Pubdate: Mon, 12 Jan 2015
Source: Globe and Mail (Canada)
Copyright: 2015 The Globe and Mail Company
Contact:  http://www.theglobeandmail.com/
Details: http://www.mapinc.org/media/168
Author: Mike Hager
Page: S1

INJECTION SITE SUPPORTERS SAY TORIES ARE HEEL DRAGGING

Three years after the Supreme Court of Canada cleared the way for more
supervised injection sites, Canada still only has its original
Vancouver facility and proponents for others across the country say an
onerous process to get approval is likely to become even more
difficult with a new law expected to pass this spring.

Only one new application for a supervised injection site has been
forwarded to Health Canada since the ruling in September, 2011.

Public-health officials and advocates are worried that the agency is
"dragging its heels" in anticipation of Bill C-2, which will add many
more steps for applicants wanting an exemption to Canada's drug laws
needed to run such a facility.

The top doctors of Canada's 19 largest cities support supervised
injection sites, but only Vancouver's Dr. Peter Centre for the
long-term care of AIDS patients has applied to Health Canada for
approval of its model.

The centre has been quietly providing supervised injections in a
residential facility, a much smaller scale than the InSite facility on
the city's Downtown Eastside.

A proposal to open four sites in Montreal is next closest to
applying.

It was delayed by Quebec's provincial election last year and is now
being evaluated by Quebec's Public Health Minister.

Its proponents are hopeful the proposal will be sent to Health Canada
for approval this spring.

Louis Letellier de Saint-Just, a lawyer with the Canadian HIV/ AIDS
Legal Network and chairman of the Cactus needle exchange, said the Dr.
Peter decision will be a bellwether for the Montreal project.

"The worst scenario will be a refusal," Mr. Letellier de SaintJust
said.

He added he wouldn't be surprised at a rejection for Dr. Peter's
plan.

"This government does not give any surprises any more. We know what
they want and what they don't want, but it would be a disaster. =C2=85

"We know it's going to be a battle but I don't want to give them the
impression that we're not fighting."

Patricia Daly, head of the Vancouver Coastal Health authority that
jointly operates the Dr. Peter facility, is worried that when Bill C-2
becomes law later this year, stringent new rules could make it almost
impossible to receive the formal exemption to Canada's Controlled
Drugs and Substances Act needed to run such sites.

"The Conservative government has made it very clear that they do not
support these kinds of harm-reduction services," Dr. Daly said. "The
good news is people in Vancouver support this service."

Dr. Daly's staff filed an "eight-inch thick" application to Health
Canada last February so the Dr. Peter model might one day be
replicated across the region.

"I could understand that [delay] if we were a brand new facility in a
new neighbourhood, but this is something that is supported by the
municipal government, the provincial government and health-care
providers at St. Paul's Hospital, right next door," Dr. Daly said.
"And yet it's taken them a year and they still haven't given us an
answer."

A Health Canada spokesperson said the agency would not comment on the
ongoing application.

Up to 63 per cent of the Dr. Peter Centre's supervised injection
clients have received addiction counselling and about 30 per cent have
been referred to withdrawal management or other long-term programs,
the centre says.

"Chronically optimistic" advocates such as Ottawa's Rob Boyd say they
are watching the Dr. Peter Centre's application closely and want to
open sites in their own cities, but the application process is already
taking years under the existing laws.

Mr. Boyd is leading Ottawa's campaign for a supervised injection site
while directing the Oasis needle exchange at the city's Sandy Hill
Community Health Centre. He said he can spend only about six hours a
month on an application that is years away as he is too busy running a
program that serves about 600 regular users.

Ottawa's mayor and police chief have consistently opposed a supervised
injection site in their city, in which Mr. Boyd says 30 people died of
overdoses last year.

"You have to be optimistic and at the end of the day it's the right
thing to do," Mr. Boyd said. "The default is unsupervised injection
and I don't know why anyone would support injection drug use [out] in
the community."

In 2013, Toronto's Board of Health asked Ontario to open a
supervised-injection site, but the provincial government refused,
citing the federal Conservatives' opposition to such harm-reduction
practices.

Over the past several years, advocates from Toronto, Edmonton, Ottawa,
Victoria and some other cities have met every six weeks as part of a
national working group on supervised-injection sites organized by the
Canadian Drug Policy Coalition, an organization of harm-reduction NGOs.

During the teleconferences, advocates plan, share data and commiserate
as they try to get supervised injection sites up and running in their
cities, according to director Donald Macpherson.

Mr. Macpherson said the Dr. Peter Centre application and the
forthcoming proposal out of Montreal are backed by public health
authorities whose familiarity with consultation processes means both
have garnered strong support from the public.

Mr. Macpherson said Health Canada is "dragging its heels" in reviewing
the Dr. Peter Centre application and that he "can only surmise that
that has to do with political pressure on bureaucracy."

"The Dr. Peter Centre is not rocket science; it's a very
straightforward, successful facility."

In the future, Mr. Macpherson said Canada's supervised injection sites
will look less like the large and expensive InSite on Vancouver's
Downtown Eastside and more like the smaller Dr. Peter Centre model.

"Globally, all of the experience in Europe, Australia and Canada there
is really no downside," Mr. Macpherson said. "Injection sites will
fade into the background as they have in Europe.

"In Europe, they're just a very small - but important - part of the
larger continuum of (harm-reduction) services."

Dr. Daly said her staff plan to file for a one-year renewal of
InSite's exemption, which expires in two months.
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