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Safe injection sites: Treating people with addictions like they matter

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.”)





21 comments to Safe injection sites: Treating people with addictions like they matter

  • Speaking as a person who lived for 10 years two-doors down from a crack house, a safe-injection site is a much better option.
    You’d think after years and years of failure, governments would realize prohibition and punishment does not work for addictions. It amazes me that people who are suppose to be so smart, so educated, can be so blind.

    • I sometimes wonder if it’s willful blindness, since none of the credible scientific evidence lends any support to the concept that prohibition and punishment will fix the drug problem. The US provides a compelling example of how not to address the drug problem – despite all the money they’ve poured into their war on drugs, their drug problem rages on because their approach is so completely wrong. Criminalizing addiction is very similar to criminalizing mental illness.

  • Florence

    I agree with you wholeheartedly! I’ve never understood why people would oppose such sites. Everyone should be taken care of regardless of of who they are or how they live their lives. Everyone’s life is valuable. Sites like this help those who use them and those who have no need for them. Everyone’s life is valuable! I know I’ve said that twice but I truly believe it.

    • You know, Flo, a lot of people, upon meeting you, might be surprised to learn that you support safe injection sites, given that you probably seem like the least likely person ever to need one. But I’ve known you most of my life, and it doesn’t surprise me at all that you feel that way, because your values include compassionate and non-judgmental acceptance of all people.

  • Agreed 100%. I was disappointed with our Mayor for this one.

    And, just for the record, I also field a LOT of calls at work from people who don’t want to live next to daycare centres. I don’t see anyone using that as a reason those shouldn’t exist.

    • What?? People have a problem with daycare centres in their neighbourhoods? That’s so bizarre. I always assumed people were opposed to those other types of facilities because they were afraid of the kind of people who use them, or because they were afraid of the impact on their property values. But what could they possibly fear from a daycare centre??

      • They complain about all kinds of things, noise being the main one. Also, having too many cars parking nearby during drop off times, play yards taking up too much space, and the anticipated amount of garbage that might be out at the curb on pick up days.

        • I’d love to have a daycare next door to me. It makes me happy every time I see a bunch of toddlers all holding onto the rope while they toddle down the street.

  • Murt

    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.

    I wish this were true.

    • Well, of course it’s not true of all people with addictions, nor at all times. But I think there are critical points in a person’s journey through addiction when it IS true. When what they need is offered to them at the moment they can accept it.

      In Canada we believe that everybody has a right to health care. For addicts, the model might be a little different than for the mainstream population, because their needs are different. Safe injection sites are an effective model for offering health care to people with addictions, without condemning them, criticizing them, or insisting that they change first.

  • recovered



    The producers of this short film are both recovering addicts who have both spent time living and indulging with drug addiction in Vancouver’s Downtown Eastside. Today they are both clean and sober with multiple years of recovery

    Addiction: Chaos in Vancouver

    • Thanks for sharing your film. I can’t say I agree with the anti-harm-reduction message that comes across in the first half. It seems like you’re blaming harm reduction for addiction, without offering addicts any concrete alternatives. The only alternative that I saw was “Just Say No. Choose Recovery.” But that seems kind of impractical and simplistic for the vast majority of addicts.

      On the plus side, I found the photographic portraits of the people of the downtown east side very powerful and touching.

      How did the two of you manage to break free of your addictions?

      • recovered

        Out of desperation for a life of any kind as opposed to living day by day like we were walking dead but most of all learning just how selfish addiction is and that by giving back we could understand our weaknesses that we suffered from as well many others

  • I’d rather have a SIS in my neighbourhood then a pub…

  • I am fascinated by the nanosecond time-lapse between the release of the results of a scientifically based research study and the chorus of rather badly-reasoned, “Nope. Not gonna happens”, from Important People Who Claim To Know And Do Things Based on Hard Facts.

    Because you know, ma’am, I don’t believe that they had time in that nanosecond to consider much of anything at all, except pre-existing biases.. which, sadly, seem to trump all.

    • Excellent observation, Coyote. They didn’t even take the time to object thoughtfully to the report. Just a standard, blanket, knee-jerk objection based on faulty logic and pre-existing biases.

  • @ Coyote: those Important People are also Decisive, whether they’ve actually processed the data or not! I mean, if you (an an Important Person) can’t come up with a photo op bon mot immediately, you won’t be important for long! I would support a SIS in my town, if it were even possible for that idea to be considered, but here in the US of A this would be a nonviable idea–no politico in his or her right mind would even suggest it.

    • Your comment may actually help explain our Mayor’s objection. Perhaps he thinks it would be political suicide to come out in favour of it. Far easier for him to officially object to it, and let public health officials fight that battle.

      Mayor Watson doesn’t seem to be opposed to harm reduction in principle. I sat behind him at the opening ceremonies for The Oaks, which is a residential managed alcohol program. It’s harm reduction. (He wasn’t mayor yet, but still…)

      Come to think of it, the former Chief of Police came out strongly in favour of The Oaks too. I saw him at a community meeting before The Oaks opened, helping to assuage the fears of locals who didn’t want The Oaks in our neighbourhood. He wasn’t saying “It’s not a good idea because it won’t be welcome in any neighbourhood” about The Oaks.

      So why are they both opposed to a safe injection site?

  • mycho saniac

    gee, it almost looks as though the united spates of hysteria were planning to criminalize aids…what’s that you say? they are?! dang it to heck! well, that explains a lot, actually…

    • It’s an interesting concept, criminalizing everything you don’t like. It’s one of the bluntest instruments of social control, but it does the job.