Safer Consumption Services – Plans are Underway for More Than Two

Several cities in Canada are planning for the implementation of safer consumption services in their communities.

That was the conclusion of the speakers at a lively event on the feasibility of scaling up supervised consumption services in Canada held at the recent Canadian Association of HIV Care (CAHR) conference in Vancouver. Sponsored by the Dr. Peter Centre, the Canadian HIV/AIDS Legal Network and the Canadian Drug Policy Coalition, this half-day workshop brought together speakers from Ottawa, Montreal, Toronto and Vancouver to discuss their plans for the scale-up of these services across the country.

The most famous of these services is Insite, located in Vancouver, BC. The vast amount of evidence from the reviews conducted on Insite suggest that this unique service has several beneficial outcomes: it is used by the people it was intended to serve, which includes over 10,000 clients. And it’s being used by people who might ordinary inject drugs in public. This service has also reduced risk behaviours by reducing the sharing of needles and providing education on safer injecting practices. Insite has promoted entry into treatment for drug dependency and has improved public order. It has also been found to reduce overdose deaths, provide safety for women who inject drugs, and does not lead to increased drug use or increased crime.[i]

But public opposition and political fears still plague the scale up of these services. Despite well-documented benefits, opponents still claim that these services “promote” illegal drug use. These claims are based on the false assumption that failing to provide health care services to people who use drugs will dissuade drug use itself. All this does is drive people away from health care and into less safe injecting practices that can result in injury, infection and death. These opponents fail to appreciate that these services promote engagement in health care for hard-to-reach populations, and protect the dignity of people who use drugs by prioritizing their health care concerns.

Formal opposition coming from the federal government has stalled the implementation of these beneficial services even in BC. In 2007, the federal government refused to grant a continuation of the legal exemption to Insite (Section 56 of the Controlled Drugs and Substances Act (CDSA)). Proponents of the site, including the PHS Community Services Society, VANDU, and Vancouver Coastal Health, challenged this refusal all the way to Canada’s Supreme Court. In 2011, that Court ruled in favour of the exemption noting the rights of people to access this health service, and ordered the federal Minister of Health to grant a continuation of the exemption. Future sites will be required to make an application for a section 56 exemption to avoid criminal charge for violations of the CDSA.

It looks like the process of making an application for a Section 56 exemption will be onerous. Because of these challenges, some speakers at the CAHR conference urged the audience to consider other options like less expensive unsanctioned sites that use peer-run models of care.

The need is clear – the will is there – the results are in.  Let’s urge the federal government to make access to these services as easy as possible so we can save lives, prevent illness and protect the dignity of people who use drugs.

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