SAFE-INJECTION SITES IN MONTREAL? PLAN CAREFULLY

In a landmark ruling late last week, the Supreme Court of Canada
issued a sharp rebuke to the federal government's attempt to shut
down Vancouver's safe-injection site for intravenous drug users, and
in the process opened the way for other such facilities across the
country, including in Montreal.

The ruling declared that the Insite facility, in operation for the
past eight years, should be allowed to remain open because the
"harmreduction" service it provides outweighs the flouting of
Canada's drug law entailed in its operation. It is noteworthy that
the ruling came backed by a unanimous vote of the top court's nine judges.

It was also widely hailed - though not in large-C and small-c
conservative circles, where such facilities are decried as
legitimized shooting galleries for scofflaw junkies. Among those
applauding the ruling within hours were the Liberal and New Democrat
health critics, the Canadian Public Health Association, the Canadian
Medical Association, the Registered Nurses' Association of Ontario
and the mayor of Vancouver.

It is notable that the court deftly sidestepped the jurisdictional
arguments raised during hearings in the case. Federal lawyers had
held that it was a matter of enforcing criminal drug laws, which are
within Ottawa's purview, while British Columbia's lawyers maintained
that Insite falls under health-care policy, which is a provincial prerogative.

Rather, the argument that was critical to the court's decision was
that of health-care professionals who have determined that the
facility, where addicts can inject their own drugs with guaranteed
clean needles and under the supervision of nurses, saves lives (in
preventing overdoses) and prevents the spread of deadly infections
such as HIV and Hepatitis C.

The court concluded that shutting down Insite would amount to an
ideologically driven move that would deprive Insite clientele of
Charter of Rights protections for life and security of the person,
and effectively deny them fundamental justice. Chief Justice Beverley
McLachlin wrote on behalf of the court: "The potential denial of
health services and the correlative increase in the risk of death and
disease to injection drug users outweigh any benefits that might be
derived from maintaining an absolute prohibition on possession of
illegal drugs on Insite's premises."

Little evidence has been produced that Insite aggravated illegal drug
use. But there have been numerous scientific studies, peerreviewed
and published in prestigious journals, that concluded the facility
saved lives, decreased crime in its neighbourhood, encouraged
rehabilitation and was of general benefit to public health.

But for all its documented health benefits, Insite is by no means a
panacea. The fact is that it does enable the consumption of illegal
and dangerous drugs. It should also be taken into consideration by
advocates of such facilities that Insite was a very specific response
to a very localized situation - Vancouver's skid row Downtown
Eastside - for which there is no really comparable equivalent in
other Canadian cities, including Montreal.

Any extension of the Insite experiment should be carefully planned,
with a strict emphasis on treating addicts and steering them into
rehabilitation programs rather than merely offering an accommodating
place to indulge nasty habits. Its ultimate effect should be to
reduce, not maintain or increase, the number of addicts. The location
for such sites should also be scrupulously chosen, with due respect
and consideration for neighbouring residents and businesses.

Failure to observe such precautions would see public support for what
now stands as an enlightened ruling quickly deteriorate.