FIRST SAFE INJECTION SITE BY MARCH: MAYOR

OTTAWA -- Mayor Larry Campbell says the country's first
safe-injection site for drug addicts will be opened in Vancouver with
federal approval by late February or early March.

Campbell made the comment after a two-day meeting with Health Canada
officials here to discuss draft guidelines for what would be the first
safe-injection sites in North America.

The meeting drew about 40 people -- including a dozen from B.C. --
from five cities across Canada.

Campbell said all indications are that no major barriers will prevent
a Vancouver team of health and science agencies from putting in a
proposal in the first week of January and getting approval within the
60 days required by Health Canada.

That was in spite of a last-minute and unexpected visit from two RCMP
officers to the meeting, including Staff Sergeant Chuck Doucette of
Vancouver's E Division, who said they do not support the idea of
opening safe-injection sites until the treatment system is fully funded.

Campbell, who said during the recent civic election campaign that he
wanted safe-injection sites in place by Jan. 1, told them the citizens
of Vancouver have strongly indicated they want this harm-reduction
measure. And it's the citizens' opinion that matters, not those of the
Canadian Association of Police Chiefs or individual police officers,
he said.

Carole Bouchard, director of the office of controlled substances at
Health Canada, said her department will take all the comments and
feedback from the meeting and incorporate them into a second set of
draft guidelines by the end of the year.

"We will be ready to accept applications at the beginning of the new
year," said Bouchard, adding there is a chance the applications could
be processed in less than 60 days.

"If everything was all there in the content of the application, it
could be faster."

The group of Vancouver agencies will likely put in an "umbrella"
proposal that would allow several sites to be approved at once, rather
than having to file a separate application for each site.

That group will probably include the Vancouver Coastal Health
Authority (VCHA), the B.C. Centre for Excellence in HIV/AIDS, and the
Centre for Disease Control.

Heather Hay, who heads the authority's Downtown Eastside health
projects, said the VCHA's position is that "we would like to start
slowly and open up a comprehensive site that would include addictions
treatment."

The site will likely include a room where addicts can inject drugs
under the supervision of medical staff and with clean needles, spoons
and water. As well, it will likely have a medical clinic for treatment
of addiction-related health problems like abscesses and other
infections, a counselling department for referrals to detox and
treatment programs, and other associated services.

Besides Hay, the B.C./Vancouver contingent included two senior
Vancouver police officers -- Inspectors Kash Heed, in charge of the
Vancouver police department's drug unit, and Bob Rich, who is in
charge of the district that includes the Downtown Eastside.

Also present were John Anderson from the ministry of health planning;
Thomas Kerr, a researcher with the Centre for Excellence; Fiona Gold,
a street nurse; Donald MacPherson, the city's drug policy coordinator;
Dean Wilson, president of the Vancouver Area Network of Drug Users,
and Campbell and his executive assistant, Geoff Meggs.

Although four other cities -- Victoria, Winnipeg, Montreal and Quebec
City -- sent police, health and government representatives, Vancouver
is the closest to finalizing a proposal.

There were no representatives from any cities in Ontario, even though
some Toronto agencies have expressed an interest in safe-injection
sites. The Ontario government does not support such sites, effectively
blocking any individual city in the province from initiating a pilot
project.

The Montreal health agencies that run that city's two major needle
exchanges are interested in opening safe-injection sites in their
existing facilities, but their members were concerned about the impact
of the guidelines.

"We'll probably do it, but we're not comfortable with taking the name
of each user," said Louis Letellier de St. Just, a lawyer who works
with a group called Cactus, which runs Montreal's largest
needle-exchange operation behind the bus station in the east end of
the city.

Winnipeg representatives said they are just looking at what Vancouver
is doing and have no immediate plans to open a site.

Many people at the meetings had been worried that Health Canada draft
guidelines issued two weeks ago would make safe-injection sites
difficult to open without a time-consuming and cumbersome application
process.

The guidelines say the sites will get exemptions from Health Canada
only if they are for a "scientific" purpose, that proposals have to
have been approved by standard peer reviews and ethical review boards,
that all users will be research subjects and that no one with a
criminal record can work in the site.

However, those concerns were largely appeased by the end of Tuesday's
meeting.

Hay said the meeting indicated there will be some flexibility in the
guidelines. She had earlier pointed out that the health authority, for
example, routinely hires people as addictions and alcohol counsellors
who have criminal records, so banning those kinds of peer counsellors
from safe-injection sites didn't make any sense.

Anderson, who said the province sees safe-injection sites as a health
issue and is actively backing Vancouver and Victoria groups interested
in taking them on, agreed. "We didn't think there were any show stoppers."

There are still some operational problems to be worked out,
though.

One large unresolved question is where the money will come from, and
no one had the answer to that Tuesday.

Federal politicians and bureaucrats have talked a number of times in
the past about creating a national drug strategy and providing a
significant amount of money to kickstart that strategy. That money
could be announced in the coming February budget.

Campbell said he believes some money will come from the Vancouver
Agreement, the formal partnership between the federal, provincial and
city governments started in 2002 to improve economic and health
conditions in the Downtown Eastside. However, there has been no direct
money allocated to that agreement yet.

It's unclear whether and how much the health authority would
contribute.

The other major issue will be exactly how the safe-injection sites
operate from a police point of view.

Inspector Heed said police are very concerned about how to deal with
the sites, which critics will say will attract drug dealers and users
from all over the region and the country.

"When these open up in Vancouver, you can be assured the police will
be under the microscope."

He said one dilemma for police is what to do about people who continue
to inject drugs openly in public places.

"We would explore charging those people with simple possession," said
Heed.

As well, he said police will have to work out with those operating the
safe-injection site whether there will be a zone around the site,
where there will be zero tolerance for any dealing, and how to prevent
people being sought by police from using the site as an arrest-free
safe zone -- issues that police and medical staff in European
safe-injection sites have had to work out.

"We have to have a lot of discussion to ensure it's not a safe
sanctuary for traffickers to run in if they are being pursued," said
Heed. "They also have to be sure they have operational plans in place
so they don't have an influx of traffickers."

There are currently 48 safe-injection sites around the world, all but
one of them in Europe. Sydney, Australia, initiated one last year.

Safe-injection sites, even though they typically represent only a
small part of an over-all strategy on drug addiction in the cities
that have them, generate a huge amount of controversy because they are
seen to be sending a message that society condones, even encourages
drug use. Critics also say the money spent on running injection sites
should go toward treatment.

Safe-injection sites have been supported primarily by two different
groups.

People who work in public health or health research see them as a
strategy to try to reduce drug-overdose deaths, to prevent the spread
of blood-borne diseases like HIV or Hepatitis C that occurs through
needle-sharing, and to entice addicts into making contact with the
health and treatment system in a way that doesn't happen when
counselling and treatment is only offered to people who have promised
to try to quit drugs.

Police and business groups in various cities have supported or come to
support safe-injection sites because the sites more or less eliminate
public drug use -- something that has been common in Vancouver's
Downtown Eastside alleys for more than a decade.