The History of Insite
In the early 90’s in the midst of an HIV epidemic among injection drug users drug related overdose deaths reached record levels. Kind, loving, intelligent people were needlessly suffering and dying. Something had to be done.
In 1997, PHS hosted a free conference in Oppenheimer Park called “Out of Harm’s Way”. Speakers from around the world presented alternatives to the status quo surrounding crime, drugs and addiction. These topics were wide ranging and included presentations about supervised injection in Germany, models of heroin maintenance in Switzerland and the UK, alternative justice approaches and stimulant maintenance. Over 800 people from across the community came inside a tent in the pouring rain, in winter, and listened all day and gathering new ideas. This event served as a watershed to establish a legitimate place for more humane and pragmatic alternatives.
PHS advocated and lobbied with drug users, families, NGOs, government officials, health professionals, academics and politicians. Through public education, media engagement, and direct action the word was spread that being a drug user in Vancouver did not have to be a death sentence. In Vancouver and across the country, PHS engaged the international community to provide support for the establishment of a supervised injection site.
In February 2003, PHS set up “Health Quest” which rented a space and constructed an injection site with private donations. It was PHS’ intent to open this site with a rotation of volunteers, politicians, and supporters who would operate it on a volunteer basis if the three levels of government did not support the initiative. This however became unnecessary when all three levels of government provided support for Insite. The local health authority became a partner in the lease, and a full scale renovation was funded to include the construction of detox beds, to create what is today known as Insite, North America’s first legally sanctioned supervised injection facility.
The site opened September 2003 with a Government of Canada exemption from section 56 of the Controlled Drugs and Substances Act (CDSA). Michel Chartrand (one of the first Portland Hotel residents) was the first drug user to inject at the site, and as he said at the time, the site was there too late for him (as he was dying of a chronic drug related infection) but he wanted it to be there for other people, to prevent the epidemic of overdose deaths and the spread of life threatening diseases. Close to 300 drug users came to use the site on the first day it was open. It was an extremely moving day, as family members came and expressed their relief at knowing such a place could exist.
The attempted closure of Insite
In September 2006, due to intense political pressure in Vancouver and from around the world.the then-federal Minister of Health announced a temporary extension to the site’s exemption that allowed Insite to operate for another 15 months. This enabled the site to operate until the end of 2007. As this second exemption neared its end, PHS was very concerned it would not be extended again as the federal government seemed to be dragging their feet.
PHS team members travelled across the country lobbying MPs at their offices.We attended conferences where we presented the story and impact of Insite in Toronto, Ottawa and Montreal. We held a vigil at the International AIDS Conference in Toronto, and we collected thousands of letters of support from across the country. We spoke to media, wrote opinion pieces, and attempted to convince the Government of Canada to do the right thing. However, it became clear that the then-government wanted the site shut. They had no intention of allowing it to continue.
In August of 2007, PHS felt time was running out, and faced with the possibility of Insite’s closure, filed a constitutional claim in the B.C. Supreme Court, alongside two drug users, Dean Wilson and Shelley Tomic. Read our constitutional claim filing here.
PHS lawyers (working pro bono), Joe Arvay and Monique Pongracic-Spier, argued that as a health care facility, Insite falls under the jurisdiction of the BC government. They argued that the alternative, denying drug users access to health services at Insite would violate their rights to life, liberty and the security of the person under section 7 of the Canadian Charter of Rights and Freedoms.
On October 4th, 2007, Minister of Health Tony Clement announced an additional six-month extension until June 30, 2008. The Minister rejected demands for a long-term solution, fueling concerns that he was preparing to end Insite.
In March 2008, the case was heard in the BC Supreme Court by Mr. Justice Pitfield, who released his decision in May 2008. Read the BC Supreme Court decision here.
The Government of Canada Becomes Involved
Justice Pitfield did not agree that jurisdiction over Insite was exclusively provincial; however, he ruled that, applied to users and staff at Insite, sections 4(1) and 5(1) of the CDSA, which prohibit possession and trafficking of banned substances, violate Section 7 of the Canadian Charter of Rights and Freedom, and were constitutionally invalid.
The Court suspended the declaration of invalidity until June 2009, to give Parliament the opportunity to amend the law to bring it into compliance with constitutional requirements. The Court also granted Insite a constitutional exemption to continue to operate in the interim.
The federal government immediately appealed the Court’s decision, and PHS and the two Insite users cross-appealed Judge Pitfield’s dismissal of the claim to exclusive provincial jurisdiction.
While the appeal and cross-appeal were before the B.C. Court of Appeal, the suspension of the declaration of invalidity of section 4(1) and 5(1) of the CDSA was continued.
On January 15, 2010, in a split decision, the B.C. Court of Appeal dismissed the government’s appeal and allowed the cross-appeal. The majority of the Court of Appeal applied the constitutional doctrine of inter-jurisdictional immunity and held that section 4(1) of the CDSA is not applicable at Insite. The Court of Appeal found that it was not necessary to address section 5(1) of the CDSA. Read the BC Court of Appeal’s decision here.
On February 9, 2010, the federal government applied to the Supreme Court of Canada for leave to appeal the decision of the B.C. Court of Appeal. The Supreme Court of Canada heard the case on May 12, 2011.
On September 30, 2011, all nine judges of Canada’s highest court ruled unanimously that attempts by the federal health minister to close Insite went against the country’s Charter of Rights and Freedoms, by threatening the safety and lives of the people who need to use it.
This decision legitimated Insite as an effective and humane health care response to the suffering of injection drug users.
It created an opportunity for other jurisdictions in Canada to build upon to create further services for drug users based on respect for the personhood of the drug user.
The InSite Story
This is a small video we edited together for InSite’s 10 year anniversary. It is part of a larger project we are in the process of making and only captures a sliver of the amazing stories and incredible people who were involved in making InSite happen.