New legislation streamlines the more than two dozen requirements previously needed to launch facilities, which offer supervision and sterile equipment
Canada’s health minister: ‘Solid evidence shows that, when properly set up and maintained, supervised consumption sites save lives.’ Photograph: Rick Callahan/AP
Ashifa Kassam in Toronto-Sunday 21 May 2017
Canada’s government has made it easier to open supervised drug injection sites across the country, offering communities a lifeline as they battle an opioid crisis that has claimed thousands of lives in recent years.
New legislation passed this week streamlines the more than two dozen requirements previously needed to launch these facilities, which offer a medically supervised space and sterile equipment for people who use drugs intravenously.
“Solid evidence shows that, when properly set up and maintained, supervised consumption sites save lives, and they do it without increasing drug use or crime in the neighbourhood,” Jane Philpott, Canada’s health minister, told parliament this week.
The law builds on Canada’s previous success in this field. In 2003, health authorities in Vancouver launched Insite – the first supervised injection facility in North America – to address an epidemic of HIV and hepatitis C in the city’s Downtown Eastside neighbourhood.
By 2015, Insite had logged more than 3m visits and had safely treated nearly 5,000 overdoses – without one death. It had earned accolades around the world for the critical role it plays in saving lives and preventing the transmission of HIV and hepatitis C, while research suggested those who visited the clinic were more likely to pursue detox programs.
But the program clashed with the then Conservative federal government and its tough-on-crime approach. After losing a bid at the supreme court to close Insite, the Conservatives hit back with legislation – described by one health authority as “unduly onerous” – aimed at muddying the process of opening safe injection sites.
Communities were now required to brandish multiple letters of support, compile reports detailing statistics on crime and HIV rates and carry out background checks for staff members, among other demands. The daunting requirements stalled plans by several communities and left others carrying out feasibility studies for more than a decade.
Canada’s health minister: ‘We know that at minimum in Canada, there were 2,300 Canadians that died last year of an opioid overdose.’ Photograph: Dominick Reuter/AFP/Getty Images
Since taking power in late 2015, the Liberals – fuelled by a surging number of overdose deaths across the country – have taken a different approach. Last year the party gave the green light to the country’s second supervised intravenous drug use site and have paved the way for three new safe injection services to open in Montreal within the coming weeks. Another 18 applications from 10 cities will be expedited, the government said this week.
The success of Insite has sparked interest across North America; groups in Seattle, San Francisco and New York City, among others, are currently exploring the creation of similar facilities.
The Canadian government’s emphasis on safe injection sites comes amid criticism that it has done little to address the devastation being wrought by fentanyl – a drug that is 50 times stronger than heroin – and other opioids across the country. “We know that at minimum in Canada, there were 2,300 Canadians that died last year of an opioid overdose,” Philpott told a conference in Montreal this week. “The death toll is worse than any other infectious epidemic in Canada, including the peak of Aids deaths, since the Spanish flu that took the lives of 50,000 people a century ago.”
Her keynote address was interrupted by protesters, who unfurled a banner reading: “They talk, we die.”
On Friday, the Canadian Nurses Association described the new law as a good start. “We do think it’s a definite significant improvement over the previous government’s legislation,” said Barb Shellian, the organisation’s president.
The new legislation sets out five categories of requirements, including a letter of support from a provincial or territorial minister and evidence of the site’s intended public health benefit. Amendments added in by the country’s senate also require a minimum 45-day period for public consultations and encouraging staff to offer pharmaceutical therapies before a client can use illicit drugs. “In a perfect world we would have preferred to see some of those five not be there, specifically ones about offering access to rehab on every single visit,” Shellian said. “But we recognise the victory when we see it.”
The organisation will continue to carefully monitor the law to ensure the requirements do not hinder the creation of these much-needed facilities, she added. “These people are someone’s brother, someone’s sister, someone’s mom. And we need to pay attention to this absolutely desperate epidemic that is happening in our country right now.