Supervised injection sites: Quebec expects federal approval

Quebec health care workers and politicians say they expect the new federal government to approve their application for supervised, illicit-drug injection sites in Montreal, which will make the city the second in Canada to host the controversial harm-reduction program.

But some are warning the strict law passed before the Conservatives left office will mean potential injection-site operators will have to navigate a complicated legal maze aimed at preventing these sites from opening.

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The chairman of the health centre expected to house Montreal's first legal injection site said he has "no doubt" the new Liberal health minister will approve the application after months of what he calls Conservative "stalling."

Louis Letellier de St-Just, a founding member of Cactus Montreal, said if the project calling for three, fixed safe injection locations and one mobile unit gets approved quickly, it might be up and running by next fall.

"The project will certainly get the go-ahead from the (new) federal health minister so we are thrilled," said Letellier de St-Just. The Cactus Montreal community centre has been working with drug users and sex workers for decades.

A City of Montreal spokeswoman said Mayor Denis Coderre was also confident that Prime Minister Justin Trudeau's Liberal government would approve the proposal.

Eyes on the Liberals

Health Canada refused to comment on Montreal's application, but the Liberals' election platform stated its support of supervised injection sites, saying they "decrease the risk of death and disease for those living with addiction and mental illness, reduce crime and protect public health and safety."

Currently, Vancouver is the only city in Canada where intravenous drug users can inject themselves with illegal substances under supervision of nurses and other health care staff.

Proponents of these facilities say that the sites offer a clean and safe location for drug users as opposed to the street, and that addicts who visit the centres can be directed towards treatment programs.

Critics say the sites encourage drug use, attract drug users to particular areas and say governments shouldn't be subsidizing centres where people consume illegal substances.

Insite's battle laid the groundwork

The previous Conservative government took the latter view, and its efforts to close the Vancouver centre — Insite — were stopped by the Supreme Court of Canada in 2011.

The high court ruled the government couldn't deny health services to addicts in the city's Downtown Eastside.

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In response to the ruling, the Tories passed legislation in June which makes it "virtually impossible" for new sites to open in the country, said Anna Marie D'Angelo, with Vancouver's Insite.

Cities seeking a supervised injection site need approval from the federal government through an exemption under the Controlled Drugs and Substances Act.

The Tories law — known as C-2 — forces potential injection site operators to provide the government with crime statistics and other neighbourhood data as well as criminal background checks of potential employees and an accounting of any local opposition to the project.

"Compiling all these statistics year in and year out is very onerous," D'Angelo said. "We don't think it could be very easily accomplished for a new centre."

Donald MacPherson, professor at Simon Fraser University and director of the Canadian Drug Policy Coalition said in the past, exemptions were allowed to "facilitate innovation and health care."

"But Bill C-2 is very much not in that vein and puts obstacles in front of people," he said, calling on the Liberals to "repeal or radically alter" the law.

But not all health care workers are open to supervised injection facilities.

Seychelle Harding, spokeswoman for Montreal's Portage addiction centre, said her organization isn't necessarily against the sites, but adds public money shouldn't be diverted from rehabilitation programs to fund them.

She said the injection sites can benefit a "small and highly marginalized" group of people resistant to treatment and also help to reduce the transmission of HIV and other infections.

Harding cautioned that supervised injection sites are a public safety measure, not a replacement for treatment and rehabilitation.

"Anything that can save lives or limit the propagation of infections is a good thing," Harding said. "It's clear that we don't want the money dedicated to treatment to be reduced."