Canada’s top court on Friday ordered the federal health minister to allow North America’s first government-sanctioned drug injection facility to remain open in Vancouver’s seamy Downtown Eastside.
The InSite clinic in one of Canada’s poorest neighborhoods is the only place on the continent where addicts can receive medical supervision as they inject heroin illegally bought on the street.
The facility was established in September 2003 in response to a rash of drug overdoses and is operated by a non-profit organization under a special exemption from federal drug trafficking and possession laws.
The federal health minister’s decision in 2008 not to renew the exemption led to a court fight pitting enforcement of federal drug laws against medical studies claiming InSite saves lives.
The Supreme Court ruled that the province of British Columbia may not offer health services that breach federal drug laws.
However, it added that the health minister’s decision to deny an exemption for InSite to operate violated the rights of heroin addicts to access health services and counseling at the facility, “threatening their health and indeed their lives.”
“The effect of denying the services of InSite to the population it serves and the correlative increase in the risk of death and disease to injection drug users is grossly disproportionate to any benefit that Canada might derive from presenting a uniform stance on the possession of narcotics,” the justices said in a unanimous decision.
Thus, “the minister is ordered to grant an exemption (from federal drug laws) for InSite.”
The decision also opens the door for more safe injection sites to be set up in cities across Canada that are coping with rising drug addiction.
“We are disappointed with the decision, but we will comply,” Health Minister Leona Aglukkaq said.
“We believe that the system should be focused on preventing people from becoming drug addicts in the first place,” she said in parliament, adding that the government would also review the court’s decision.
Supporters of InSite, meanwhile, applauded the ruling.
“Addiction-related drug use is a health issue and not a criminal justice issue,” said Canadian Public Health Association chief executive Debra Lynkowski.
“Collectively, we have the responsibility to protect the health of all Canadians, no matter what their situation.”
Liberal MP Justin Trudeau called the decision “a victory for medical science, Charter rights, and common sense over narrow, right-wing ideology and politicking.”
“It’s a wonderful repudiation of (Prime Minister Stephen) Harper’s ideology,” echoed InSite manager Russ Maynard, as dozens of people outside the facility celebrated the court decision.
Canadian Medical Association president John Haggie, meanwhile, commented: “While for some this is an ideological issue, for physicians it’s about the autonomy to make medical decisions based on evidence, and the evidence shows that supervised injection reduces the spread of infectious diseases and the incidence of overdose and death.”
The stated aim of the drug supervision facility frequented by 12,000 clients annually in Vancouver is to prevent overdoses, offer health services and refer addicts to detoxification facilities.
There have reportedly been nearly 2,400 overdoses at the clinic, but no fatalities.
Lawyers for InSite in court pointed to more than 50 peer-reviewed studies showing it has helped reduce the spread of diseases such as HIV and hepatitis, as well as curbed open drug use.
Ottawa, however, argued the facility fosters addiction.
The government also suggested that InSite’s nearly $3 million annual budget — paid by the province of British Columbia through its health authority — would do more good if spent on expanding detoxification centers.