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Ottawa approves second supervised injection site

An injection kit is shown at Insite, a safe injection facility in Vancouver, on Tuesday, May 6, 2008. Research using Vancouver's Insite as a case study is making a dollars-and-cents argument in favour of opening five supervised-injection sites across Ontario. THE CANADIAN PRESS/Jonathan Hayward

A renowned HIV/AIDS clinic in Vancouver has received permission to operate Canada's second approved supervised injection site – the first such approval granted under the Liberals, signalling a departure from the previous Conservative government's staunch opposition to such facilities.

The Dr. Peter Centre, located in downtown Vancouver's West End neighbourhood, has offered the controversial service since 2002 – one year before the opening of Insite, the dedicated supervised injection site in the city's Downtown Eastside.

"For the Dr. Peter Centre today, it's health care as usual," Maxine Davis, executive director of the Dr. Peter AIDS Foundation, said Friday. "For Canadian health care, it is a significant step forward."

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The centre is now the first in North America approved to integrate supervised injection service into an existing health care facility where not everyone injects or uses drugs.

The Conservatives spent years attempting to shut down Insite, eventually losing at the Supreme Court of Canada, which ordered the government to allow the site to remain open. The Conservatives responded to that court ruling by introducing legislation to govern when a facility would receive an exemption from federal drug laws, but proponents argued that the new rules were too restrictive and would make proposed facilities in cities such as Montreal and Victoria difficult, if not impossible, to open.

The centre submitted a formal application to Health Canada seeking a Section 56 exemption under the Controlled Drugs and Substances Act in January, 2014; the approval, announced Friday and valid for two years, ensures that nurses and clients will not be charged for activities related to injection services.

Health Canada said in a statement it arrived at the decision "after a rigorous, evidence-based review that included an assessment of the centre's application, an inspection of the facility, and the establishment of terms and conditions to protect public health and safety."

Supervised injection has been a lightning rod for controversy, with critics saying it facilitates the use of dangerous drugs and is an affront to federal laws. Supporters say it prevents overdose deaths and reduces associated harms by, for example, offering users clean supplies and a sterile environment, preventing the transmission of HIV and other blood-borne viruses.

In 14 years, nurses at the Dr. Peter Centre have supervised more than 15,000 injections. Insite, meanwhile, averages more than 500 injection-room visits a day. There have been no fatal overdoses at either facility.

Chris Buchner, regional director of prevention at Vancouver Coastal Health, said the health authority saw 1,486 emergency-room visits for overdoses last year, up from 492 in 2010.

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"Access to supervised injection services is especially critical now, because of these consistently increasing rates of overdose and because of the availability of very dangerous [opioids] such as fentanyl in the illicit drug market," he said.

Perry Kendall, B.C.'s provincial health officer, said the approval represents "a triumph of science, common sense and compassion over ideology.

"I hope that this is going to be the start of a policy which will consistently support the expansion of supervised injection services where they are most needed," he said.

Further, Dr. Kendall called for the repeal of Bill C-2, the so-called Respect for Communities Act, which he said "makes it virtually impossible … to open up, or even think about opening up, such services in Canada."

Under the act, facilities that wish to operate such a site must meet a lengthy list of requirements, including: a letter from the head of the local police force; statistics and other information on crime, public nuisance and inappropriately discarded drug paraphernalia in the vicinity of the site; and a report on consultations with "a broad range of community groups."

Ms. Davis of the Dr. Peter AIDS Foundation said the "galvanizing impetus" for providing supervised injection in 2002 was two non-fatal overdoses at the centre – one in a bathroom, one in a laundry room. Those overdoses seemed to put a lie to the organization's mission to care for people living with HIV/AIDS, she said: "Distributing sterile needles while not providing a safe place to inject risked death."

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The centre consulted with the College of Registered Nurses of B.C. and the College of Registered Psychiatric Nurses of B.C., both of which supported the service for the purposes of preventing illness and promoting health.

The Section 56 exemption is a "safety valve" to ensure nurses and clients would not be charged while offering or receiving the service, Ms. Davis said.

B.C. Health Minister Terry Lake said the approval is "excellent news for public health and safety" in Vancouver.

"The evidence is clear: Supervised injection services prevent overdose deaths and saves lives," Mr. Lake said in a statement. "They have become a valued part of health services in Vancouver and are an important part of our response to substance use and addiction."

The Dr. Peter Centre, named after Peter Jepson-Young, a Vancouver doctor who documented his own battle with AIDS in the early 1990s, is B.C.'s only HIV/AIDS day health program and 24-hour nursing care residence.

Recently released figures reveal that the centre's clients show a markedly better HIV viral load suppression rate than other people living with HIV in B.C. According to the numbers, released last month, 80 per cent of the centre's 359 clients are virally suppressed, compared to 57 per cent of other people living with HIV in B.C.

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Based in Vancouver, Andrea Woo is a general assignment reporter with a focus on multimedia journalism. More

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