The principle feels counterintuitive, and for many Canadians, the idea of applying it in their neighbourhood is instinctively repellent. Make it easier for intravenous drug users to shoot up by giving them a safe and legal place to do it? Really?
Research and experience from multiple countries reveal a simple truth, namely that supervised injection sites work and the most frequently expressed concerns about them are overblown.
Overdose deaths tend to drop, without an increase in property crime or drug dealing in the immediate vicinity (the evidence is less conclusive on countering the spread of infectious disease). The number of addicts tends to fall, as do public disorder offences.
In other words, the recent decision to approve three new supervised injection sites in Montreal, which has sought for years to replicate Vancouver's experience with Insite, the continent's first legal injection facility, is necessary and commendable.
For far too long, drug addiction has been viewed primarily as a law enforcement problem rather than a public health issue.
Ideally, we want people to not get addicted to heroin or fentanyl in the first place. We also want them to not die if they do, and to overcome that addiction. Because the reality is Canada is faced with a growing opioid epidemic.
Just this week the government of Alberta reported 343 fentanyl-related deaths in 2016, a 40-per-cent jump from 2015. In British Columbia, a record 914 died last year after ingesting illicit drugs.
There is no authoritative figure on intravenous drug users in this country, but the Canadian Centre on Substance Abuse, citing various sources, pegs it between 75,000 and 125,000 – by way of comparison, about 200,000 Canadians were diagnosed with cancer last year, and 50,000 or so with heart failure.
Injection sites are proven to be effective with habitual users; the problem is fentanyl is killing casual consumers as well.
Alberta has reacted by widening access to treatment programs and to naxolone, an opioid antagonist; the province has also set $750,000 aside to establish "supervised consumption services."
These developments are important steps toward a more enlightened approach to tackling drug use and addiction. Many more can and must be taken.