If B.C. hopes to set up a place where crack addicts smoke up legally, it will have to contend with the federal government.
Health Canada has said any additions to InSite's supervised injection site would require another federal exemption under the Controlled Drugs and Substances Act - an exemption Ottawa refused to renew for InSite nearly two years ago.
"All activities with narcotics such as cocaine and crack cocaine are prohibited under the CDSA unless authorized under the regulations," said Health Canada spokesman David Thomas. "If B.C. established such a site [without permission] this would become a matter for law enforcement."
But the organizers behind North America's only sanctioned supervised-injection site say they've asked Ottawa for an inhalation-room exemption multiple times - and received no response. "We've done it a few times," said Mark Townsend, executive director of PHS Community Services, which runs Insite.
Health Canada could not immediately confirm that it received such requests yesterday.
B.C.'s chief health officer, Perry Kendall, came out in favour of the inhalation rooms this week after the publication of a Canadian Medical Association Journal article that found dramatically higher rates of HIV transmission in Vancouver's crack-user population.
The study, Mr. Townsend said, "adds to the pressure that maybe a trial should take place, and so we are going to ask [Health Canada]again."
The proposed facilities, which already exist in several European countries, would give addicts a designated place to smoke crack cocaine in the company of health professionals equipped with "crack kits."
Ottawa is already embroiled in a protracted legal tug-of-war over who has final say over controversial harm-reduction strategies in the province. The case, part of an appeal over whether InSite's services are a constitutional right, was heard by the B.C. Court of Appeal in the summer, and parties are awaiting a verdict.
Larry Campbell, the Liberal senator who helped spearhead InSite's creation in his role as Vancouver mayor, said an inhalation room, complete with necessary ventilation facilities, was built into InSite's Downtown Eastside facility when it was built in 2003. But organizers didn't want to push the envelope by asking for permission to set up a crack inhalation room in addition to a space where addicts can inject with the help of health-care professionals, so they let it go.
"We said, 'Well, you know, let's get the supervised injection site up and running and go on,' because I didn't want it to be dragged on forever. ... I don't think we even applied for it. I think it was discussed and my feeling was that probably it was just adding a wrinkle in there that was going to hold up the whole process."
Mr. Campbell said it's time Vancouver gets moving on the site - something he doesn't think it should need Ottawa's permission to do. "It would be the federal government messing in a provincial health-care matter."
Dr. Kendall said he wants to pursue a supervised inhalation room, but there are no concrete plans to do so.
Evan Wood, a researcher at the B.C. Centre for Excellence in HIV/AIDS and the senior researcher behind the CMAJ paper, says a clinical study could be under way as soon as the summer of 2010. He said he would have no problem asking the federal government for an exemption allowing the site to operate - as long as Ottawa does its due diligence and makes a decision based on the trial's scientific merit, which he said would be "groundbreaking" if it can help get high-risk drug-using populations off the streets.
"You're using, basically, supervised injection sites and inhalation rooms as a strategy to recruit people into addiction treatment," he said.Report Typo/Error