A Health and Human Rights Approach to Substance Use
Insite: making history
Insite, Vancouver’s supervised injection site, is a harm reduction program where individuals who inject drugs can do so within a comprehensive multiple service health care setting, reducing the risk of overdose death, blood borne infection, harassment and arrest.
On September 30th 2011, the Supreme Court of Canada ruled against the federal government’s attempts to close Insite. The ruling found the government’s efforts in contradiction of Section 7 of the Canadian Charter of Rights and Freedoms: The right to life, liberty and security of the person.
An important step closer
The Supreme Court’s Insite decision acknowledged the tension between Canada’s drug control legislation, the Controlled Drugs and Substances Act, and the right to critical evidence-based health services for people who use drugs.
The decision to instruct the government to support these services by issuing a permit for Insite to operate took Canada a step closer to realizing a more comprehensive approach to substance use.
Shifting policy and practice
Insite showed us that a comprehensive approach to substance use requires shifts in policy and practice at the national, international, regional and local levels.
When these shifts occur, policy and practice will:
- reflect the best available evidence,
- openly acknowledging the obligation to uphold human rights,
- measurably decrease the marginalization of minority groups, and
- seek to eliminate the social conditions that contribute to problematic drug use.
Together, services and supports for people who use drugs, including law enforcement and public safety initiatives, will become a more integrated, effective multidisciplinary response system.
A public health approach
A comprehensive strategy takes a Population Health approach, which considers the health needs of groups of people, rather than individuals. “It considers the entire range of factors that determine health – including factors such as employment and income, social support, education, housing and health services” (Healthy Minds, Healthy People. Province of BC, 2010). These factors are referred to as the social determinants of health.
The World Health Organization defines the social determinants of health as:
“the conditions in which people are born, grow, live, work and age, including the health system. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels, which are themselves influenced by policy choices. The social determinants of health are mostly responsible for health inequities – the unfair and avoidable differences in health status seen within and between countries.”
Substance use takes place on a spectrum – from beneficial to problematic. Appropriate responses are required in order to maximize benefits and minimize the harms related to substance use.
The Spectrum of Psychoactive Substance Use
Please join us in advocating a public health and human rights approach to drug problems in Canada.