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In February, the City of Victoria, B.C. wrote to federal Health Minister Jane Philpott seeking her advice on how to get an exemption to operate safe injection services in the city as part of its Strategic Plan for 2015-2018.
"We're doing it because we think it's going to improve the quality of life for our residents; we're doing it because we have had ample evidence to show that it saves lives," says Victoria City Councillor Marianne Alto. "We've unfortunately also had ample evidence that without [harm reduction] services we lose people to overdoses, we lose people to poor quality drugs and we lose people who are forced to use in isolated areas with no supervision. All of those losses of lives are unnecessary."
Victoria's not alone. Across Canada other cities are conducting feasibility studies to understand how safe injection services could be integrated in their communities. Organizations in London and Thunder Bay, Ontario recently announced their intention to research the feasibility of offering these health services starting in March.
These actions highlight the need for a harm reduction framework to be incorporated into Canada's health-care system.
Liberals' approval of Vancouver's Insite could signal bigger things
In Vancouver, the Portland Hotel Society's (PHS) Insite has been a model for groups interested in safe injection services. However, PHS Acting Director of Programs, Coco Culbertson, points out that people from other health districts are looking at Insite through a different lens lately.
"It's not like 'what are you doing, how does this work,'" she says. "But 'we want to do this, how can we do this and what can we learn from what you've learnt.'"
Insite certainly has a lot of wisdom to share: since its formation in 2003 the safe injection site has faced multiple battles in keeping its federal exemption in order to continue running, particularly under the Harper government.
However, Culbertson notes that the Liberal government has already validated Insite's work, including sending Minister Philpott to visit the site in January.
"It was incredibly moving and validating for us to have Minister Philpott come and see us so soon after the election," she says. "It really instilled our hope that these kinds of services will be supported by the new Liberal government."
Barriers to new safe injection sites still exist
Culbertson notes that there are still barriers in place for communities -- particularly small ones -- seeking to offer safe injection services that the federal government needs to address. She points specifically to Bill C-2, the Respect for Communities Act, which tightens requirements for new safe injection sites and exemption applications.
More specifically, a safe injection site needs to apply for an exemption from the Controlled Drugs and Substances Act, which prohibits activities related to controlled substances -- including illicit drugs -- at the federal level.
However, for those applying for an exemption, Bill C-2 now requires a longer application process with several regulations including a letter from the head of the local police force, statistics on crime and information on public nuisance and crime in the area.
"The process of exemptions should be reviewed," she says. "I would like to see the federal government offer support for smaller agencies across the nation that may not have the resources of bigger health authorities."
Culbertson points out that this support would allow communities to address the needs specific to their demographic, suggesting that a broad, sweeping model of care would be ineffective.
"Every community has nuances and its own culture that these services need to be provided within," she says. "This type of service needs to be incredibly trauma-informed and client-centered."
Harm reduction framework necessary, not new legislation
One agency that finally felt the satisfaction of having their exemption approved to continue offering safe consumption services is the Dr. Peter Centre, also located in Vancouver. The Centre applied for their current exemption in 2014 but it wasn't granted until January 19, 2016, shortly after the Liberal government was sworn in.
"The new government of Canada has put the words 'evidenced-based harm reduction' back into health care," says Executive Director at the Dr. Peter Centre, Maxine Davis.
Moving forward, Davis would like to see a harm reduction framework from the federal government.
"A significant amount of the harms associated with illicit drug use can be addressed by the federal government using a harm reduction framework for its decision making," she says. "It doesn't need new legislation."
Expanding this even further, Councillor Alto suggests that while it would be ideal for Bill C-2 to be revoked, a long-term goal would include the federal government looking at the overarching criminal code that requires a federal exemption in the first place.
- READ: Understanding drug related stigma: A guide for facilitators
- LISTEN: The world's first union for harm reduction workers
"We're hoping that they're going to change the law so we can ask for an exemption," she says. "But the next questions is, why are we asking for an exemption from a criminal code statute that prohibits health care? Fundamentally that makes no sense."
While the federal government still has several steps it can take in supporting safe injection services, communities across the country are continuing to push forward to offer these services for their residents.
"There's such a moral panic around addiction and enabling," says Culbertson. "These services are essential, life-saving services for people that have experienced such hardship and trauma."
To take action and send a letter to Minister Philpott asking her to repeal Bill C-2, join the BC Health Coalitions campaign here.
Alyse Kotyk is a Vancouver-based writer and editor with a passion for social justice and storytelling. She studied English Literature and Global Development at Queen's University and is excited by media that digs deep, asks questions and shares narratives. Alyse was the Editor of Servants Quarters and has written for the Queen's News Centre, Quietly Media and the Vancouver Observer. She is now rabble's News Intern.
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