Insite gets stamp of approval from Canada’s health minister

Federal Health Minister Jane Philpott has given a heartfelt stamp of approval to the work of Vancouver's Insite supervised-injection site, a dramatic shift in tone from the previous Conservative government on harm reduction strategies that could have consequences across the country.

The new Liberal Health Minister, a family doctor who founded a charity that has raised more than $4-million to help those affected by HIV/AIDS in Africa, visited Insite on Wednesday, one day before joining her provincial and territorial counterparts for meetings on a new health accord.

While supervised-injection sites are not on the agenda, Dr. Philpott was asked about her visit during a break in the discussions.

"I have to say my visit to Insite was extremely moving for me," Dr. Philpott said on Thursday. "It meant so much to me because I've been involved in responding to things like the HIV pandemic for many years in my career and I've followed the work of Insite. I've always known that what they do absolutely saves countless lives. It has a huge impact on people."

Insite has operated on Vancouver's Downtown Eastside since 2003. The Dr. Peter Centre, a renowned HIV/AIDS clinic in the city's West End, has offered supervised-injection service in an integrated model since 2002, receiving federal authorization last week.

The federal Liberal government, however, has not made any commitment to repealing the legislation that makes it extremely difficult to open other supervised-injection sites.

Andrew Day, a Vancouver Coastal Health manager for Insite, said Dr. Philpott engaged with users and front-line clinical staff during her one-hour visit, showing a detailed understanding of the complexities of drug use.

"From our perspective, we've seen a total pivot in terms of attitude, in terms of a willingness to engage with the research and the scientific community," Mr. Day said.

"I think that is significantly important not just for Insite, but for health care in general. We don't have to fight ideological battles; the focus is on what the evidence suggests will work, what the science says."

Mr. Day said the group engaged in a "sophisticated level of dialogue" because there was no need to explain the basic concepts of harm reduction and how science supports it.

"We had someone who was well-engaged and has a clear understanding from her physician background," he said. "We were genuinely moved. It wasn't just a photo op. It wasn't a quick in-and-out."

Supporters of supervised-injection sites – including B.C.'s provincial health officer, Perry Kendall – have called on the new federal government to repeal the so-called Respect for Communities Act, which presents a barrier to opening such a site. Stephen Harper's Conservative government introduced the legislation after spending years trying to shut down Insite, eventually losing at the Supreme Court of Canada.

Dr. Philpott said Thursday that there has not yet been a discussion of the legislation. However, she did allude to those who tried to shut down the Vancouver facility.

"It was incredibly moving for me to be there, to be able to thank the folks that have put the program together over the years and have sometimes faced some adversaries along the way," she said.

Other provincial health ministers also expressed openness to consulting with residents on harm reduction strategies, including supervised-injection sites.

Alberta Health Minister Sarah Hoffman said it is promising that the new federal government is talking about harm reduction and taking actions such as its recent move to make naloxone, a drug that reverses the effects of an opioid overdose, available without a prescription.

"I think it is going have an impact on Canada," Ms. Hoffman said in an interview. "Right now there are certainly barriers to some of the harm reduction strategies in legislation."

Ms. Hoffman said the province will respond to any changes in federal legislation and would consult with the public before taking action.

"Certainly, we would have to have discussions with Albertans, but the research that I'm seeing is that the social benefits to society when people have a supervised place to use rather than using on our streets as well as the economic benefits warrant further discussion," she said.

The topic of supervised-injection sites also was raised by reporters on Wednesday, and Quebec Health Minister Gaétan Barrette said that province will soon follow British ColumbiaB.C.'s lead. "We've watched the Insite project with great interest and it works. We're in favour of this type of initiative," Dr. Barrette said.

The minister said he supports Montréal Mayor Denis Coderre's plan to gradually open four supervised-injection sites in Montréal, and they will open with or without the federal government's approval.

In Victoria, a coalition of health-care professionals, social workers and advocates called YES2SCS has also been working to open a supervised-injection site in that city.

On Thursday, B.C. Health Minister Terry Lake reiterated his strong support for harm reduction measures such as like supervised-injection sites, saying "they save lives and they save costs."