Last October, the Supreme Court ruled that Insite, Vancouver’s safe injection site, could stay open despite the Harper Government’s objections. The arguments hinged on whether addiction was primarily a health issue or a crime issue. If it were a health matter it would fall under provincial jurisdiction; if it were a criminal code issue, it would fall under federal jurisdiction.
When the Supreme Court ruled (unanimously) that Insite could remain open because of the rights of addicts to accessible health care, it opened the door to the possibility of safe injection sites opening in other Canadian cities.
For those of you unfamiliar with how a safe injection site works, it’s a facility where injection drug users can bring their own drugs and inject them under the supervision of a nurse. The facility provides the client with a clean, safe(r) place to inject, and if he or she overdoses, there’s someone there to provide medical assistance. In addition, it’s a point of contact for other health care questions or issues the client might have – for example, drug treatment, pregnancy, infections, mental health issues, etc. In addition to the heath benefits to the individual, there are public health benefits to the community, such as lower rates of transmission of infectious diseases, and fewer hastily discarded needles in public places.
For the past four years, researchers at the University of Toronto and St. Michael’s Hospital in Toronto have been conducting a feasibility study to determine if safe injection sites were needed in Toronto and/or Ottawa. The study looked at costs, the potential impact on property values, and the effect on rates of transmission of infectious diseases, among other things. The study determined that Ottawa could use two safe injection sites.
Ontario’s Minister of Health, Deb Matthews, says Ontario has no plans to open any safe injection sites. Ottawa’s mayor, Jim Watson, says if we have extra money to spend on the drug problem, we should put it into treatment. Ottawa’s new Chief of Police, Charles Bordeleau, says he’s opposed to a safe injection site, suggesting he’s more concerned with the criminal aspects of obtaining illegal drugs than with any potential health benefits from how or where they’re consumed. The former Chief of Police, Vern White (now a Harper-appointed senator) says he is opposed to a safe injection site in part because it would be unwelcome in any neighbourhood.
I find the Mayor’s reasoning weak on this subject. Treatment and harm reduction are not mutually exclusive. We need both. Drug addiction takes place along a continuum, and we need to meet people where they’re at. I agree absolutely that we need more treatment centres. But we also need harm reduction initiatives, like safe injection sites, for those who aren’t ready for treatment yet (or treatment isn’t ready for them – ie, they’re on a waiting list). If we treat people with addictions like they matter, like their health matters, like their lives matter – instead of like vermin who are relegated to the back alleys – maybe they’ll start taking better care of themselves.
The Chief’s reasoning is understandable given that his profession demands that he look at everything through a crime lens. But I think he needs to try harder to understand that much of the drug problem stems precisely from the fact that drugs are illegal and addicts are therefore criminalized. To say you’re against a safe injection site because drugs are illegal is to ignore a complex set of factors that need to be taken into consideration in order to understand and alleviate the drug problem.
Former Chief Vern White argued against a safe injection site, saying it wouldn’t be welcome in any neighbourhood . True enough. But that’s not a good reason not to do it. There are a lot of things people don’t want in their neighbourhoods. Composting facilities. Shelters for abused women. Halfway houses. Children’s Aid group homes. Parole offices. Homeless shelters. Does that mean we shouldn’t have those things? Of course not. (And, as one of my colleagues said the other day, “I’d rather live next door to a safe injection site than a crack house.”)