Supervised consumption services and community support

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Supervised consumption services and community support

4 December 2012

Supervised injection sites help save lives and protect communities. This was the conclusion of over 30 research studies on Vancouver’s own supervised injection site (SIS) known as Insite. And Canada’s Supreme Court agreed in September 2011, ordering the federal Minister of Health to grant a Section 56 exemption to the Controlled Drugs and Substance Act to allow Insite to continue to operate.

To scale up harm reduction and support the development of similar services throughout the province, the BC Ministry of Health has now revised its “Guidance Document for Supervised Injection Services.” Written for health care professionals, it provides advice to health authorities and other organizations considering supervised injection services in their local areas.

According to provincial policy, anyone who wants to offer this service will need to consider how they will sustain the support of local groups like medical health officers, police departments and other potentially interested groups. The decision of Canada’s Supreme Courts makes brief mention of future applications for a section 56 exemption:

[153] The CDSA grants the Minister discretion in determining whether to grant exemptions. That discretion must be exercised in accordance with the Charter. This requires the Minister to consider whether denying an exemption would cause deprivations of life and security of the person that are not in accordance with the principles of fundamental justice. The factors considered in making the decision on an exemption must include evidence, if any, on the impact of such a facility on crime rates, the local conditions indicating a need for such a supervised injection site, the regulatory structure in place to support the facility, the resources available to support its maintenance, and expressions of community support or opposition.

This last sentence has raised concerns about the likely success of future supervised consumption services. Despite overwhelming evidence of their successes, harm reduction services continue to generate public controversy, meaning that some members of a community are likely to object to supervised consumption services. But the existence of opposition does not necessarily mean that potential applicants must halt their efforts. In fact, the Supreme Court’s judgment is not a checklist of requirements for a successful application but rather a description of the factors the Minister must consider when making a decision. Potential applicants must be able to demonstrate that they have gauged public support and can offer evidence that it exists. Applications, as the B.C. provincial government suggests, must include evidence of positive support along with opposition.

It is important to remember that Insite did not necessarily start out with full community support. Rather, over time, and as the facility continued to operate, the surrounding community felt its positive effects and researchers were able to demonstrate its effectiveness in terms of health and social order. This does not mean that if one group objects then the application will necessarily fail. Potential applicants for an exemption will need to describe what efforts will be made to respond to community concerns and they will need to consider how they plan to educate their community about the positive effects of these services.

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