POLICY CASE STUDIES
Prospects for scaling-up supervised injection facilities in Canada: the role of evidence in legal and political decision-making
Article first published online: 3 JAN 2013
© 2013 The Authors, Addiction © 2013 Society for the Study of Addiction
Volume 108, Issue 3, pages 468–476, March 2013
How to Cite
Hyshka, E., Bubela, T. and Wild, T. C. (2013), Prospects for scaling-up supervised injection facilities in Canada: the role of evidence in legal and political decision-making. Addiction, 108: 468–476. doi: 10.1111/add.12064
- Issue published online: 18 FEB 2013
- Article first published online: 3 JAN 2013
- Manuscript Accepted: 13 NOV 2012
- Manuscript Revised: 22 OCT 2012
- Manuscript Received: 30 AUG 2012
- harm reduction;
- illicit drug policy;
- injection drug use;
- supervised injection facilities
North America's first supervised injection facility—Insite—opened in Vancouver in 2003 under a special federal legal exemption. Insite has faced significant political and legal opposition, which culminated in a recent Supreme Court of Canada ruling that ordered the federal Minister of Health to extend the facility's exemption and cited evidence that the facility is life-preserving and does not increase public disorder. Officials in several other cities have initiated or accelerated preparations for new facilities due to speculation that the ruling provides sufficient legal basis to expand supervised injection in Canada. However, a comprehensive assessment of the barriers and facilitators to supervised injection facility scale-up is lacking.
This policy case study reviews a corpus of jurisprudence, legislation, scientific research and media texts to: describe the role of evidence in legal and political decision-making around Insite; analyze the implications of the Insite decision for new facilities; and discuss alternative avenues for supervised injection facility expansion.
The Insite decision does not simplify the path towards new supervised injection facilities, but nor does it does pose an insurmountable hurdle. Whether new facilities will be established depends largely upon how the Minister of Health interprets the ruling, the proponents' ability to demonstrate need and support from municipal and provincial governments and community members. Formally defining supervised injection as within nurses' scope of practice could further efforts to establish new facilities.
Additional court action may be required to establish a stable legal and policy basis for supervised injection facilities in Canada.