SCC OKs Safe Injection Sites

September 30, 2011 11:08 AM

SCC approves safe injection sites. The Supreme Court of Canada today ordered the federal government to stop its efforts to shut down a safe injection clinic in Vancouver, opening the door to more clinics opening across the country.

In its 9-0 decision, it said the federal government has the jurisdictional right to use criminal law to restrict illicit-drug use – but that the concerns it cited in an attempt to close Insite were “grossly disproportionate” to the benefits for drug users and the community.

“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 Court said. “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 clinic in question has been discussed previously on MeFi]

Text of the decision.

posted by modernnomad (35 comments total)

Hooray for common sense. Diseases like AIDS that can be transmitted via needle are a risk to the community as a whole, not just drug users. (Though the risk to the users is certainly enough to pursue sensible harm reduction policies like safe injection)
posted by furiousxgeorge at 11:10 AM on September 30, 2011 [2 favorites]

Ooh, the Harper government got spanked by the SCC! This makes me smile.

If those safe injection sites prevent even ten people a year from getting HIV, they pay for themselves. And I bet they do that and much, much more.
posted by orange swan at 11:14 AM on September 30, 2011 [2 favorites]

Well it's about time.
posted by ubermasterson at 11:18 AM on September 30, 2011

The Canadian government also has to pay InSite's legal costs, which is a nice slap in the face.
posted by vansly at 11:23 AM on September 30, 2011 [6 favorites]

As well as the happy outcome, it is also a very significant decision constitutionally. It balances the Federal governments rights/responsabilities for criminal enforcement with the Provincial madate for health. The court is saying very clearly that public heath benefits can trump the criminality of the act. This could have implications for other drug issues too, for example.
posted by bonehead at 11:24 AM on September 30, 2011 [6 favorites]

Well at least there's still the Supreme Court.


For now.
posted by mazola at 11:26 AM on September 30, 2011 [5 favorites]

I wonder what would happen if Susan Anton becomes mayor. Or is that even possible? From what I can tell, the NPA is not even running a full slate in the municipal elections, so I guess Insight is safe for the next 3 years or so, anyway.
posted by KokuRyu at 11:28 AM on September 30, 2011

This is good news.

I also made an InSite FPP a while back.
posted by Alvy Ampersand at 11:28 AM on September 30, 2011

This is great. Also, what bonehead said.
posted by chemoboy at 11:31 AM on September 30, 2011

Good. Hell, it's great.
posted by GuyZero at 11:33 AM on September 30, 2011 [1 favorite]

As well as the happy outcome, it is also a very significant decision constitutionally. It balances the Federal governments rights/responsabilities for criminal enforcement with the Provincial madate for health. The court is saying very clearly that public heath benefits can trump the criminality of the act.

Actually, the Court did not rest its decision on the constitutional division of powers issue, but on the s. 7 Charter violation that would have occurred had the federal exemption to Insite not been extended.

On my reading, the SCC actually affirmed that the federal Controlled Drugs and Substances Act would trump provincial health legislation in this case, had a Charter claim not existed. From the decision: "The criminal prohibitions on possession and trafficking in the CDSA are constitutionally valid and applicable to Insite under the division of powers. First, the impugned provisions of the CDSA are, in pith and substance, valid exercises of the federal criminal law power. The fact that they have the incidental effect of regulating provincial health institutions does not mean that they are constitutionally invalid."
posted by Urban Hermit at 11:35 AM on September 30, 2011 [3 favorites]

Suck it moralist politicians!

Harm reduction for the win!
posted by porpoise at 11:56 AM on September 30, 2011 [5 favorites]

THANK GOD.
posted by monkeymike at 12:04 PM on September 30, 2011

As a former needle-using junkie, this makes me so happy. I only wish that the policies of our northern friends held more influence here in the U.S
posted by item at 12:06 PM on September 30, 2011 [2 favorites]

Heh. This is what my morning has been about. This is such a huge victory. Here are a few more good links:

-- legal analysis from one of the lawyers

-- "Insite saves lives. Its benefits have been proven. There has been no discernible negative impact on the public safety and health objectives of Canada during its eight years of operation," the ruling said, written by Chief Justice Beverley McLachlin.

-- BC Health Minister's statement
posted by gingerbeer at 12:12 PM on September 30, 2011 [1 favorite]

WOO HOO!!!
posted by rtha at 12:17 PM on September 30, 2011

Suck it moralist politicians!

Huh? The people in this debate who most like to trumpet their moral superiority are on the side of Insite.
posted by Dasein at 12:18 PM on September 30, 2011

From gingerbeer's links:

The SCC says that – absent any Charter issues – the CDSA applies and can oust health care because of another constitional doctrine: paramountcy.

but:

...the [Federal] Minister’s failure to continue an exemption of the CDSA [criminal drug laws] was a Section 7 infringement.

That's the right to life, liberty or security of the person without being in accord with the “principles of fundamental justice”.

From the judgement itself:

This requires the Minister to consider whether denying an exemption would cause deprivations of life and security of the person that are not in accordance with the principles of fundamental justice. The factors considered in making the decision on an exemption must include evidence, if any, on the impact of such a facility on crime rates, the local conditions indicating a need for such supervised injection site, the regulatory structure in place to support the facility, the resources available to support its maintenance, and expressions of community support or opposition.

So, evidence of effectiveness and the provincial and municipal laws present can't be ignored. Allowing an exemption can't just be a "moral" or political decision.

Different from what I thought, and more subtle. That will teach me to trust the G&M.
posted by bonehead at 12:23 PM on September 30, 2011

On the slightly more frivolous side, if you want to support Insite, you can buy this t-shirt.
posted by gingerbeer at 12:32 PM on September 30, 2011

If those safe injection sites prevent even ten people a year from getting HIV, they pay for themselves. And I bet they do that and much, much more.

Yes, the biggest advantage created by this site is the ability to treat ODs as soon as they happen. They had a guy on the CBC this morning talking about how the safe injection site saved his life, even though he doesn't remember it, when he OD.
posted by Mitheral at 12:43 PM on September 30, 2011

Doesn't it save money in emergency response and hospital time as well?
posted by captaincrouton at 12:48 PM on September 30, 2011 [1 favorite]

That's great news. The US still seems to be stuck in the arguing about syringe exchange programs step, but hopefully we will eventually get to the point of being able to legalize programs like this.
posted by Forktine at 12:52 PM on September 30, 2011

It saves money, it saves lives, it gets people off drugs, it reduces crime in the neighborhood. It wins on every level. The best the Harper government could do was set up false dichotomies, like saying this takes money away from prevention.

Here's a summary of all the research on Insite. The cost-benefit studies are in there, and they showed that it is the cost savings from averted cases of HIV that produce the greatest cost effectiveness.
posted by gingerbeer at 12:57 PM on September 30, 2011 [3 favorites]

"Serious drug addiction is not a moral choice; it is an illness which essentially negates the notion of “choice” altogether, Chief Justice McLachlin said. She said that adopting a moral attitude toward an addict's “choices” – as the federal government did – was simply the wrong approach to take. " --CBC article

I can't tell you how happy this makes me feel. I do policy-relevant scientific research and those of us in Canada, including my colleagues in public health, are often frustrated to the point of despair at how difficult it is to inject evidence into policy. Unlike the US with its systems of national labs and regular reports to Congress, in Canada methods for reporting scientific information to policy-makers are ad hoc and ineffective. And what happens again and again is that the country makes a policy that will not do what is best for the country, or even will not do what the policy-makers want it to do or think it will do, because the information we have gathered to understand the problem is simply ignored.

It doesn't get much more slam dunk, open and shut than Insite. It saves hundreds of lives, it reduces the spread of disease, it encourages people to go to rehab and thus actually helps solve addiction, all with no negative effects to the public. We have study after study confirming this and a unanimous voice from the academic and public health community, joined by the police department, city government (three past mayors, by no means allies on every issues), and the provincial government, which despite the name of the party is conservative. We're at a point where we KNOW what the best choice is. If your interest is public welfare, which should be the interest of any government, then there is no debate. Or at least, there should be no debate. The vigorous court challenge by the Federal government has therefore been so tremendously frustrating. It's as if they don't think the lives of addicts are worth saving; that if you "choose" to take drugs you no longer deserve help. The numbers must stare them in the face and they must be willfully blind.

But moreover it is part of a disturbing pattern of repression of science in the conservative government whenever it conflicts with conservative political goals or ideology. For example, new restrictions on government scientists preventing them from speaking them to media: a fisheries researcher recently published a landmark study in Science and all the journalists that came calling were turned away and handed government talking points. The message is clear: the conservatives have an agenda and a vision for this country, and those views which dissent are not welcome, evidence and facts be damned.

So finally, finally, finally, a victory for common sense, and a vindication for evidence, facts, and science over what I can only describe as ideology and ignorance. We were all holding our breath, because a loss here would signal the death of public health research and indeed all policy-relevant research in Canada. Because if a slam dunk fails, what's the god damned point. But we won, and we can carry on the struggle to make this country a better place, having faith that our efforts have a chance of doing good. Thank God.
posted by PercussivePaul at 1:04 PM on September 30, 2011 [12 favorites]

> Doesn't it save money in emergency response and hospital time as well?

Anecdotal evidence, but a paramedic friend saw a distinct drop in their calls to their 'regulars' in the DTES after InSite got going.
posted by N-stoff at 1:31 PM on September 30, 2011

Dasein - morality vs. ethics.

It's sure nice to see that the Canadian Supreme Court made the decision based on actual facts and weighed all the benefits and detriments of keeping InSite open, rather than rely on opinions such as "Drugs are bad. People who use drugs are bad. Bad people don't deserve help/kindness."
posted by porpoise at 2:12 PM on September 30, 2011 [1 favorite]

'ERE WE GO VA~N, 'ERE WE GO! HOOO! HOOO!
posted by Slackermagee at 2:20 PM on September 30, 2011

I like very much that one of the comments on the CBC story on the Insite ruling has a comment from a reader who disagrees with the ruling. He criticizes "the 'so-called' Supreme Court of Canada," (and goes on to post his counterargument cribbed from Paul's letter to the Galatians).

It is hard to know where to begin.
posted by ricochet biscuit at 4:01 PM on September 30, 2011 [1 favorite]

New Democrat MP Libby Davies, whose riding includes Insite, immediately called on the Harper government to abandon its ideological opposition to the facility.

"I don't believe any of them ever went there, they never took the time to really find out what Insite was about," she said.

"They always took this political, partisan, ideological position. And I want to say to them, have you now understood and learned the importance of what Insite is about, and how it's so much a part of our community?"
posted by gingerbeer at 4:09 PM on September 30, 2011 [2 favorites]

As a Vancouverite, this makes me very happy indeed. Nice to see The Hair That Walks Like A Man not get his way, especially in light of his career long extremely bizarre relationship to those pesky 'facts' things.
posted by Phlegmco(tm) at 8:05 PM on September 30, 2011 [1 favorite]

"The court is saying very clearly that public heath benefits can trump the criminality of the act".

Finally!

Now, if only we had an adequate and tolerable health care system. I know many addicts who are banned from hospitals, clinics, doctor's offices etc... (yes, it does happen in Canada!).

I hand out needles and rigs on a daily basis - much to the daily criticism by the public. It's a great victory legally, the convincing the voters is a whole other ball game.
posted by what's her name at 8:27 AM on October 1, 2011 [2 favorites]

This is good news, hooray for common sense. Keep up the good work InSite.
posted by arcticseal at 8:35 PM on October 1, 2011

A diplomatic cable shows U.S. officials opposed the Insite supervised injection site in Vancouver and wanted the federal and municipal governments to shut it down.
posted by gingerbeer at 9:42 PM on October 1, 2011

I'm pretty sure the best way to get the Canadian government to do something is for the US government to vigorously oppose it.
posted by miyabo at 9:49 PM on October 1, 2011

Miyabo, that was before Harper. If the US wanted to go to war against a new country today for some BS reason, I bet Harper would try to get us to go join up.
posted by Iax at 10:04 PM on October 1, 2011