New rules drafted by the Harper government for establishing supervised injection sites for drug addicts could make it more difficult for Vancouver's InSite to be replicated elsewhere in Canada.
Health Minister Leona Aglukkaq, who expressed disappointment in 2011 when the Supreme Court of Canada ordered the government to stop interfering with the controversial clinic, will table a bill in the House of Commons on Thursday that clarifies how supervised-injection sites can be created.
It is expected to focus heavily on the need to consult members of the community and respect their values and voices. That means any opposition could make it difficult for proponents of a supervised-injection site to move forward.
Groups in cities across Canada – Montreal, Toronto and Ottawa, in particular – have expressed an interest in having a supervised-injection site in their communities. But police in Toronto and Ottawa are unequivocally opposed, as are both mayors.
Julio Montaner, the director of the British Columbia Centre for Excellence in HIV/AIDS, said he is proud of the fact that InSite's supporters won the legal battle to keep the facility open. The clinic has been credited with preventing overdose deaths and reducing the spread of blood-borne infections.
"Having said that, the evidence to date suggests that we lost the war," Dr. Montaner said in a telephone interview on Wednesday. "Because the reality is that InSite is open. But there has been not a single [additional] site opened across this country."
That's because the federal government has sent a chill down the system, he said.
For a supervised-injection site to open, the federal Health Minister must grant a clinic an exemption to the laws that prohibit the use of illegal drugs. It is the same sort of exemption that is obtained by doctors who apply for methadone treatment programs for patients, or veterinarians who want to euthanize sick animals, or researchers conducting clinical trails with restricted substances.
The federal Conservatives, who objected to the notion of providing addicts with legally sanctioned hard drugs, ended the exemption for InSite in 2008, although the clinic continued to function while the decision was challenged in the courts.
In a unanimous ruling three years later, the nine judges of the Supreme Court said the federal government may not ban such sites if closing them would increase the risk of death and disease among drug addicts – and that to do so would violate the rights to life and security.
On the other hand, the court said a federal health minister can block a safe-injection site after considering "the impact of such a facility on crime rates, the local conditions indicating a need for such a supervised-injection site, the regulatory structure in place to support the facility, the resources available to support its maintenance, and expressions of community support or opposition."
The government is expected to rely heavily on the last condition in the new rules it is preparing to unveil.
Dr. Montaner said consultation and a buy-in on the part of a community are important first steps to the establishment of a supervised-injection site.
"But what we need is a mechanism to facilitate the opening of safe injection sites, which is what the Supreme Court of Canada actually intended with the ruling," he said. "The fact is that nothing has moved and I am very concerned that we have raging epidemics in Saskatchewan and Manitoba, for example, predominantly driven by injection drug use."