A renowned HIV/AIDS clinic in Vancouver has received permission to operate Canada’s second approved supervised-injection site – the first such approval granted under the Liberals that signals a departure from the previous Conservative government’s staunch opposition to such facilities.
The Dr. Peter Centre, located in downtown Vancouver’s West End neighbourhod, has offered the controversial service since 2002 – one year before the opening of Insite, the dedicated supervised-injection site in Vancouver’s Downtown Eastside.
The Conservatives spent years attempting to shut down Insite, eventually losing at the Supreme Court of Canada, which ordered the government to allow the site to remain open. The Conservatives responded to that court ruling by introducing legislation to govern when a facility would receive an exemption from federal drug laws, but proponents argued the new rules were too restrictive and would make proposed facilities in cities such as Montreal and Victoria difficult, if not impossible, to open.
The centre submitted a formal application to Health Canada seeking a Section 56 exemption under the Controlled Drugs and Substances Act in February, 2014; the approval, announced Friday and valid for two years, ensures that nurses and clients will not be charged for activities related to injection services.
B.C. Health Minister Terry Lake said the approval is “excellent news for public health and safety” in Vancouver.
“The evidence is clear: supervised injection services prevent overdose deaths and saves lives,” Mr. Lake said in a statement. “They have become a valued part of health services in Vancouver and are an important part of our response to substance use and addiction.”
The harm-reduction service has been a lightning rod of controversy, with critics saying it facilitates the use of dangerous drugs and is an affront to federal laws. Supporters say it saves lives and reduces harm by, for example, offering users’ clean supplies and a sterile environment, preventing the transmission of HIV and other blood-borne viruses, and preventing overdose deaths.
Maxine Davis, executive director of the Dr. Peter AIDS Foundation, has long defended the service, saying both the College of Registered Nurses of B.C. and the College of Registered Psychiatric Nurses of B.C. confirmed it was within the scope of nursing practice.
The colleges support supervised injection for the purposes of preventing illness and promoting health, Ms. Davis said in an interview with The Globe and Mail last month.
“We are then upholding provincial law by permitting the nurses to practice this way,” she said.
“In terms of federal law, our position is that we take every measure to uphold federal law. Nurses don’t touch the drugs, they don’t inject the drugs and they don’t provide the drugs. That is the logic for when we started [in 2002] and it remains our position today.”
The Dr. Peter Centre, named after Peter Jepson-Young, a Vancouver doctor who documented his own battle with AIDS in the early 1990s, is B.C.’s only HIV/AIDS day health program and 24-hour nursing care residence.
Recently released figures show the centre’s clients show a markedly better HIV viral load suppression rate than other people living with HIV in B.C. According to the numbers, released last month, 80 per cent of the centre’s 359 clients are virally suppressed, compared to 57 per cent of other people living with HIV in B.C.
Published Friday, Jan. 15, 2016
Vancouver — The Globe and Mail
Statement from the Minister of Health - Health Canada Authorizes Dr. Peter Centre to Operate Second Supervised Consumption Site in Canada:
Health Canada has informed Vancouver's Dr. Peter Centre, a world-renowned HIV/AIDS treatment and support facility, that its application to operate a supervised consumption site has been approved. The application to Health Canada was jointly submitted by Vancouver Coastal Health and the Dr. Peter AIDS Foundation.
Supervised consumption sites provide a controlled space where people can bring their own illicit substances to consume under the supervision of health-care professionals, and gain access to other health and social services including treatment. International and Canadian evidence shows that, when properly established and managed, supervised consumption sites have the potential to save lives and improve health without increasing drug use and crime in the surrounding area.
The decision by Health Canada experts was arrived at after a rigorous, evidence-based review that included an assessment of the Centre's application, an inspection of the facility, and the establishment of terms and conditions to protect public health and safety.
To operate the consumption site, the Dr. Peter Centre has been granted an exemption from the Controlled Drugs and Substances Act. The Act provides the legislative framework for the control of substances that can alter mental processes and that may produce harm when diverted or misused. Supervised consumption sites require an exemption under the Act to ensure public health and safety requirements are met.
Compare this to what happened in Canada less than a year ago and rejoice in last fall's change of government!
Bill C-2 could impede harm-reduction sites, advocates say
The House of Commons has passed a bill that critics say will impede the operations of supervised consumption sites such as Vancouver’s Insite and endanger severely addicted Canadians.
Bill C-2, the Respect for Communities Act, consists of a host of new regulations that will make it much more difficult for a community service provider to open one of the harm-reduction sites. The new legislation will also complicate the process by which existing sites have to apply annually for an exemption from the Controlled Drugs and Substances Act to operate.
The bill passed its third reading in the House on Monday, by a vote of 143-108, and had its first reading in the Senate on Tuesday.
Adrienne Smith, a health and drug policy lawyer with Vancouver’s Pivot Legal Society, said the bill’s guiding principle is that the exemptions that allow supervised consumption sites to operate will be granted only in exceptional circumstances.
This is in contrast to a 2011 Supreme Court of Canada ruling in which the court found that supervised injection sites have been proven to save lives and that the health minister’s failure to provide an exemption was in violation of drug users’ constitutional rights to life and security of the person.
“The Supreme Court of Canada said the minister has discretion, but that discretion must be operated in accordance with the Charter of Rights and Freedoms,” Ms. Smith said. The court, at that time, ordered the Harper government to stop interfering.
Under Bill C-2, facilities that wish to run a supervised consumption site must meet a lengthy list of requirements, including: a letter from the head of the local police force; statistics and other information on crime, public nuisance and inappropriately discarded drug paraphernalia in the vicinity of the site; and a report on consultations with “a broad range of community groups.”
Background checks will also be required for those in charge at the facility, along with key staff members.
The Canadian Nurses Association says it is “disappointed” that the bill was passed in the House and “concerned” by the Conservative government’s “tough-on-crime position.”
“A government truly committed to public health and safety would enhance access to prevention and treatment services instead of building more barriers,” the association, which represents 135,000 registered nurses, said in a statement.
A statement to parliamentarians opposing the bill includes the names of about 120 signatories, including the Canadian AIDS Society, Vancouver Coastal Health and Toronto Public Health.
Federal Health Minister Rona Ambrose has been clear in her opposition to harm reduction measures, saying she instead favours “harm elimination.” Eve Adams, former parliamentary secretary to the Minister of Health, has defended the legislation by emphasizing the importance of thorough consultation with communities and other stakeholders before such a site can open.
But Ms. Smith says the additional requirements are so onerous that even a compassionate health minister could be unable to grant an exemption.
“What this bill does is prevent a minister from being able to exercise their discretion in accordance with the Charter,” she said. “It forecloses potential in lots of places and it makes existing centres face really unreasonable barriers to their continued operation.”
Anna Marie D’Angelo, a spokeswoman for Vancouver Coastal Health, which funds and operates Insite, noted that there have been more than 1.8 million injections done under the supervision of nurses at the facility.
“There have been no overdose deaths at Insite despite more than 1,500 overdose interventions, some of which have included full respiratory arrest,” she said.
A study published in The Lancet in 2011 found that fatal overdose deaths within 500 metres of Insite decreased by 35 per cent in the first few years of the facility’s opening. In comparison, overdose deaths decreased by only 9 per cent in the rest of Vancouver.
The Globe and Mail
Mar. 24, 2015