Tomorrow, the Supreme Court will begin hearing the case for continued operation of Insite, Vancouver’s safe injection site. Proponents call it a life-saving health facility, while critics view it as a dangerous facilitator of criminal activity. Whatever the court's ruling, Vancouver will be deeply affected.
Doctors, nurses and recovering drug addicts gathered at the Insite safe injection site on Wednesday morning to speak in support of the facility.
Vancouver Coastal Health's chief medical officer, Dr. Patricia Daly, said that studies show supervised injection to be a "legitimate public health project that saves lives".
Nicola Keate, a recovering addict, said that Insite helped her overcome her long-term drug addiction. "If they hadn't come down and stepped in to get me up here and get me some help, I'd be dead today," she said.
Speaking with a slight British accent, Keate reminded people how drug addicts don't always conform to social stereotypes of poverty and abusive households.
"I'm kind of an oddity because I come from excellent parents and had an extremely good upbringing," she explained.
Keate said her main problem was shyness, and that being teased as a child for over her accent caused her to become more withdrawn. After being introduced to drugs by a man "twice her age", she spent a large part of her young adulthood addicted to hard drugs.
Keate is currently receiving treatment at OnSite, the drug recovery centre on the second floor of Insite, and says she has been clean for the last three months.
So far, public health officials and drug users have praised Insite as a life-saving facility that provides a necessary service within the Downtown Eastside, with its estimated population of 5,000 intravenous drug users its high concentration of drug users. A recent UBC study in the peer-reviewed medical journal, The Lancet, reported a 35 per cent drop in overdose deaths in the immediate vicinity of Insite since the facility opened in 2003. As for political support, Mayor Gregor Robertson and previous mayors have called on the federal government to keep Insite open.
Still, Prime Minister Stephen Harper and the Conservative Party have long opposed Insite have asked Canada's top court to consider giving them power to shut it down. The question is, why?
A health issue, or a criminal activity?
One of the major points of contention over Insite is whether it is a health facility, or a judicial twilight zone where users can freely inject drugs banned by federal law.
For Hugh Lempick, a board member of Vancouver Area Network of Drug Users (VANDU), Insite is clearly the former.
"It's a health facility," he said. "If it weren't a health facility, they wouldn't have nurses there, it wouldn't be supervised, it wouldn't have saved over a thousand lives a year. It saves lives ... the federal government, with their law-and-order argument, it's bullshit."
Lempick said that many of VANDU's members rely on Insite, and that he knows "about a dozen" users who have managed to recover from drug use as a result of being introduced to treatment through Insite. Monika Stein, a manager of harm reduction programs at Insite, affirms that drug users at Insite are three times as likely to seek treatment than those who don't.
In Lempick's view, drug use is only a visible part of deeper problems. He said many drug addictions are caused by personal traumas such as child abuse and death of family members. Adding that it's "no excuse" for becoming drug-addicted, Lempick insists that drug users often decide to take steps to break their habit through interaction with Insite's staff.
Critics, however, are not convinced that Insite helps drug users seek treatment. Simon Fraser University criminology professor Garth Davies expressed doubt over Insite's effectiveness, writing in a 2007 paper that Insite produced only one referral for every 112 visits.
Al Arsenault, a retired police officer who spent much of his 27-year career in the Downtown Eastside, said some people who use Insite's services are not interested in stopping their substance abuse.
"Some people are incorrigible," he said. "They will never, ever quit drugs, as long as we give them a place to shoot up ... All they’re doing (at Insite) is facilitating, enabling and condoning destructive, illegal, unhealthy behavior."
Arsenault, who is director/producer at Odd Squad Productions, a filmmaking company that produces documentaries to prevent youth from criminal activity, has worked on production such asThrough a Blue Lens and Tears for April, which show the devastating effects of drugs on people in the Downtown Eastside.