INSITE LEGAL FOR THE NEXT NINE MONTHS

Conservative Stall Tactics On Supervised Injection Put Politics Ahead
Of Saving Lives: Critics

VANCOUVER - It has become the most controversial medical experiment
in Canada. That is quite an achievement for a place with 12 chairs in
a nondescript building on East Hastings Street.

That's where, since September 2003, thousands of Vancouver heroin and
cocaine addicts have been injecting their street-bought drugs under
the watchful eyes of a small team of government-paid nurses and drug
counsellors. On Tuesday, the controversy intensified as the federal
government issued a terse statement.

It said, in full: "Health Minister Tony Clement has advised the
Vancouver Coastal Health Authority which operates Insite, a
supervised-injection site, that their exemption under Section 56 of
the Controlled Drugs and Substances Act has been extended until June 30, 2008.

"This extension will allow research on how supervised injection sites
affect prevention, treatment and crime to be continued for another six months."

The extension, the second the Conservative government has reluctantly
given the site in the past year, wasn't greeted with expressions of
relief the way the first, 18-month extension was last August.
Instead, it has prompted a torrent of blistering criticism.

Scientists say the short extension represents political interference
in medical research. Community advocates say it's a case of ideology
trumping human lives. And some B.C. politicians are critical because
they resent the federal government sticking its nose into something
that has been supported by local governments.

"To be honest with you, it's time that we call things by their name,"
said Dr. Julio Montaner, an internationally respected AIDS researcher
at Centre for Excellence in HIV/AIDS, whose team has done extensive
research of Vancouver's drug-using population for a decade.

"The time has come for uncovering the plot that is emerging on the
part of the federal government," Montaner said.

'All Politics And No Policy'

That plot, he said, is a deliberate effort to keep changing the way
the site is evaluated and keep stalling on a long-term decision about
it, in order to get it out of the way until an election victory --
presumably later this year -- gives the Conservatives the opportunity
to close it entirely.

Montaner's team has already done 25 studies looking at the impacts of
the site. They have shown the site has reduced the numbers of
syringes on the street in the area, reduced syringe-sharing and
therefore infection-causing behaviour among users, dramatically
increased rates of entry into detox and treatment, and eliminated
drug-overdose deaths for people who use the site.

Three studies by other groups found the site did not lead to
increases in crime, didn't lead to increases in people starting to
inject, and didn't have any negative impact on community drug-use patterns.

But the research goalposts keep changing, Montaner says.

"Now, it seems if the supervised-injection site doesn't solve all of
the problems of mankind in B.C., then it's a failure."

Montaner's view was echoed by many. Former Vancouver mayors Philip
Owen and Senator Larry Campbell, who both championed the site, were
outraged by the announcement.

"It disgusts me," said Owen. "They're not serious at all. This is all
politics and no policy."

Campbell said it's an example of gross interference in both health
and the province.

"Butt out. This is a health issue, this is a provincial issue," said
Campbell, who vowed earlier to to the injection site and personally
help keep it running if the federal government rescinded the exemption.

NDP MP Libby Davies and Liberal MP Ujjal Dosanjh both said they were
concerned that ideology seemed to be overruling everything else.

"It's reprehensible for a government to be putting partisan politics
ahead of saving lives," said Dosanjh.

For Mark Townsend, director of the community group that manages the
site's operation for the Vancouver Coastal Health Authority, the news
is especially discouraging because it means other initiatives remain
stalled while everyone focuses on the injection site.

"There's a comprehensive strategy that needs to be built for
prevention, treatment and harm reduction," said Townsend, whose group
just opened a 12-bed detox facility above the injection site.

"The federal government has already spent $1.5 million on research,
the research is in, but they want someone to say the world is flat," he said.

The Ethical Dilemma

The injection site was already controversial when it started, since
it pits two passionately held ethical beliefs against each other.

One holds is that it is unethical to allow sick people to take
powerful, addictive drugs that are ruining their lives, and the only
moral course of action is to use whatever means available to convince
them to stop.

The other says it is unethical to allow sick people who are addicted
to powerful, addictive drugs essentially to kill themselves unless
they agree to treatment, and the only moral course of action is to
use whatever means are available to keep them alive and healthy so
they can get treatment when they are ready.

The injection site also, unsurprisingly, pits federal political
parties against each other. What has been remarkable, as the debate
has gone on for the past four years, is how it has pulled many other
groups into the conflict. B.C. Premier Gordon Campbell came out
solidly in support of the site this week, highlighting the gap that
has opened up on the issue between local, urban-based politicians and
federal, rural ones.

More than 150 scientists wrote a letter to the federal government in
May, protesting the terms of its research requirements, an unusual
example of conflict between science and politics.

Feds Want More Evidence

And Vancouver police have given their official support to the site,
while the RCMP remain as disapproving as they can be without openly
criticizing local government.

The RCMP position is that the force is opposed to any new sites
opening "until we see convincing evidence that such sites can help
people get off street drugs," said local RCMP spokeswoman Const. Annie Linteau.

The Conservative government has adopted that kind of approach, saying
it wants more research to show that the site isn't only helping
people using it stay healthy, but also reduces drug use. What is
unclear now about the federal government announcement is how
extending the deadline to June 2008 will contribute to improved research.

A Health Canada representative said she was not able to provide any
further information.

The 150 scientists noted that the extension was so short no
meaningful research could be done.

The whole process has been an unusual one in the annals of medical
research, says UBC health professor Sam Sheps, who added that he
can't think of another health issue that has become so political.

"The question is, do you consider this a legal issue only, or a
health issue? We consider it a health problem if people smoke or
drink, but a legal issue for people who take drugs. It doesn't seem
very consistent."

[Sidebasr]

Years Of Controversy Mark Vancouver's Supervised-Injection Site

What began as a recommendation that addiction be considered a health
issue instead of a criminal one eventually developed into the
well-used Insite, which has just received another six-month extension.

January 1995

B.C. chief coroner Vince Cain issues a major report on drug overdose
deaths and recommends that addiction be treated as a health issue
instead of a criminal one. He even advocates giving out free heroin.

July 1997

Downtown Eastside organizers put up 1,200 crosses in Oppenheimer Park
to mark deaths from drug overdoses, the beginning of a street-level
campaign for sanctioned injection sites.

July 1998

A report by B.C. public health officer John Millar says the province
has an "epidemic" of death and disease caused by drugs, as overdose
deaths spike and HIV and hepatitis C infection rates reach Third-World levels.

November 2000

Vancouver mayor Philip Owen launches a draft drug strategy called the
Four Pillars approach, focused on harm reduction, prevention,
treatment and enforcement. It refers to injection sites, but doesn't
endorse them.

November 2002

Former coroner Larry Campbell is elected mayor on a promise to clean
up the Downtown Eastside and get an injection site opened by the end
of the year. He heads to Ottawa in December to twist arms.

September 2003

Insite opens its doors, with a three-year exemption from Health
Canada. Within six weeks, it is getting 500 users a day and the
Centre for Excellence in HIV/AIDS begins to evaluate the site's
effects on health and public disorder.

August 2006

Health Minister Tony Clement approves an 18-month extension, but the
site will no longer get money for research. Clements said the only
thing research had proved was that addicts need more help to get off drugs.

April 2007

The federal government issues a proposal call for new research. It
wants new studies on the site's impact on community overdose rates,
users' progression to treatment, public injection and drug-related litter.

June 2007

A B.C. poll shows that 63 per cent of people in B.C. support the
site. Among Conservative voters, 50 per cent support it, 41 per cent
are opposed. In Vancouver, 76 per cent of people say they support the site.

Oct. 1, 2007

B.C. Premier Gordon Campbell expresses public support for the injection site.

Oct. 2, 2007

Clement announces the site will get a six-month extension, to June 2008.