Insite users and supporters celebrate after the Supreme Court of Canada ruled that the supervised injection site can stay open in Vancouver, British Columbia, Friday, September 30, 2011.Rafal Gerszak
As Quebec looks to open its first supervised-injection clinics, the federal government should respect legitimate attempts to protect the health of drug addicts, within the guidelines set down by the Supreme Court of Canada in last month's Insite case.
Those guidelines are worth recalling as Quebec moves toward opening some – perhaps several – clinics in which addicts may inject illegal drugs such as heroin and crack, under the eye of a nurse.
The court did not swing the doors wide open. It approved of Insite because of the specific conditions that gave rise to it – including a skid-row neighbourhood, the Downtown Eastside in Vancouver, which is sui generis in Canada, with long-time addicts openly injecting on the streets, and dying of overdoses by the score.
Montreal has no Downtown Eastside. Yet Montreal could wind up with as many as eight smaller versions of Insite, after a period in which a smaller number is tested out, according to Jean-François Mary of Cactus Montreal, which provides services to drug addicts. Already, eight needle-exchange programs are being run in the city, and supervised-injection could be easily added without disturbing a community, in his view.
Is this too much? Is any of it necessary? If it saves lives and doesn't harm the neighbourhood, it's worth exploring. The federal government would prefer to stress prevention, but when prevention fails, addicts need medical supports.
The Supreme Court said the federal Health Minister should not stand in the way where a clinic "will decrease the risk of death and disease, and there is little or no evidence that it will have a negative impact on public safety." The government should look at the impact on crime rates, local conditions indicating addicts' needs, the regulatory structure that supports the facility, the resources available and expressions of community support or opposition, the court said.
The federal government was at the table when Insite was launched eight years ago in response to a public-health emergency. Now it is on the outside. It can only watch as others do the difficult work with the hardest-to-reach addicts. If it can't find a constructive role, it should at least stay out of the way.