Pubdate: Thu, 29 Dec 2011
Source: Montreal Gazette (CN QU)
Copyright: 2011 Canwest Publishing Inc.
Author: Henry Aubin


Logical Objections Valid But The Need To Save Lives Should Take A
Higher Priority; The Sites Should Be Opened Soon

The Tremblay administration has given conditional support this month 
to the city getting its first legal druginjection site - a clean, 
well-lighted place inside of which drug users could shoot up cocaine, 
heroin or anything else, with a nurse on hand to supervise. Indeed, 
city hall wants three - count 'em, three - such sites. Plus, for good 
measure, a large van could travel around the city offering the same 
service to a less mobile clientele.

Granted, this service makes no sense at all from a logical 
perspective. On the one hand, the state enforces the law prohibiting 
these drugs; on the other, it would provide a setting for consuming them.

But cold logic is irrelevant here. A moral imperative overrides 
consistency: Life is sacred, and supervised injection sites can save lives.

The experience of North America's first such site in Vancouver 
convinced all nine Supreme Court of Canada justices in September that 
such a service could prevent overdose deaths, avert the spread of 
disease from dirty needles and assist the entry of addicts into detox 
programs. In rejecting the Harper government's logic-based argument 
for closing the site, the court ruled that respect for the Charter of 
Rights and Freedom's guarantee to "life, liberty and security of the 
person" trumped enforcement of anti-drug laws.

In response to the ruling, the city's department of public health 
published this month a report recommending the creation of the three 
injection sites plus the one on wheels. The member of the city 
executive committee responsible for social development, Jocelyn Ann 
Campbell, immediately backed the plan in principle.

This swiftness is laudable: The report says that about 70 Montrealers 
die every year from overdoses and injection-transmitted diseases such 
as HIV and hepatitis C, and the sooner the sites are running the 
fewer deaths there'll be.

And yet it's easy to support this concept while still having concerns 
about its actual implementation. Would you want such a site in your 
neighbourhood? Me neither. Let those who would jeer "NIMBY" first put 
themselves in the shoes of those who'd be affected.

True, an injection site might reduce the number of needles in nearby 
alleys and parks, but it could also attract people with mental health 
problems, beggars and sellers of drugs.

Where would these sites be? The report's co-author, Dr. Carole 
Morissette, tells me they'd be downtown, on the Plateau and in 
Hochelaga-Maisonneuve. Her preference is that they'd be inside three 
community centres that already distribute free needles to drug users. 
(There are about 40 such centres across Montreal Island.) The most 
precise she gets is to say it is possible that the downtown site 
could be at the largest of these community centres, Cactus, which 
operates discreetly out of an attractive building (it looks like from 
the outside like a recreation centre) at the corner of Ste. Catherine 
St. E. and Sanguinet St.

In addition to the centres' staffers, each site would have one nurse 
on each of two shifts; the nurses would belong to CLSCs but would 
work full-time at the centres.

The Tremblay administration agrees with the report's conclusion that 
a multi-site approach is better than Vancouver's singlesite model: 
Several sites avoid concentrating social problems in one area.

Yet such a dispersal of facilities could also mean looser oversight 
and greater potential for abuse. Drugs and corruption aren't strangers.

The administration's Campbell prefers that the injection sites be 
inside CLSCs, hospitals or other health-system facilities. The 
argument for this approach is that it would make supervision easier. 
As well, the coming and going of these institutions' large staffs and 
their many patients might keep street life from getting too sketchy 
and prop up local shops.

The argument against injection sites inside such institutions, 
however, is that drug users would not feel relaxed - the facilities 
would be arms of officialdom - and that they might stay away. Maybe.

But maybe, too, there are ways to design injection sites inside or 
adjacent to such institutions in ways that feel more welcoming.

Location is key, and so far, there's been no real debate on it. Let's 
have one out in the open where residents can make legitimate concerns 
heard. The Office de consultation publique de Montreal, a credible 
and impartial body, could hold hearings.

But let's do it swiftly. Lives are at stake.
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MAP posted-by: Jo-D