This summer Trevor Thomas wrote a series about supervised injection and his experience at a facility in Canada called Insite.
A woman with terrible arthritis came in on May 13 and so she couldn’t prepare her morphine injection—she couldn’t even hold a rig. The track marks on her arm were dark and bumpy. When I lifted her sleeve, I touched them. They felt like the rough spots on a globe that stand for mountains, or the brail underneath men’s room signs. A nurse and I cooked the morphine and pulled it up into a syringe.
After she injected, she fell into a state of deep relaxation. Enlightenment, some might say. Insite was her Bodhi tree and she had been meditating for 49 days—The Dharma in a syringe. But just like Buddha, she eventually got up. She started crying and wanted to call her mom, so I led her to the phone in the chill room. That was the first time they had spoken in years. May 13 was Mother’s Day.
This was the end of my first week in Vancouver. I was volunteering at North America’s only supervised injection facility, Insite, and this was just another day for me. A supervised injection facility is a type of clinic at which injection drug users can use under the direct supervision of healthcare professionals so that they do not overdose. Additionally, these clinics provide a supply of clean equipment so that users do not share with other users and thus promote the spread of HIV. Insite was opened in 2003 in response to the outrageous HIV/AIDS and overdose death statistics representing the Downtown Eastside. Since its opening, it has been the subject of numerous political debates in Canada, all of which involve the government’s will to shut it down.
There was a monumental Canadian Supreme Court case on the May 12 that was held to decide whether Insite could continue to aid ‘Canada’s Poorest Postal Code,’ or if Downtown Eastsiders would need to find a new method of addiction recovery. On Oct. 7 the decision was released that Insite would indeed continue to operate in Vancouver. The more than 700 people who use Insite daily, the hundreds of staff members who have worked at Insite and the thousands of people who support Insite around the world rejoiced that day.
It was a unanimous decision by the court for the reason that not allowing the facility to remain open would violate the Charter of Rights and Freedoms. Many interpret the unanimity as an embarrassing indication of the how invalid the arguments against Insite really were. As I mentioned in my previous articles, there has been absolutely no scientific evidence presented that shows Insite to be harmful in any way. The fact that this May 12 case is the third case from which Insite has emerged victorious only further supports supervised injection’s success in Vancouver. Stephen Harper and the conservative government have been challenging Insite solely with partisan and ideological arguments, and this was clearly demonstrated with the decision on Friday.
One of the most relevant implications of this ruling is that it yields the opportunity for other supervised injection sites to open across Canada. Officials in both Victoria and Toronto are already considering the option. Obvious and appropriate digression, however, must be used. Injection sites aren’t necessary in areas that do not reflect the needs of the Downtown Eastside—you wouldn’t open a facility in Durham, for example, because there is not an HIV or drug overdose epidemic in the area.
The Supreme Court stated that the ruling "is not a license for injection drug users to possess drugs wherever and whenever they wish," and "nor is it an invitation for anyone who so chooses to open a facility for drug use under the banner of a 'safe injection facility.'"
Another item worth notice is the discord created within the Supreme Court because of this case. Because one of the major factors encouraging the Insite decision was the empirical proof behind supervised injection, Canadian legislation now must confront the importance of scientific evidence when it comes laws that may worsen the state of a group of individuals. Academics infer that laws governing prostitution, assisted suicide, and minimum prison sentences might now be subject to change. In fact, the Ontario Court of Appeal says that it wants to reopen a case that significantly changed the country’s prostitution laws in light of the Insite decision.
An anonymous Supreme Court judge reported, “it will force us to look at policies and make difficult qualitative judgments about their effects. That is something that leaves a lot of us uncomfortable.”
With more than 1,400 overdoses having occurred at Insite, there is still yet to be a single death, a sobering reminder of this facility’s necessity in the Downtown Eastside and the importance of this decision.
“The federal government will look back and regret the day they took Insite to the Supreme Court,” said Maxine Davis, executive director of the Dr. Peters AIDS Foundation in Vancouver.
Oct. 7 was that day.
I would like to thank David Noble and the Noble Foundation for providing me with the support I needed to travel to Vancouver and observe at Insite. Additionally, I would like to thank Darwin Fisher and Russell Maynard for welcoming me to the facility in May.
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