Sober N Clean

BACK in 2003 many residents of Vancouver reckoned that an answer had finally been found to the worsening hard-drug problem in the liberal-minded city’s Downtown Eastside district. A reformist city council, borrowing a European idea, opened the first supervised heroin-injection clinic in North America. It was set up as a research experiment, with a three-year remit (since twice extended). The idea was that giving addicts a safe place to inject themselves would remove them from crime, disease and other risks, and make them more amenable to treatment. The Liberals who were then running the federal government agreed, and blessed Insite, as the project is called, with C$1.5m (then worth $1.1m) and a vital exemption from drug laws.

Five years on, Insite has proved a disappointment to many in Vancouver. It has also become the object of partisan conflict. The Conservative federal government of Stephen Harper dislikes the project. A committee set up to advise it on the issue found that only about 500 of Vancouver’s 8,000 addicts use Insite each day, and fewer than 10% of those use it for all their injections. It found no clear evidence of any increase in treatment, nor of any fall in HIV cases. It did estimate that the project might have saved one life per year but found that overdose deaths were still about 50 a year among addicts. Crime continues unabated as addicts steal to feed their habits, something which frustrates the local police. The government therefore proposed to allow Insite’s legal exemption to lapse when it expired in June.

Many health workers thereupon sprang to Insite’s defence. They are convinced that the project’s “harm-reduction” approach can work. In May they gained an order from a justice of British Columbia’s Supreme Court to stop the federal government from closing the clinic. In a radical ruling Justice Ian Pitfield found the federal law prohibiting the possession and trafficking of drugs to be unconstitutional and said that closing Insite would deny addicts access to a “health-care facility”. Allowing the clinic to stay open, he gave the federal government a year to amend its anti-drug law. The federal government promptly appealed against the ruling.

Health care in Canada is a provincial matter. Last month Quebec stepped into the drug debate. Its public-health director announced that he was considering plans for supervised injection sites in Montreal and Quebec City. This seems to have made things even stickier for the federal health minister, Tony Clement.

This week Mr Clement restated his opposition to Insite. “Allowing and/or encouraging people to inject heroin into their veins is not harm reduction, it is the opposite,” he said while attending an international conference on AIDS in Mexico City. He wants to focus instead on treatment and prevention. But he has remained silent as to whether the government would grant any request from Quebec for exemption from drug-prohibition laws. Mr Harper’s hopes of turning his government’s minority status into a majority at the next election depend on winning seats in Quebec. So the future of drug policy in Canada may turn on a political calculation.
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source: The Economist, http://www.economist.com