Posted by John Michael McGrath on Wednesday, April 11, 2012

So far, Canada has only one safe drug use site in Vancouver—the well-known Insite facility where drug addicts can use drugs under observation from trained nurses. The University of Toronto and St. Michael's Hospital have been studying whether Toronto and Ottawa should have safe drug use sites of their own, and today they released their report. From the report, available online here:

We project that Toronto would benefit from implementation of three supervised injection facilities and that Ottawa would benefit from implementation of two supervised injection facilities. These projections are based on considerations of the number of people who use drugs in each city, their geographic location, the projected use of supervised injection facilities, the demonstrated decrease in risky behaviours among clients of other supervised injection facilities, and the associated projected long-term costs and health benefits, including the prevention of HIV and hepatitis C infections.

Multiple supervised injection facilities are optimal to address the dispersed patterns of drug use in both cities. A similar approach has been used to establish needle and syringe programs and methadone maintenance programs. Implementation of multiple facilities that are located close to where people inject drugs will likely optimize access and utilization. Our research indicates that people who use drugs generally did not want a single facility that could serve as the focus of opposition. Community members also preferred multiple facilities spread out across each city to minimize possible impacts on local neighbourhoods.

After a years-long court battle, the Canadian government (specifically, the Conservatives) was forced to renew Insite's permission to operate as a safe injection site by a Supreme Court ruling last September. But the ruling did not, necessarily, clear the way for future facilities. The Supreme Court of Canada crafted a very narrow ruling that said, in effect, that the Government of Canada had the power to deny people the right to use places like Insite, but not Insite particularly in that specific instance. As Emmett MacFarlane wrote in Maclean's at the time:

Nor does the Court’s ruling pave the way for broader reform of the way Canada addresses the problem of illicit drugs. While the ever-expanding scope the judges give to the Charter make future challenges potentially ripe for success—another attempt at striking down the prohibition of marijuana, perhaps—this decision on its own places no burden on the Harper government to reassess its overall approach to drug policy.

In certain respects, the Court was quite cautious and tried to craft its decision as narrowly as possible. The Charter finding itself is limited to former Minister of Health Tony Clement’s decision to refuse Insite another exemption from Canada’s anti-drug laws. Not providing the exemption in this instance runs contrary to Insite users’ right to “life, liberty and security of the person” under section 7 of the Charter. The law itself, and the general discretion the minister has to make decisions within that framework, remain valid.

It's not clear, then, that the government of Canada would be obligated to permit more Insite-like facilities to operate based on the Supreme Court ruling. Perhaps as important, it's unclear that any public body would be willing to cough up the money for such a facility in Toronto. Mayor Rob Ford has railed against harm-reduction programs for drug addicts as a councillor and Mayoral candidate, and the Ontario government is probably not eager to get in to this fight while it's in minority-land.