Supreme Court decision on Insite

Just woke up after night shift to learn the Supreme Court of Canada has ruled Insite, the controversial supervised injection site, can stay open.  I haven’t had a chance to dissect the ruling or contemplate what it means for the Downtown Eastside, although I’m sure it won’t end debate over the facility.  Some are already saying the decision paves the way for other supervised injection sites to open.

To read the entire Supreme Court decision on Insite, click here.

Insite opened in 2003, operating under a constitutional exemption to the Controlled Drugs and Substances Act. The exemption allows intravenous drug users to possess and consume otherwise illegal substances in the building under the eye of medical staff.

The legal history since 2003 has been complicated, as have the arguments for and against, which are outlined in this Globe and Mail piece.

I can’t wait ’til everyone’s comments begin rolling in.

I’m rushing off to spend the first day of my weekend in court, but tonight I’m being treated to one of the many perks of my job. I get to work the opening game at the revamped BC Place stadium between the BC Lions and the Edmonton Eskimos. I’ll try to sneak a couple of snapshots to share with you tomorrow.

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24 Responses to Supreme Court decision on Insite

  1. Lindyloo49 says:

    Ohhhh Boy, what a bad decision. Go back to the days when people were given methadone for their addictions. Help trying to get off if they want it. They will never get off the needle if it is given to them. You yourself said that there are people still shooting up in the allies because for one reason or another eg: they can’t wait, lines too long, nurses won’t help shoot up…

    • Chris says:

      It depends what you view as being the successful outcome of the service. If you want it to solve DTES drug problem, then it doubtless fails. If you want it to reduce some of the preventable externalities associated with drug use (HIV spread, overdose deaths), doesn’t it go some way to addressing these?

      What’s your take on a solution?

  2. pete1972 says:

    I am glad to see that a positive action is being kept alive and moving forward instead of a return to the blind eye to people fixing in the middle of wasted and pain.The idea has merit with a motivation towards treatment and recovery. The payout is in addicts not overdosing in filthy allyways.Larry Campbell, a city coroner at the time was a so appalled at the waste of human life and potential that his outrage managed to get him elected to the office of mayor. He enacted some new actions that have paid out life dividends for humanity. Not every junkie is a setting sun.
    Peace luv and happiness everybody… :)

  3. Silly Safety Girl says:

    I’ve always thought that Insite was a good idea. Yes, it’s not perfect, but we don’t live in a perfect world and sometimes you just have to work with what you’re given. No matter what we do, there will always be people who choose to use drugs and to use them in an unsafe way, the best thing we can do is to give them a safer option. People say that we should spend more energy and money on getting people off drugs, but having worked and lived with people with addictions before, there’s not a damn thing you can do to help them until they WANT to help themselves. Insite gives them a safe place to ask for help if they want it, and if not, at least help them to keep themselves a little safer until they do.

  4. Ruth Bard says:

    In any such project, there’s a fine line between harm reduction and enabling. If we can walk that line with care, and save a few lives along the way, so much the better. As long as InSite has the goal of getting people the help they need to beat their addictions, it’s worthwhile. If it’s nothing more than a shooting gallery, it should be shut down and the money should go to Union Gospel Mission, because they have an excellent track record of changed lives.

  5. Janice says:

    I think any kind of prevention against the spread of diseaseor ilness is a positive step forward.Addicts are going to do what they need to do no matter what, but for those who want to use Insight it’s a start.Like everything else, there are not enough safe places for them to go, very little housing, and not enough help and support to go around, the list goes on.Not all street people are down there by choice so every little bit of positive is better than none.I think Insight is a good idea.Anyone that has never seen first hand what aids can do to a life, should think twice about saying no to having a place like Insight. My cousin died a very painfull and tragic death from aids, sharing dirty needles, perhaps if Insight was there then, he might still be alive. Dying at the age of 22 is not very good. Prevention has to start somewhere.
    On a more happier note, I hope that you enjoyed the football game! The stadium looks incredible:-)

  6. hotel goddess says:

    I am glad to hear those fighting these addictions will continue to be housed in a safe, clean place. To those opposed to safe injection sites, the alternative is to have them injecting in front of our children and disposing of used needles in an unsafe manner. We are privileged to live in Canada, and this is another example of providing freedoms to all. Now let’s spend our taxpayers money on providing detox and rehabilitation to those who need and want it versus fighting against these facilities.

  7. Jonathan Caswell says:

    I live in the U.S. and I must say, reading your blog today has given me hope for law enforcement everywhere. It is so easy to look at the news coming out or newyork about wallstreet protestors right now and feel like no one will ever be there to serve and protect the people, in our country the police are frequently encouraged to overstep their bounds in the name of maintaining order. I wish to express my admiration to you personally sir, and to say that when I was in Vancouver persuing my education last year it felt like the sort of place that an american southerner like myself would love to live some day.

    • saddison says:

      Thank you Jonathan for your kind words. I hope you continue to read. I don’t speak for police officers everywhere, and I don’t know all the details of the New York protest. Based on your comments I assume you do not approve of the way police handled the situation in New York. As part of the Vancouver Police Department’s crowd control unit, I’ve attended a number of protests. I was on the front lines when a small group of anarchists began trashing storefronts on the first day of the 2010 Winter Olympics. I was also there last week when a smaller group tried to prevent your former VP, Dick Cheney, from attending a book-signing dinner in Vancouver. While it’s our responsibility as police to allow peaceful and lawful protests, it’s also our duty to step in when those protests become dangerous and unruly, or threaten public safety. It’s often a difficult balance. You have to remember that we are there to serve everyone. Unfortunately, not everyone has the same agenda and it’s often impossible for the police to make everyone happy.

    • DC says:

      There are many around the world who wear a patch indicating they are the police. But there are plenty of countries where they are working on a different agenda than to serve and protect the people and are often in fact working against them.

      I think we’re generally lucky in both countries (US & Canada). But I must admit a certain pride in policing in Canada. During the Vancouver playoff riot some have said there should have been a stronger immediate response but I fully support the intelligent, thoughtful and, most of all, targeted response by the VPD. Be strong but be just. I wish we them out here in Toronto for the G20.

      I don’t think Anthony Bologna would have lasted long under Chief Chu and the watchful eye of the officers of the VPD.

  8. Justme says:

    I’ve really loved this blog. I think it gives great insight into the other side of things — a different perspective which is a wonderful thing to have.

    I’m very pleased to hear about Insite. When I think about things like HIV reduction (in terms of spreading) and saving lives I feel its worth it. When I think too of how difficult it is to turn your life around completely I can understand how it can be so overwhelming. Small steps often lead to big changes, and I view insite as a small step for these addicts. It can help them get the message that they are worth it, and overcoming this addiction is worth it.

  9. V.Hope says:

    My mother has been struggling with addiction since I was 8 years old. She has gone through so many programs and treatments over the years I can’t even keep track of them.
    The times she was using were absolute nightmares. Sometimes she would disappear for days on end leaving me with little food and the constant worry of her turning up dead. Once I found a card for insite, and I have to say it was a major comfort knowing that she had accesses to a clean facility like that and she was possibly using it. Yes, it was not the greatest thing knowing that she was using drugs again, and I was really angry but it was better then the alternatives (one of them being at home, I have seen her OD twice) and it was a small piece of mind for me at the time.
    Right now my mother is going to peardonville, and I am really hoping that with my support she can get back on track.
    I have to say even after everything that I have seen and been through, I can not even begin to imagine what it is like with an addiction, to me it is as simple as not doing it, but to my mother is not.

  10. Steve says:

    I will preface my comments by identifying myself to a degree as a person who has been a street worker in a major Canadian city for a while, and who has the utmost respect and compassion for those ‘on the street’…

    The people who use places like Insite are held together by, among other things, their common unhappiness. Their lives are miserable. Every day is a struggle. They feel unworthy of the better things life has to offer. Thoughts of suicide are often present. The drugs serve only to perpetuate this negativity and ensure that it persists and, in many cases, grows.

    I don’t see how providing a place to ‘safely’ use their drugs is addressing the roots of any of the negativity that pervades the lives of these people. I do, however, see that it helps to perpetuate their misery, as the drugs play a major role in their misery.
    Sure, the drugs are “a symptom of a larger problem” – but the drugs also create more problems. At best, the drugs help to keep them where they are at – in the miserable cesspool that has become their life. More often, though, the drugs only serve to worsen the misery long term and drown them deeper and deeper into the cesspool.

    To say “come and abuse yourself and destroy your life more comfortably here” is not a solution.
    This is simply a lowering of the standard. Instead of having the goal to actually and practically help these people to attain a level of happiness and health (both physical and emotional health), the goal of the ‘safe injection sites’ is simply to help keep them alive – so that they can continue living their unhappy, miserable lives. This is to perpetuate the status quo in terms of their misery.

    If the goal is to help these people clean up their lives and attain a level of actual happiness and health, the success rate, admittedly, is low. If you succeed in getting only 10% of your drug addicted ‘clientele’ to clean up their life, you have done remarkable work.
    But a 10% success rate does not look very good to those who do not possess a knowledge of this type of lifestyle. And many of those people who don’t possess this knowledge, and who therefore don’t understand, are potential funding sources.
    If the goal is changed, however, to merely keeping your clientele alive for, say, one year, then your success rate immediately jumps to something over 80%. This looks good to potential funding sources, who rarely look beyond the surface of things.
    So you’ve succeeded in keeping 80% of your clientele alive for a year… but what would their survival rate have been without you? I’d say pretty close to that same 80%. Of course, though, there is no practical way of measuring this.
    And, while you’re keeping them alive, you are doing nothing to address – let alone try to remedy – the roots of their problems.

    This approach might eliminate some of the risk of catching HIV, Hepatitis C, etc. But the threat of getting HIV, Hepatitis C, etc. are actually motivating factors for some people to quit using whatever substance they are using. It may sound odd, but if you remove this risk, then you’ve removed one of the reasons that people quit.
    Also, even with the risk of catching HIV or Hepatitis C removed, drug use obviously remains very unhealthy in many other ways. None of this is addressed in the ‘harm reduction’ approach.

    There are those who claim that these ‘safe injection sites’ open the door to treatment that helps people kick their addictions. I have seen precious little evidence of this in reality. I have seen needle exchange places give out needles to young people who are there for the first time – with no questions asked. No questions like “How long have you been using?” or “Are you aware of the risks involved?” The only thing told to them as they are given their 25 syringes is “Don’t shoot up in our bathroom”.
    I have never been to Insite, but I’ve seen several reports and documentaries about it, and what I’ve seen are the workers there also “asking no questions” and “not judging”. In other words, the overall approach seems to be “If you want to continue to destroy your life, that’s perfectly fine with us – we’re not going to encourage you to clean up your life. But if you’d rather continue your unhealthy decline in the relative comfort of our building, rather than out in the streets ans alleys, you’re welcome to come in and do so.”
    This is the ‘non-judgmental’ approach – which goes hand in hand with the ‘harm reduction’ approach. The ‘non-judgmental’ approach might as well be called the ‘non-caring’ approach. I’m sorry, but caring and compassion inherently involve a judgment – we first have to judge that the individual is unhealthy and that they could use some assistance. To not judge is to have no opinion; to be indifferent – to not care.
    The truth is that we all make dozens upon dozens of judgments each day. It is a very natural part of being a human being. To not judge is to not be human (or humane, as the case may be). Just allow people to do what they do – no matter how harmful or destructive. Where is the caring and compassion in this approach?
    When I was young, I was encouraged to use GOOD judgment. Today, people are encouraged to have NO judgment! Might as well be a machine, then.
    “Social progress makes the well-being of all more and more the business of each.” – Henry George.

    True, one cannot help another unless the person WANTS help. But is it not part of the caregiver’s responsibility to try to get the troubled person to a point where he/she wants and accepts help? This cannot be done by being “non-judgmental”.

    Drug use – especially at the level that those who go to these ‘safe injection sites’ are at – is an incredibly unhealthy and harmful and dangerous thing. Many people are implying that drug use is somehow rendered ‘healthy’ if done at these ‘safe injection sites’. While it may be slightly safer physically (only slightly, because this type of drug use is inherently unsafe no matter what), it is certainly no more healthy emotionally and psychologically.

    To say that all of these addicts are “going to use anyway”, and so lower the standard of ‘care’ to that of merely keeping them alive for their next fix, and the next one, and the one after that, is to do them a great disservice. It is giving up on them; it is saying that they’ll never be anything more than a junkie, and so they should be as safe a junkie as possible.

    It is not enough to aim to merely ‘reduce harm’ – because, even if the harm is reduced – relatively -, there is still great harm being done – both physically and emotionally/psychologically. And that is not acceptable if you truly care about someone. These people are in tremendous emotional pain. The goal should be to eliminate harm and self-abuse and self-destruction – nothing less.

  11. Jackie says:

    “Every Junkie is a Setting Sun”. I do believe that is true. I think all the money spent on Insite should be used to fund more beds at Addictions treatment programs. Offering needles & clean spaces to a junkie will not encourage them to quit.
    Just because there is Insite doesn’t prevent these junkies from stealing anything they can get their hands on, just to buy their fixes.

    • Tim says:

      Actually, the comment was “NOT every junkie is a setting sun”.

      • Raingurl says:

        At least with insite there aren’t as many people using alleys and the urine soaked puddle water. I do think the place should be relocated off Hastings Street and off a very main artery into the city. I do think that if anyone gets picked up and arrested for drugs, trafficking et al, they should be FORCED into treatment. I told my sister this and a few other thoughts on the subject and she said I missed my calling. All I said was “I could not be around this every day, it would kill me to see others killing themselves” And NO, not every junkie is a setting sun. I’m still shining………….

  12. Anna Woons says:

    I agree with the Supreme Court Decision, but think that in order to avoid property owner opposition, the service provided should be mobile.
    This way, we will be able to avoid the concentration of services in one place and at the same time ensure that the addicts who cannot make it to the site are looked after.
    In order to reduce theft, the site could also supply free synthetic drugs to those who have life-long history of addiction. It doesn’t cost that much to make a substitute and the drug dealers wouldn’t be able to prey on the most vulnerable.

  13. Russ says:

    InSite refers OVER 400 people a year into detox/recovery! There is no other project on this continent that refers anywhere near that many people into treatment. Also, when most program’s statistics say ‘referred’, they mean that they talked to someone and gave them info on how to go to detox, or even arranged an intake. But they don’t (can’t) follow up and don’t know how many actually make that appointment. At InSite we KNOW that over 400 are going to our detox program because we intake them and walk them upstairs to the residential program designed specifically for this population.

    • Jane says:

      Russ is right.
      And for those that would rather go to another detox and not be right on top the they injection site, staff follow up and will even walk them right to the door. And if they leave after 24 hours the staff do not just give up there. They will do this over and over until the person is ready to stay and then go on from detox to a treatment centre.

  14. jeremy strother says:

    im sorrybut any body who says ” go back to the days where junkies are givin methadone for the addiction ” have totally miss interpreted the reasoning for a place like insite. im gonna lay it down to you so everyone can understand. first off there are people in society wether you like it or not that are gonna use heroin and crack cocaine period. they will do it wether theres clean needles around and they will do it with puddle water if they have too. in society we cant just say well there waste bags so let them be wastes. and the truth of the matter is a junkie who shares needles and shoots up with rain water isent gonna be the type to see a docter regularly or have any contact with health professionals.

    i have visited insite im from toronto and im a IV heroin user. i have seen first hand how this places helps the community. for one thing they have been open since 2003 i believe and they have not had one single death from an overdose. not that there hasent been overdoses they happen dayly there but overdoses are preventable deaths. with medical assistance any user who overdoses can be brought out of it. so from that point it saves lifes.

    but the real interesting thing that isent mentioned on the news when talking about insite is that the safe injection site is only half of the program.

    the upstairs is a totally free to patents rehab facility. and by having people frecquanting the injection site. first thing they get treated like human beings which helps some of them open up. from my exsperiance most junkies dont wanna keep using but lack the mature development to make that next step. in other words its common place for junkies to use dope as a coping mechnism because in there upbringing they never developed skills to deal with the ups and downs of dayly life.

    usually a junkie will have started there use because of a tramadic exsperiance they couldent deal with and desided to use dope and an escape. must users are conflicted because on one hand they love the feeling they get from heroin but hate what heroin is doing to them.

    a place like this gives junkies another option, it make takes years it could only take months but slowly being treated like human being and having access to doctors will get a certain percentage up stairs to the next step in a long recovery chances are the user has already been going through for years.

    and as a society what kinda message are we putting across trying to shut a place like this down, who cares about junkies there hardly even people, there gonna die anyways. thats all im hearing im glad the supreme court of canada came to its sences about this issue, and i hope more open up because of it.

    methadone isent a soild option for treatment for heroin addicts its suggested that in canada the methadone program is only successful for 5% of the patients entered in it.
    the problem with methadone is its mainly run by private clinics the doctors are aloud to see as many patients as a normal family doctor does in a week.

    the only difference is the average methadone doctor only works 2 days a week so say a family doctors aloud to see 2000 patients that would meen the methadone doctor is seeing about 1000 patients a day when they are in the office. so it give the addict no face time with the doctor. because of this the addict is left on his own devices to deal with the reasons they started using heroin in the first place. and since they dont get the same escape from methadone because methadone doesent have the euphoric effect the majority of methadone patients just end up using methadone and heroin on top of it.

    we need to try to find away to get junkies to trust the medical system again and find away to get them in with theripists and the works. i truely believe the most effective way to treat opioid addiction is by dealing with why the user decided to use it in the first place and teaching them other ways to deal with there problems or else and records show this they will undoubtable relapse time and time again also most junkies receive social assitance so there methadone is payed by the government. what does that meen in effect the average canadian is paying for a drug treatment program methadone that is only successfull 5% of the time. but not only are they paying for the methadone most users cant wait till there social assistance shows up so they can get alot of heroin and believe it or not your paying for that as well . so you can see in society the average citizen has an invested interest in finding alternative treatment options if they know it or not they are invested in it. and INSITE is a treatment center harm reduction is part of treatment even if it looks like complacency its not. sometimes you need to look at the hole picture not just the use of narcotics.

  15. Raingurl says:

    I know someone that needed a nurse ASAP (he fell, he wasn’t on drugs) on the street and the wonderful Insite staff came running. I always thought it should stay open. This just firmed up my belief. If the community is going to continue the way it is we at least need certified nurses close by.

  16. Janice says:

    Sometimes it’s not a matter of understanding, it’s a matter of accepting what is. Some things can never be changed so we have to adjust our ways of thinking and accept what is handed to us. I don’t think the DTES, will ever be anything else but what it has become.Unless there are millions of dollars to house, feed and treat those who want it, it won’t change. So we have to come up with ways to try and do harm reduction and prevention. Nothing will be perfect and nothing is be all end all ither.

  17. Raingurl says:

    I almost puked when I looked out the window at some guy sticking a needle in his leg. He was sitting on a bench on Carrall Street. It was the first time I’ve seen it in person. I will not accept that this is the way the neighbourhood will always be. It is not open for discussion.

  18. sarah says:

    I am USA.. But, I love your blog.. I come from a birth mother who was a addict who suffered from mental illness. This hits home.. Please continue to post.