Opioid crisis

Canada is making it easier to open up supervised drug consumption sites

It’s going to be a lot easier for cities across Canada to open safe drug consumption sites, as new legislation is set to become law within days. The new centres could help combat an overdose crisis that has killed at least 2,300 people across the country just last year.

After a volley of amendments in both the House of Commons and the Senate, Bill C-37 is finally on track to become law, meaning that stiff regulatory burdens that can impede the opening of safe injection sites will finally be removed.

Bill C-37 will also make it harder to import pill presses and it grants border guards new powers to search envelopes in the mail if it’s suspected they contain illicit substances like fentanyl. Until now, the border agency had to request special permission from the government to open packages under 30 grams.

Health Canada is currently going through 18 applications for supervised injection sites from 10 cities, including from Ottawa and Toronto. Both cities have seen an uptick in overdose deaths, which are attributed to an illicit drug supply that has become contaminated with fentanyl, and its deadlier cousin carfentanil. The department approved two safe injection sites for Montreal last week.

On Wednesday, the Senate approved the amendments to the bill, and it will officially become law once it receives royal assent.

The Liberals, particularly Health Minister Jane Philpott, have faced immense pressure to respond quicker and more efficiently to the opioid overdose crisis that’s had a higher death toll than any other infectious epidemic in Canada. British Columbia declared a public health emergency over the matter in 2016, and saw nearly 1,000 overdose deaths that year. 

Philpott has pursued a suite of progressive drug policies including easing restrictions around the importation of prescription heroin to treat those with chronic opioid addictions, although she has rebuffed calls from frontline workers to decriminalize all drugs, citing the need for more scientific evidence on the matter.

Vancouver was, for years, the only city in North America with a supervised injection site where users consume their drugs under the supervision of a healthcare practitioner who can assist in the event of an overdose. There are now two federally approved sites in the city, and a number of “overdose prevention sites” in other parts of the province. Thousands of deaths have been prevented at Vancouver’s InSite alone since it opened more than a decade ago. Over the last few months, Philpott already relaxed some of rules under Canadian drug laws that made it nearly impossible for other cities to follow suit.

The high barriers to opening sites like InSite exist because the previous Conservative government, under the Respect for Communities Act, gave police, community groups, and the federal government an effective veto over opening these sorts of sites, despite a ruling from the Supreme Court of Canada protecting access to the harm-reduction sites. The new legislation will knock down those requirements, which many public health experts say are onerous.

The original language of C-37 proposed changes caused concern in the Senate, which in turn proposed three amendments. The health minister accepted some of the changes, including a 45-day minimum for the public to provide input on new plans for supervised injection sites. However, she rejected another amendment to create a citizen advisory committee to produce yearly reports on any concerns raised regarding the sites.

“It particularly was felt by many stakeholders to be stigmatizing because we don’t put this burden on any other kind of health facility,” Philpott said last week on that amendment.

Further, Philpott pushed back against another proposed amendment put forward by Conservative Senator Vern White that required doctors to offer pharmaceutical alternatives to drug users, such as pharmaceutical heroin, to help curb the illegal street supply. Philpott instead suggested that doctors “shall offer” or “may offer” such alternatives, instead of forcing them to.

A study released on Monday by the Vancouver Coastal Health found that around 80 percent of drugs tested at InSite tested positive for fentanyl, including non-opioid drugs like cocaine and crystal meth. It bolsters concerns that the illicit drug supply in Vancouver and elsewhere has become increasingly contaminated with the highly potent opioid, in many cases without the user knowing.

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