INSITE IS INCREASINGLY MAINSTREAM

Today, federal government lawyers will be in the Supreme Court of
Canada putting forward its case for shutting down Insite, Vancouver's
internationally recognized supervised injection site for people who
inject drugs. The Dr. Peter AIDS Foundation will be there as an intervener.

Study after study have shown the individual and health system
benefits of supervised injection service. It is increasingly
mainstream thinking in Canadian health care as reflected by other
interveners in the Supreme Court case - Canadian Nurses Association,
Association of Registered Nurses of British Columbia, Registered
Nurses Association of Ontario, Canadian Medical Association, and
Canadian Public Health Association.

And, it's also becoming increasingly mainstream thinking on our
streets as evidenced by a recent Ontario survey presented at the 20th
Annual Canadian Conference on HIV/AIDS Research in Toronto last
month. Now that Insite has been operating for over seven years, many
wonder what all the fuss is about. The sky hasn't fallen.

I hope the Supreme Court will rule in favour of Insite. It would mean
one of two things, or both -the Court agrees Insite falls under
provincial jurisdiction as a health care undertaking, or the Court
agrees that the right to access Insite free from prosecution is
protected by Section 7 of the Canadian Charter of Rights and Freedoms
for individuals who inject drugs.

Individuals are suffering from the ravages of long standing injection
drug use in towns and cities across Canada. The legal and political
battles to keep Insite open leaves other cities and provinces
reluctant to open supervised injections sites, despite knowing the
need. The Dr. Peter Centre experience offers a way for supervised
injection service to be integrated into health clinics and communities.

In 2002, a year and a half before Insite opening, the Dr. Peter
Centre integrated supervised injection service into its broad range
of health care services for people living with HIV/ AIDS. The Centre,
a part of Vancouver's downtown West End neighbourhood alongside
heritage houses, daycares, an elementary school and, in the midst of
a bustling urban life, continues to provide the service in its day
health program and 24-hour skilled nursing care residence.

The galvanizing impetus to pursue implementing the service was two
overdoses (one in a bathroom, the other in the laundry room),
fortunately neither fatal. We were aware there had never been a death
in a supervised injection site anywhere in the world. It would have
been inconsistent with our mission of care for people living with
HIV/AIDS to ignore there was a way to reduce risk of death by overdose.

We proceeded after consultation with the College of Registered Nurses
of British Columbia, the entity authorized and required, under B.C.'s
Health Professions Act, to establish standards for registered nursing
practice. The College confirmed that it was within the scope of
registered nursing practice to provide individuals with
evidence-based information so they can give themselves injections
more safely, and that teaching and promoting such self care prevents
illness and promotes health. Nurses do not touch, inject, or provide the drugs.

A March 2011 report from the B.C. Office of the Provincial Health
Officer, Decreasing HIV Infections Among People Who Use Drugs by
Injection in British Columbia: Potential Explanations and
Recommendations for Further Action, recommends that access to
supervised injection services should be incorporated into routine
public health clinics throughout B.C., using the Dr. Peter Centre model.

Health care leaders and policy-makers from Prince George to Victoria,
Saskatoon to Toronto, New York to San Francisco, Kiev to Kaliningrad
have visited to gain an understanding of our integrated approach.

The Lancet, a leading medical journal, in its recent online
commentary states, "Misplaced moral judgments have underpinned the
neglect of people who inject drugs. Yet, it is wholly immoral to let
people become infected with HIV or die when evidence based
interventions exist to prevent these outcomes. A bold and human
response is needed from governments. Lives are at stake."