BRITISH COLUMBIA

Safe Injection Site Rules Bring Stiffer Requirements

06/06/2013 10:08 EDT | Updated 08/06/2013 05:12 EDT
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OTTAWA - The federal government has introduced tough new rules for supervised drug injection sites in a move some see as an effort to stamp out such facilities.

The government says it's a response to a Supreme Court of Canada ruling that ordered the Conservatives to keep a Vancouver clinic open against their will.

But NDP health critic Libby Davies said the government is effectively blocking any chance of setting up a new clinic.

The proposed legislation would require advocates of new clinics to meet two dozen specific criteria before they can apply. Among other things, they'd have to canvass community opinion and gain the support of provincial and municipal authorities.

The federal cabinet then makes the final decision.

As Health Minister Leona Aglukkaq tabled her bill Thursday, she made it clear which way she will lean.

"Our government believes that a site involving the use of illicit substances should be strictly controlled to protect everyone in the community," she said.

"Accordingly, we believe that the application process needs to be changed to create formal opportunities for local voices to be heard and their views considered before an exemption would be considered."

The Conservative party immediately followed up with a plea for supporters to sign a petition to "keep heroin out of our backyards."

In a note attached to the petition, Conservative operations director Jenni Byrne says, "special interests are trying to open up these supervised drug consumption sites in cities and towns across Canada — over the objections of local residents and law enforcement.

"We've had enough — that's why I am pleased the Harper government is acting to put the safety of our communities first."

The Canadian Drug Policy Coalition accused the government of "fear-mongering" and acting in bad faith.

"It's hard to imagine how anyone could expect good faith on the part of the government in considering applications when it's simultaneously demonizing people with addictions and stoking misinformed fear as a way to block health services for some of the most vulnerable Canadians," Connie Carter, the coalition's senior policy analyst, said in a release.

The 2011 court ruling has maintained the Vancouver InSite clinic, but the new rules will make it more difficult for it to stay open and for supporters to open clinics in other cities.

InSite advocates say the clinic's presence has reduced fatal overdoses and connected drug addicts with the social services they need to improve their health. But no other city has yet set up a similar injection site.

Such clinics require an exemption under the Controlled Drugs and Substances Act to operate.

The new rules will require input from local and provincial authorities.

Applicants must include letters from provincial ministers, local government, local police forces and provincial health authorities, as well as proof of consultation with doctors, nurses and a broad range of community groups.

They will need to show they are financially sustainable. And they must provide scientific evidence of medical benefits from safe injection facilities.

Applicants will also have to predict impacts on public safety and set up procedures to mitigate the risk of harm to health, safety and security.

And they must take into account other drug treatment services available.

In order to stay open, the Vancouver facility would have to meet all the new requirements and show how it has already affected neighbourhood crime rates and individual and public health.

A spokeswoman for InSite had no official comment Thursday on the legislation, but noted the facility meets current provincial requirements for public consultation and community engagement. The facility has federal permission to stay open until March 2014, when it must apply to Ottawa again.

Davies, whose riding includes the Vancouver site, said the government has designed the legislation to thumb its nose at the Supreme Court. The long list of criteria gives the government grounds to reject every application, she said.

"You're setting up a scenario for failure."

The Canadian Police Association said it opposes supervised drug-injection sites in almost every circumstance.

"There are communities that would be absolutely lost," said Sgt. Matt Skof, president of the Ottawa Police Association, who appeared alongside Aglukkaq.

"InSite encourages anti-social behaviour," he said, adding he doubts any community in Canada would be open to hosting a supervised drug clinic.

The Supreme Court ruled two years ago that the Vancouver clinic could stay open, siding with supporters who argued shutting InSite would essentially deny health benefits to fragile drug addicts.

The ruling was a blow to the reach of the law-and-order agenda of the Conservatives.

Aglukkaq and her officials say the new bill is completely compatible with the ruling and responds to the court's urgings to consider applications on a case-by-case basis and include community input.

Groups in Toronto, Ottawa, Montreal and Quebec City have suggested they want to open clinics, too, although they have met local resistance.

At least one advocate said it's not clear any application would ever stand a chance of passing muster with the minister.

"Her opposition is well-known," said Ahmed Bayoumi, a doctor and researcher at St. Michael's Hospital in Toronto.

"What worries me in particular is that it's not entirely clear how all these inputs are going to be put together. So if there's one particularly vocal group that's opposed, if the police are opposed, is that sufficient for the minister to deny the exemption? That's very unclear to me."

Bayoumi and other researchers at the University of Toronto last year recommended three supervised injection facilities in Toronto and two in Ottawa, arguing the clinics would prevent HIV and hepatitis C infections and improve the health of drug addicts.

Bayoumi said their research showed most people are at least somewhat open-minded about having a supervised drug site in their communities. And he said research around the world showed such sites were usually accompanied by increased safety and less drug paraphernalia litter.

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