North America's only legal drug injection facility saves lives and should stay open, Canada's Supreme Court ruled Friday.
The court's decision could facilitate the eventual opening of other facilities in different cities, but the court's ruling applied only to the site in Vancouver.
The facility called Insite was promoted by its founders as a safe, humane space for drug abusers. Canada's Conservative government said it aids drug abuse, but the court ruled the government should stop interfering in the controversial clinic.
The top court issued its 9-0 decision in a landmark case that received international attention.
As of 2009, there were 65 injection facilities in 27 cities in Canada, Australia and western Europe, according to the Canadian Medical Association Journal. The World Health Organization has called them a "priority intervention" in slowing the spread of AIDS via infected needles.
When Insite opened, the Bush administration's drug czar, John Walters, called the operation "state-sponsored suicide."
Addicts are given clean needles and sterilized water in which to mix their drugs. They bring their own drugs and inject at 12 stainless steel alcoves with mirrors on the walls so nurses on a raised platform can see them.
Defenders of Insite _ a taxpayer-funded operation in a seedy, drug-infested district of Vancouver, British Columbia _ said the facility is providing a form of health care that is a provincial matter under Canada's constitution. The Canadian government countered that because heroin is a federally banned substance, national law should trump provincial rights.
The ruling said the government's previous decision to end the drug-law exemption threatened injection drug users' health and their lives.
"During its eight years of operation, Insite has been proven to save lives with no discernible negative impact on the public safety and health objectives of Canada," the court said. "The effect of denying the services of Insite to the population it serves and the correlative increase in the risk of death and disease to injection drug users is grossly disproportionate to any benefit that Canada might derive from presenting a uniform stance on the possession of narcotics."
Insite lawyer Joe Arvay said it means the facility can remain under a permanent exemption from Canada's criminal drug laws.
The president of the Canadian Medical Association said he was pleased with the ruling and said it could pave the way for similar sites in Montreal and Toronto.
"It saved lives and it's a proven tool in management of addiction," Dr. John Haggie said. "We would like to see it as part of a national strategy."
Laura Thomas, California deputy director of the Drug Policy Alliance, said no one has tried to open a legal safe injection facility in the U.S. but that the Canadian ruling will help U.S. cities, such as New York and San Francisco, where there are advocates.
Conservative Health Minister Leona Aglukak said in Parliament that the government was disappointed with the ruling but would comply. She said the system should be focused on prevention and treatment as the best ways to combat drug addiction.
Canadian Prime Minister Stephen Harper underscored that sentiment.
"We're disappointed. We have a different policy. We'll take a look at the decision but we'll clearly act within the constraints of the decision," he said.
Arvay said there is no other avenue of appeal for the Canadian government.
The decision was greeted with a massive cheer from hundreds gathered outside Insite before dawn Friday.
The storefront facility sits in the Downtown Eastside, 15 blocks of cheap rooming houses where addiction and street prostitution are rampant and an estimated 5,000 of the area's 12,000 residents are believed to be addicted to drugs.
Julio Montaner, past president of the International AIDS Society and the director for the B.C. Centre for Excellence in HIV/AIDS, said the area's infection rate is the worst in the developed world. He said the decision "represents a victory for science over ideology."
The Vancouver Coastal Health Authority Chief Medical Health Officer Patricia Daly said it means they can prevent life-threatening diseases in a vulnerable population.
Insite averages more than 800 visitors a day and has supervised more than a million injections since it opened in 2003. Insite has not reported any deaths at the facility.
Dr. Thomas Kerr of the University of British Columbia's Faculty of Medicine said there have been about 1,500 overdoses at Insite.
"Nobody has died at this facility," he said. "This is without a doubt a facility that saves lives."
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