Supervised consumption site users need ID, Alberta judge rules

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People who access supervised drug consumption services in Alberta will be required to show identification after a judge dismissed an application seeking to suspend the rule.

The advocacy group Moms Stop the Harm and the Lethbridge Overdose Prevention Society launched a legal action against the Alberta government last August, saying that a host of new rules – including a requirement that users provide a personal health number (PHN) – were unconstitutional and would impede access to a lifesaving service during a runaway overdose crisis.

The groups sought an interlocutory injunction, which would have immediately suspended the requirement pending the outcome of the broader action.

In a ruling released this week, Court of Queen’s Bench Justice Paul Belzil wrote that the applicants had met the burden of establishing that some illicit drug users will suffer “irreparable harm,” including death, if the injunction is not granted.

However, “if this interlocutory injunction application succeeded, Alberta’s ability to formulate addictions policy, pending the outcome of the action, would be severely restricted,” the judge wrote.

“The challenged regulation is part of an overall strategy to respond to the opioid overdose epidemic within the broader framework of the health care system. Whether one agrees or disagrees with this approach, it cannot be denied that Alberta is responding with a defined policy and not ignoring the issue.”

Avnish Nanda, an Edmonton-based lawyer representing the groups, said he read the ruling with disbelief.

“I just can’t comprehend any circumstance where someone could take the position that the deaths of these people is justified as long as the government can do what it wants when it comes to addictions policy,” Mr. Nanda said in an interview on Tuesday.

“You would think that a government decision that leads to the death of people – large numbers of people – would be a significant, pressing public interest concern that we would halt that government action until we figured out if it was lawful, to ensure that people can continue to live.”

The PHN requirement, which comes into effect on Jan. 31, is contained in Alberta’s Recovery-oriented Overdose Prevention Services Guide, released last year. It states that service providers must collect identification so that clients can be easily referred to a continuum of services within the health care system. Other requirements include good neighbour agreements and continuing engagement with local government, police and other community groups.

Alberta’s Associate Minister of Mental Health and Addictions, Mike Ellis, said he was pleased with the court’s decision, and that the guide introduced by his government is intended to improve the quality of addiction services as well as community safety in areas surrounding supervised consumption sites.

“That is exactly what these quality standards will do, and why they are essential to safe and orderly provision of high-quality supervised consumption services as part of a recovery-oriented system of care,” Mr. Ellis said in a statement released Tuesday.

At least 1,372 people died from drug poisonings in Alberta in the first 10 months of 2021, making it the deadliest year for such deaths with two months still yet to be tallied. In 2020, 1,351 people died.

The applicants filed a number of affidavits in support of the challenge. A 37-year-old Calgary resident identified as T.F. wrote that he has faced much discrimination in the Alberta health care system as a result of his crystal meth use, citing as an example a reluctance by a doctor to refill a prescription because the doctor believed that he was lying to seek drugs.

“I fear that this (PHN) information will … be made available to health care providers at walk-in clinics, or at the hospital, which will result in me being denied the quality of health care that I deserve,” he wrote.

Sahil Gupta, a Toronto physician who works with inner-city populations, wrote that people facing stigma for their medical illness or behaviour often choose not to participate in medical or preventative care, and that low barrier participation, including anonymous and confidential participation, allows engagement of people who would not otherwise engage.

Elaine Hyshka, an assistant professor at the University of Alberta’s School of Public Health, wrote that requiring supervised consumption sites to collect PHNs would create a “high-threshold, institutional model that is unprecedented among community-based [supervised consumption sites] in Canada.” Collecting this information would create an identifiable, electronic record associated with illicit drug use that could deter people from using the service, she wrote.

The federal Ministry of Mental Health and Addictions said it is aware of the decision and will take time to review it before commenting.

“Since 2017, supervised consumption sites in Canada have received more than 2.9 million visits, reversed almost 27,000 overdoses without a single death at a site, and made over 120,000 referrals to health and social services,” a statement provided by a ministry spokesperson read. “We will continue to work with provinces and territories, and stakeholders, to take measures so that Canadians continue to have access to these lifesaving services.”

Mr. Nanda said he will seek an expedited hearing at the Court of Appeal to have the decision overturned while the broader legal action continues.

“There are real people out there that are going to be directly affected by this,” he said. “More than four Albertans die every day, and this is just going to fuel this overdose crisis.”

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