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An intravenous drug user injects drugs that he bought on the street, while in a booth at the Insite center in Vancouver, Canada, Jan. 17, 2011.

ED OU/NYT

As Vancouver moves to open two new supervised injection sites amid an unprecedented level of overdose deaths, B.C.'s top health officials are once again calling for the repeal of legislation they say imposes unnecessary barriers to the life-saving harm-reduction measure.

Vancouver Coastal Health this week announced the locations for two of five proposed injection sites, both to be located in the city's Downtown Eastside. Speaking with media about the sites and the troubling surge of fatal overdoses in British Columbia, the province's top health officials once again spoke of the Respect for Communities Act, which requires prospective operators to satisfy more than two dozen time-consuming and costly requirements to get the exemption from federal drug laws needed to operate.

The act, introduced by the previous Conservative government, is widely seen by critics as a deliberate effort to curb all supervised consumption sites. The Harper government had introduced it after fighting Insite, Vancouver's supervised injection site, all the way to Supreme Court, which sided with the Downtown Eastside facility.

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"The federal legislation … is, what we consider, a significant barrier to the establishment of safe consumption sites," Health Minister Terry Lake said this week.

"We have advocated with the federal government to repeal that bill."

The Globe and Mail has reported on the issue extensively. Federal Health Minister Jane Philpott has said several cities have applied to open supervised injection sites under the current legislation and while there are no immediate plans to repeal or modify the law, her department is open to changes in the future.

Dr. Philpott, who called her tour of Insite early this year "extremely moving," reiterated her support of the sites on Thursday.

"I've made it very clear to my department that there should be no unnecessary barriers for communities who want to open supervised consumption sites," she told reporters in Ottawa.

"They are working with communities that are interested in this. We're also looking at the legislation … and if it becomes clear to us that we need to make some further amendments to that act, to ensure that there are no barriers, then we will certainly do that."

Patricia Daly, chief medical health officer and vice-president of public health for Vancouver Coastal Health, noted that the Liberal government has not granted a single exemption for any new application – excluding the existing sites Insite and the Dr. Peter Centre – since taking office.

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"Although people have submitted applications, the process is much too slow," Dr. Daly said Thursday.

"I would respectfully request that they take a look at that legislation and if it is delaying the ability of those of us working in the provinces to begin to offer these needed, life-saving health services, that they would repeal that legislation."

The two new sites proposed for Vancouver would be at 528 Powell St., which will soon become a mental-health and addictions drop-in centre, and 330 Heatley St., the yet-to-be-opened Heatley Integrated Health Centre. The former is intended for the general public, while the latter is slated for clients of the centre, but will accommodate other members of the public if needed. Both sites are expected to start with four injection booths each. Insite, in comparison, has 13 booths.

Stakeholder consultations are planned for the coming weeks; the health authority expects to submit applications for the two sites within a month. If approved, both sites would require significant renovations before opening.

The health authority is also keen to offer supervised injection service at three more sites: one at an acute-care facility, one in a community health centre and one at a women's only facility. However, these locations have not yet been determined.

Dr. Daly, Mr. Lake, Vancouver Mayor Gregor Robertson, Provincial Health Officer Perry Kendall and others sent a joint letter to Dr. Philpott on Aug. 30 officially requesting she repeal the Respect for Communities Act after a Globe and Mail report that there were no planned changes. In it, they called the act "a flawed, mean-spirited and ineffective piece of legislation that only serves to marginalize our most vulnerable residents and criminalize people suffering from addiction."

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From Jan. 1 until Aug. 31, 488 people died of illicit drug overdoses in British Columbia. The year-end death toll is projected to be between 600 and 800 people – the largest number in nearly three decades of record-keeping.

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