Insite: Evidence, compassion and effectiveness overcome fear and reactiveness

I’m so deeply pleased to hear that the Supreme Court has ordered the federal government to allow Insite, Vancouver’s supervised injection site, to stay open. While on one level the case was about a battle of powers between the provincial and federal government – does health policy trump criminal law – at a deeper level it was a case about evidence based public policy. The question was, when lives are at stake and people will die as a result of a policy choice, can ideology trump evidence?

The answer, for now, is no.

Thank god.

It is great to know that data, analysis, evidence, along with compassion and effectiveness can overcome fear and closed mindedness.

For those unfamiliar with Insite, it is a needle injection site, where heroine users can use drugs under the supervision of a nurse. There has not been one death at the injection site since its opening in 2003 (unlike on the streets), and the facility reduces the spread of AIDS and other diseases, puts users in contact with the health system where they are more likely to ask for help and get into detox, as well as takes pressure off (and reduces costs) the regular medical system, in particular ambulatory services and the emergency room. In Vancouver, it is a measure that has support across the spectrum, from the left to the right.

To read more on the Supreme Court ruling it can be found here. My friend DR points out that paragraph 140 is particularly relevant. It is in this piece that the court discusses how the government may set policy, but it cannot do so in a way that violates Canadians “right to life.” Removing access to Insite diminishes greatly the prospect of an addict to not only live, but to find the help they need and so meets that test:

[139] Canada submits that exempting Insite from the prohibitions in the CDSA “would effectively turn the rule of law on its head by dictating that where a particular individual breaks the law with such frequency and persistence that he or she becomes unable to comply with it, it is unconstitutional to apply the law to that person” (A.F., at para. 101). Canada raises the spectre of a host of exempt sites, where the country’s drug laws would be flouted with impunity.

[140] The conclusion that the Minister has not exercised his discretion in accordance with the Charter in this case, is not a licence for injection drug users to possess drugs wherever and whenever they wish. Nor is it an invitation for anyone who so chooses to open a facility for drug use under the banner of a “safe injection facility”. The result in this case rests on the trial judge’s conclusions that Insite is effective in reducing the risk of death and disease and has had no negative impact on the legitimate criminal law objectives of the federal government. Neither s. 56 of the CDSA nor s. 7 of the Charter require condonation of crime. They demand only that, in administering the criminal law, the state not deprive individuals of their s. 7 rights to life, liberty and security of the person in a manner that violates the principles of fundamental justice.

There will be lots of coverage on this. I’ve already linked to the Globe article above. It also appears Maclean’s will be writing quite a it on this (good for them) as they have had some truly excellent and disturbing coverage on this issue in the past.

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