In today’s world, should it really be a radical notion that drug users deserve the same health rights as people who do not use? When it comes to drug use, prejudice and emotion often trump undeniably beneficial, evidence-based policy. Contrary to the “tough on crime” ideology of the Harper government, stigmatizing and imprisoning drug users is not for the good of individuals or society. With the passage of Bill C-2, which received royal assent on June 22nd, Canada has opened the door to the unnecessary suffering and death of people who are often already severely marginalized.
Bill C-2, which is ironically named the “Respect for Communities Act,” amends Section 56 of the Controlled Drugs and Substances Act to add 27 new criteria to opening or maintaining Supervised Injection Sites (SIS). SIS are places where injection drug users (IDUs) can consume illegal drugs in an indoor environment in the presence of nurses who provide medical and social support and supervision. These services provide clean needles, discard used needles, allow nurses to intervene in overdoses, and give individuals (who may otherwise be difficult to reach because of homelessness or other factors) access to rehabilitation, counseling, condoms, and a variety of other services that are essential to any person’s well being and dignity. SIS are founded on an ideology of harm reduction; instead of idealistic thinking and moral condemnation, harm reduction offers pragmatic and compassionate resources to people who use.
Bill C-2 gives an unreasonable amount of power to uninformed or biased groups to object to new SIS being opened. Certain community groups and police associations may have vested interests in keeping the status quo of absolute prohibition, and their opinions and ideologies should not be placed above empirical evidence when it comes to dictating public health policy. One of the new amendments irrationally does not allow anyone with a criminal record to be work at an SIS. This ignores the fact that those who have been to prison on drug-related convictions and achieved sobriety frequently make the best addiction counselors. This amendment takes community-based support away from people who use, replacing harm reduction workers who have lived experience of marginalization with individuals who may be less sympathetic or relatable.
The history of SIS both in Western Europe and in Canada has shown that these services are undeniably beneficial, life-saving, and cost-effective. Supervised injection sites have existed in Western Europe since the late 1980s, with over 90 locations currently operating in the region. There is a wide body of research proving that SIS are positive for drug users and society in general. In 1999, Portugal decriminalized possession, and implemented SIS and other harm reduction policies. Ten years later, a national study showed that there were less people using drugs, less crime associated with drugs, more people in treatment, and a decreased transmission of bloodborne diseases.
During the 1990s, Vancouver’s Downtown Eastside community had HIV transmission rates similar to those of Sub-Saharan Africa. As a response, ground level advocacy groups pushed for the adoption of a SIS. In 2003, Insite was founded and the social and scientific research produced as part of its mandate has been overwhelmingly positive. While Bill C-2 implies that SIS increase local crime, thorough comparative research shows it causes either no change or a decrease in crime.
Between 2004 and 2010 there were 1418 overdoses at Insite, with not one resulting in a fatality. Cost analyses vary, but they all reveal a net positive, for both lives and money saved. It is estimated that Insite prevents more than 2 fatal overdose deaths per year and up to 80 new HIV cases annually. The prevention of these diseases saves the government millions of dollars. After Insite opened, there was a 35 percent decrease in overdose deaths in the area near Insite. Above Insite is Onsite, a highly used drug detox and treatment center. In October 2014, a toxic batch of heroin circulated Vancouver and caused 31 overdoses in two days at Insite, none of which caused premature death.
Regardless of the concrete evidence in favour of Insite, the Harper administration attempted to close it in 2011 with Bill C-65. The Supreme Court of Canada ruled that the right to health and safety should come before adherence to strict criminalization. The ruling cited section 7 of the Charter of Rights and Freedoms, which gives all individuals the right to life, liberty, and security of person.These life-saving services are a fundamental human right, as outlined by Canada’s charter. Bill C-2 stands in blatant opposition to the 2011 ruling, the droves of scientific evidence supporting SIS, and the very nature of our Charter rights.
Toronto, Ottawa, and Montreal, are cities with high concentrations of injection drug users that would benefit greatly from SIS. It is highly probable that the creation of SIS in all major Canadian cities would save countless lives and millions of dollars of taxpayer money per year. It is estimated that an SIS in Montreal could prevent over 11 new HIV cases a year. When Insite seeks renewal of its exemption status in 2016, it may not meet the new unreasonable criteria and is at risk of being shut down.
Supervised injection sites have international approval from the UN’s Declaration on HIV Prevention, as well as the World Health Organization. Associations of nurses, social workers, public health professionals, researchers, lawyers, and officials at all levels of government have also openly supported these services. The opposition to harm reduction services often comes from individuals and groups with political agendas guided by opinions grounded in rigid morality, and who have no practical experience with the issues.
A survey of 1407 Ontarians concluded that 60 percent of the province’s adult population is in favor of adopting SIS. Public opinion is a fundamental component of how policy and legislation should be adopted, in democracies. Creating obstacles for new and existing supervised injection sites to be able to operate is not only against concrete evidence and public opinion, it will have real world fatal consequences. Denying these services will allow preventable deaths and the spread of disease. It will cost taxpayers millions of dollars. When there is a clear life saving policy, preventing its adoption is unjust and inhumane. The Canadian public must consider this legislation as hostile to our values and fight to challenge Bill C-2. We must call for the end to harmful criminal enforcement of irrational drug laws. Treating drug use as a physical and mental health concern instead of criminal is demonstrably the best way to prevent drug-related harm.