Amid rising levels of intravenous drug use, Canada passes stringent legislation that makes new safe injection sites “almost impossible”

In September, harm reduction proponents gathered in Vancouver to celebrate the fourth anniversary of Insite’s legal backing by the Canadian Supreme Court. The celebration was darkened by the fact that—although it’s been open for twelve years—Insite is still the only safe injection site in North America.

Located in Vancouver’s Downtown Eastside neighborhood, Insite provides front-line healthcare and counselling services, clean injection equipment, and peer-support networking for intravenous drug users, all part of a continuum of care program aimed at individuals with addiction, mental illness and HIV/AIDS. The center was designed to facilitate access to services for a hard-to-reach demographic and serves as “the first rung on the ladder from chronic drug addiction to possible recovery; from being ill to becoming well,” according to Vancouver Coastal Health, which operates the clinic.

Increasing heroin use in the U.S. and Canada has lent momentum to the ongoing struggle to establish new safe injection sites, which have been shown to improve the health and safety of injection drug users and the communities they live in. So too has a rising number of voices criticizing current drug policies, which some say are falling short of tangibly saving lives.

Numerous studies in peer-reviewed journals demonstrate an array of benefits to safe injection sites, including the reduction of public injecting, infectious disease transmission and overdoses, as well as increased access to healthcare and social services, including addiction treatment. This year, however, the Canadian government passed legislation that runs contrary to these research findings and, in some cases, public opinion.

A new law in Canada makes it “nearly impossible” to open new safe injection sites

In June 2015, Canada’s Conservative government enacted Bill C-2, known as the Respect for Communities Act, which forces facilities wishing to operate safe injection sites to meet stringent requirements, such as holding public consultations and providing information about crime rates and public nuisances in areas surrounding projected sites.

“The views of concerned parents, community members, leaders and law enforcement must now be sought when groups want to allow addicts to inject dangerous and addictive street drugs in their neighbourhoods,” said Health Minister Rona Ambrose during a press conference.

The Bill also requires facilities to provide proof that they are offering treatment and recovery programs, in addition to safe injection spaces.

Vancouver Coastal Health has termed the legislation “unduly onerous.“

“It is our view that resources could be better spent on direct client care and addiction treatment,” a Vancouver Coastal Health representative told CTV News, adding that the legislation would make it nearly impossible to open new safe injection sites.

Montreal insists it will create safe injection sites

The debate is especially poignant for the urban centers that have made efforts to establish safe injection sites.

The city of Montreal, which gave the go-ahead for safe injections sites in 2013 with a plan that included three permanent sites and a mobile unit, has been caught in a long-standing political battle with the federal government over their plan.

The delay seems to have cost lives. The city’s leading English-language newspaper, the Montreal Gazette, reported that at least 80 people overdosed from drug injections in Montreal–causing 25 deaths–in 2014.

“What are we waiting for? People are dying,” urged the city’s mayor, Denis Coderre, stating that he planned to move ahead with the project despite opposition.

“We are talking about respecting the Charter of Rights and Freedoms, and access to an essential health service,” said Sandhia Vadlamudy, director of CACTUS Montreal, one the busiest needle distribution centers in Eastern Canada.

Montreal, like many urban centers in Canada, has undergone massive gentrification campaigns, which target public sites where at-risk communities congregate, placing further hurdles on front-line care as a result of displacement, loss of community ties and isolation. The older generation of drug users is particularly at risk, given their smaller spheres of socialization and the added weight of accumulated loss and shame, often in a context of deteriorating physical and mental stamina.


Mayor Denis Coderre Credit: Ville de Montréal

There’s a rumbling in the United States

In September, hundreds of people turned out to a public forum in New York City held by SIF NYC in support of supervised injection facilities.

At the event, Liz Evans, who was instrumental to the implementation of Insite, called for the end to the ‘War on Drugs’ policy.

She said, “It’s time to say to people who use drugs, ‘Peace. The war is over.’”


Interactive Media Content – Documentary Film
Everywhere But Safe: Public Injecting in New York

Peer Reviewed Article – Canadian Medical Association Journal
Evaluating Vancouver’s supervised injection facility: dollars and data, symbols and ethics

Popular Media – Huffington Post
Montreal Mayor Denis Coderre Promise Safe Injection Site Without Federal Approval


ESC ProfileEve St-Cyr works as a freelance researcher, reporter and photographer. She is occasionally based out of Montreal, Quebec, and travels internationally, chasing noteworthy stories and people of interest. She has a formal academic background in comparative History and Literature; Print and Broadcast Journalism; and Conflict Analysis and Management, with a specialization in Political, Ethnic and Security Issues. She is currently developing a violence-monitoring system for marginalized minority groups in India, and continues to be fascinated by people, cultures, and the resilience of the human spirit in the face of adversity.