OTTAWA WANTS SAFE-INJECTION SITE SHUT DOWN

Arguing Vancouver Clinic Is Not Effective, Health Minister Says He
Will Appeal B.C. Supreme Court Ruling That Allows It To Stay Open

OTTAWA -- Ottawa moved yesterday to close Canada's only sanctioned
safe-injection site, announcing it will appeal a B.C. court ruling
that Vancouver's Insite should stay open because reducing the risk of
drug overdoses is a vital health service. "In my opinion, supervised
injection is not medicine; it does not heal the person addicted to
drugs," Health Minister Tony Clement told the House of Commons health
committee yesterday.

"Injection not only causes physical harm, it also deepens and prolongs
the addiction. Programs to support supervised injection divert
valuable dollars away from treatment. And government-sponsored
supervised injection sends a very mixed message to young people who
are contemplating the use of illicit drugs."

Mr. Clement told the committee he will ask Justice Minister Rob
Nicholson to appeal a British Columbia Supreme Court ruling that saved
Insite, North America's only sanctioned safe-injection facility, from
closing at the end of June when its exemption from Canada's drug laws
expires.

Allowing addicts to inject themselves with illegal drugs at a
supervised site in Vancouver prevents the death of one person a year,
Mr. Clement said.

"The evidence is that Insite's injection program saves, at best, one
life per year. A precious life, yes. I believe we can do better and we
must," Mr. Clement said, citing a report from an advisory committee he
struck to investigate the merits of the site. "My job as Health
Minister is to balance that one life against any possible negative
effect of supervised injection that might take one life elsewhere."

The advisory committee, which released its report in March, concluded
that although Insite staff have intervened in more than 336 overdoses
since 2006 and no overdose deaths have occurred at the site, "Insite
saves about one life a year as a result of intervening in overdose
events."

The committee said long-term studies would be needed to verify that
number, and the "mathematical modelling" may not be valid. On the
whole, the panel found Insite to be cost effective and helpful to
addicts looking for treatment.

"Over a million injections have taken place at the site," said Liz
Evans, a nurse who is executive director of the group that runs the
site. "You don't have to be a rocket scientist to know that of the
over 900 overdose incidents that have occurred since it's opened,
probably more than four of them could have resulted in a death."

The facility operates in the city's blighted Downtown Eastside on the
strength of exemptions granted by Ottawa under a section of the
Controlled Drugs and Substances Act.

"In this case, we have given it due process, we've looked at all the
evidence, and our position is that the exemption should not be
continued," Mr. Clement said.

Removing the exemption will shut Insite down if an appeal court
reverses the B.C. court's judgment.

In his ruling this week, Mr. Justice Ian Pitfield upheld arguments
that Insite provided vital health services to addicts by reducing the
possibility of drug overdoses, curbing the risk of transmitting
infectious diseases and giving users access to counselling that may
lead to abstinence.

As a result, Insite's injection-drug users have the right to
protection from drug laws under Section 7 of the Canadian Charter of
Rights and Freedoms that guarantees everyone "life, liberty and
security of the person," the judge found.

He gave the federal government until June 30, 2009, to redraft laws
against possession and trafficking of illegal drugs to accommodate
Insite's operation. Without that adjustment, those key sections of the
law are unconstitutional, Judge Pitfield said.

If the ruling is allowed to stand, advocates will press for additional
sites in Vancouver and across Canada, Mr. Clement said.

He stressed that he approves of many of the services offered at
Insite, including needle exchanges and condom distribution, and would
not want it closed entirely. But he does not agree with supervised
injections.

The minister's rejection of the safe-injection site came after the
health committee heard from a series of witnesses supporting its
continuation.

Others, like Thomas Kerr, director of the urban health research
program at the B.C. Centre of Excellence in HIV/AIDS, cited the more
than 25 peer-reviewed scientific papers that have found, among other
things, that the injection site reduces public disorder, overdoses and
disease while connecting the users of illegal drugs with avenues for
treatment.

But Mr. Clement discounted that research, saying many of the studies
have been conducted by the same authors who "plow their ground with
regularity."

When asked when Mr. Nicholson will launch the appeal, his office
referred calls to Health Canada, which would only say that it will ask
the minister to do so at the earliest opportunity.

Mr. Clement's announcement that he will ask for an appeal was greeted
by cheers from a large group of people in the committee room who had
been organized to attend to back the government's position.

But opposition MPs sided in favour of Insite.

David Butler-Jones, Canada's chief public health officer, looked
decidedly uncomfortable when asked whether he agreed with Mr. Clement.

"The science, I think, speaks for itself. The debate speaks for
itself," Dr. Butler-Jones replied. "We provide the best advice we can.
Governments and jurisdictions, as appropriate, make their decisions
and have the political context in which they make their decisions."