A triumph for Insite

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Photo: Russell Maynard

During its eight years of operation, Insite has been proven to save lives with no discernible negative impact on the public safety and health objectives of Canada. The effect of denying the services of Insite to the population it serves and the correlative increase in the risk of death and disease to injection drug users is grossly disproportionate to any benefit that Canada might derive from presenting a uniform stance on the possession of narcotics.

- The Supreme Court of Canada, Sept. 30, 2011

Maxine Davis is the executive director of Vancouver's Dr. Peter AIDS Foundation. In 2002, it was the first organization in North America to offer supervised injection services, 18 months before Insite opened in the Downtown Eastside. Dr. Peter AIDS Foundation was an Intervener in the Supreme Court of Canada hearing.

She describes her feelings about the Supreme Court's landmark ruling which orders the federal government to ensure that Insite remains open.

Cathryn Atkinson: What is your reaction to the Supreme Court decision?

Maxine Davis: It's more than I had hoped for -- I am very proud to be a Canadian today. It's a triumph for Insite and drug injection users. The Supreme Court went beyond what I'd expected and the federal minister will have to consider Section 56 exemptions for other healthcare providers, where similar benefits [for injection drug users] could be derived.

Where there is a city or town in this country that needs supervised injection service... They can now ask for a Section 56 exemption as well.

The Dr. Peter Centre model of integrating supervised injection into a health clinic is going to be very helpful for other towns and cities, certainly we've already over the years had healthcare leaders from other places come to learn how we do it.

CA: How can what has been learned at Insite and through your centre be used elsewhere?

MD: We have very well-established practice standards here for how we operate. The same as those at Insite. The positive thing is that there are already pre-established standards of practice from the British Columbia College of Registered Nurses.

Also, it is worth noting that in March this year the provincial medical health officer produced a report that recommended that supervised injection services be integrated into public health clinics, using the Dr. Peter Centre model.

CA: I understand that the Dr. Peter Centre was also involved in the Supreme Court case.

MD: We were an intervener in the court case because we felt we had something important to say because of our experience. We needed to air our voices to be able to continue. A Supreme Court judgement would be specific to Insite, but would have implications for us. It was a case of stand up and be counted.

CA: Why did the Harper government not come after you?

MD: That is a good question that I can't answer. One would have to ask the federal government. 

CA: Do you think it may have been that Insite had a very prominent media profile?

MD: Yes. It may be that ours was the far lesser profile, though we were very public from almost day one. About two months after we initiated the service, we were at a press conference in 2002 and were front page of The Vancouver Sun the next morning.

Later, it was a different era, with the Conservative government refusing to provide Insite with an extension -- things were already underway for Insite, for scientific study [proving its effectiveness]... but it was a different political climate.

CA: What is the difference between yourselves and Insite?

MD: The difference is scope. Insite is specifically set up as a supervised injection site; on a daily basis it oversees 500-600 injections. The Dr. Peter Centre has 375 registered participants in the day program. We are first and foremost an HIV-Aids facility -- people focused on are mostly those at-risk with deteriorating health. Our clients are HIV positive, many have serious mental illness issues, and longstanding addiction and unstable housing.

They would come from surrounding neighbourhoods to the West End, where we are based, for all our services.... Definitely people are there who use both Insite and us, but not the vast majority.

CA: How do you describe the Supreme Court decision?

MD: It's a complete victory. The decision was unanimous, which is unusual for the Supreme Court. I didn't expect them to be so explicit in directing the minister -- that he also had to consider other Section 56 requests. I thought it would be a decision on Insite and the rest of us would have to read between the lines. But they were very, very clear. It was unexpected.

They were also very direct in stating how grossly disproportionate the original decision was by the minister. It was remarkable to see them be explicit in describing how the minister erred and that this was a violation of people's Charter Rights.

CA: Are Insite and the Dr. Peter program now safe?

MD: The futures of safe injection centres are secure. I was in discussion with our lawyer earlier today, and it's a pretty clear direction [by the court].

CA: I've seen some commentary that says the Harper government may go after the Supreme Court now.

MD: When it's a unanimous decision by a court like this one was, I think it should be quite sobering for a government. You can't even say it was a split decision. They'd be hard press not to comply with this judgement.

It really is so remarkable that the opportunity is now there for all Canadians who use injection drugs to potentially have access to this healthcare.

CA: How many lives do you think the decision will save?

MD: Back before Insite opened, about 300 people would die per year of overdose deaths in Vancouver. But it is certainly not just about saving lives, it is also about them leading healthier lives -- it validates the dignity of healthcare for injection drug users.

I would think it must be so meaningful for them today to think they are equal citizens of this country. Section 7 of the Charter of Rights, security of person, is there for them. We're all standing together in the same place as citizens of this country.

Cathryn Atkinson is rabble's news editor.


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