Pubdate: Thu, 17 Jul 2008 Source: Globe and Mail (Canada) Copyright: 2008 The Canadian Press Contact: http://www.globeandmail.ca/ Details: http://www.mapinc.org/media/168 Author: Jonathan Montpetit, The Canadian Press Bookmark: http://www.mapinc.org/hr.htm (Harm Reduction) Bookmark: http://www.mapinc.org/find?142 (Supervised Injection Sites) Bookmark: http://www.mapinc.org/topic/Insite (Insite) Bookmark: http://www.mapinc.org/find?137 (Needle Exchange) Bookmark: http://www.mapinc.org/people/Tony+Clement QUEBEC PLANS TO OPEN SAFE-INJECTION SITE IN MONTREAL Project Gains Momentum After Recent Court Decision on Insite; Health Officials Say It Could Be the First of Many Across the Province MONTREAL -- Health officials in Quebec are preparing to open a supervised-injection site in Montreal in the coming months and say it could become one of many in the province. The idea of creating a network of injection sites is already part of Quebec's public health plan, but a recent court decision in British Columbia has given the project momentum. "There is a team in Montreal looking at the feasibility and acceptability of all this, but there is no date set yet," said public health director Alain Poirier. "We're working on it at the moment and we hope there will be one soon." Vancouver is the only other city in North America home to a safe-injection site for intravenous drug users. Set up as a pilot project in 2003, Insite was operating under a limited exemption from federal drug laws until a ruling in May granted it a permanent constitutional exemption. British Columbia's Supreme Court declared Insite to be a health facility and said it was unconstitutional to prevent addicts from using its services. That ruling appears to have cleared one of the legal obstacles to similar sites opening in other parts of the country, namely running afoul of federal authorities. "It's an interpretation that views injection sites as health services and those are under provincial jurisdiction," Mr. Poirier said of the decision. "We're the ones who pay for the treatments of [addicts]; we pay for their care if they contract HIV. "In short, it falls under the panoply of preventive services." But as Quebec forges ahead, Prime Minister Stephen Harper's Conservative government could be in a difficult position and be forced to decide whether to oppose the progressive plans of a province where it needs votes. The Tories appealed the B.C. ruling earlier this month and federal Health Minister Tony Clement has claimed the Insite approach doesn't work. "We don't consider it the best health outcome to keep people in a position where they continue to use the illicit drugs, to inject the illicit drugs," he said in May. Mr. Clement's office wouldn't comment on Quebec's plans yesterday, other than to say it hasn't received a request for an exemption. Others expressed dismay the province is opting to follow Vancouver's lead. "We're in the business of helping them [addicts] get off drugs," said Gerald Sidel, the Quebec chair of the Canadian Addiction Counsellors Certification Federation. "The real struggle is between abstinence and the other side," said Mr. Sidel, who also runs an addiction treatment centre. "I think at this point in time more money and help should be provided to people who provide recovery services." Plans for a supervised-injection site in Montreal have been in the works for some time. Former Quebec health minister Philippe Couillard, who stepped down last month, was said to have been monitoring Insite's fate closely. Quebec already has close to 800 locations where heroin addicts and other intravenous drug users can exchange needles. For Mr. Poirier, establishing safe-injection sites is the logical next step. "We can't do this in hiding without saying or announcing anything," he said. "The public has to be aware that this is one step more." He acknowledged that the facilities in Quebec would be modelled partly on Insite, which offers addicts clean needles, a safe place to inject and access to counselling and detox. Insite enjoys a long list of supporters - law-enforcement officers and political leaders among them - who say it benefits users and the public by keeping drug use off the streets. It's that idea of harm reduction, coupled with the possibility of lowering health-care costs, that has Quebec willing to launch a project much more ambitious than Vancouver's lone site. "We'll probably start in Montreal, then look at Quebec City's downtown area," Mr. Poirier said. "We haven't ruled out other cities being chosen. "We would like to see sites where they are justified by the need." - --- MAP posted-by: Richard Lake