WE'LL KEEP SAFE INJECTION SITE OPEN NO MATTER WHAT, INSISTS OPERATOR

The organization that runs Vancouver's safe injection site says it
will keep it open --whether the federal government extends the
exemption allowing the site to operate legally or not.

"It would be like a war crime to not be allowed to continue," said
Mark Townsend, a senior manager of the Portland Hotel Society, which
runs the site.

"If [the federal government] does not grant us the exemption to
continue running, we'd be put in a difficult moral position," he
said. "The evidence is crystal clear that this saves lives and
reduces the appearance of AIDS and hepatitis C."

On average, 700 intravenous drug users inject daily at the safe
injection site, called InSite. InSite users and employees are
dismayed the site's future is even in question.

Supervised injections at InSite would be illegal as of Sept. 12,
unless the federal government grants it a continued exemption under
Canada's narcotics law.

Despite the looming deadline, InSite's managers are pushing to
increase the services it provides.

In July, they applied to the City of Vancouver to add 30 detox beds
to the site.

And last week, they applied to Health Canada to be allowed to start a
heroin maintenance program at the site. Under such a program,
longtime addicts would be allowed to receive and inject heroin at the site.

"There's a tremendous amount of evidence to show that heroin
maintenance treatment is very successful," said Dan Small, another
Portland Hotel Society senior manager.

A one-year experimental heroin treatment program, called NAOMI, has
been running at the site since March 2005. The patients chosen for
the program had all tried other options, such as methadone, unsuccessfully.

However, the heroin maintenance ended after one year and, when the
patients were offered alternatives such as methadone, Small says most
ended up back where they started.

"If there was a really successful new drug for blood pressure we
wouldn't give it to people for a year and then put them back onto
drugs that didn't work for them, would we?" Small said.

Small and the Portland Hotel Society want to offer permanent heroin
treatment, not another experimental program.

Small said scientific evidence from around the world supporting
heroin treatment is more than sufficient to justify a program without
another pilot project.

"These aren't academic issues for us -- we all know people who are on
the NAOMI project or who are addicted to illegal heroin who need
help," said Small.

"Let physicians do their jobs -- if a doctor sees a patient
unamenable to [abstinence] treatment and methadone, they should be
able to try heroin maintenance."

In support of the application for the heroin maintenance program,
Small asked for written opinions from three addiction experts about
the efficacy of heroin treatment.

All three voiced strong support for immediate permanent heroin
maintenance programs, not as a cure for heroin addiction but as a
palliative for the pain and destruction the drug wreaks on users.

"There are no panaceas for societies' drug-related ills, only
'second-order' solutions that will help turn a disaster back into a
problem," wrote Barry Beyerstein, a professor of biological
psychology at Simon Fraser University. "Heroin maintenance has proven
it can be one arm of that solution."

Beyerstein listed the benefits heroin treatment programs have shown,
including dramatically reduced overall death rates, lessened
transmission of HIV and hepatitis C, reduced criminal activity,
reduced homelessness and improved employment statistics among substance users.

In the application, Small also submitted a legal opinion from lawyer
Craig Jones regarding the constitutionality of cutting the NAOMI
trial addicts off the drug, and not offering it to others in need.

Jones wrote: "a constitutional challenge against the federal
government, based on the failure to provide heroin maintenance
therapy, has a reasonable chance of success."

He said the failure to provide a treatment that has been proven
effective in helping a disabled group in society would be in breach
of the Charter of Rights and Freedoms. Specifically, failing to offer
a heroin program would breach Section 7, which guarantees the right
to life, liberty, and pursuit of happiness, and Section 15, which
guarantees freedom from discrimination.