

  1. Follow topics and authors relevant to your reading interests.
  2. Check your Following feed daily, and never miss an article. Access your Following feed from your account menu at the top right corner of every page.

Follow the author of this article:

View more suggestions in Following Read more about following topics and authors
Report an error Editorial code of conduct
Due to technical reasons, we have temporarily removed commenting from our articles. We hope to have this fixed soon. Thank you for your patience. If you are looking to give feedback on our new site, please send it along to If you want to write a letter to the editor, please forward to

Welcome to The Globe and Mail’s comment community. This is a space where subscribers can engage with each other and Globe staff. Non-subscribers can read and sort comments but will not be able to engage with them in any way. Click here to subscribe.

If you would like to write a letter to the editor, please forward it to Readers can also interact with The Globe on Facebook and Twitter .

Welcome to The Globe and Mail’s comment community. This is a space where subscribers can engage with each other and Globe staff. Non-subscribers can read and sort comments but will not be able to engage with them in any way. Click here to subscribe.

If you would like to write a letter to the editor, please forward it to Readers can also interact with The Globe on Facebook and Twitter .

Welcome to The Globe and Mail’s comment community. This is a space where subscribers can engage with each other and Globe staff.

We aim to create a safe and valuable space for discussion and debate. That means:

  • Treat others as you wish to be treated
  • Criticize ideas, not people
  • Stay on topic
  • Avoid the use of toxic and offensive language
  • Flag bad behaviour

If you do not see your comment posted immediately, it is being reviewed by the moderation team and may appear shortly, generally within an hour.

We aim to have all comments reviewed in a timely manner.

Comments that violate our community guidelines will not be posted.

UPDATED: Read our community guidelines here

Discussion loading ...

To view this site properly, enable cookies in your browser. Read our privacy policy to learn more.
How to enable cookies