Thank you very much, Madam Chair.
Good afternoon, ladies and gentlemen.
Good morning, ladies and gentlemen. Thank you for taking the time to be here, and thank you for providing me with this opportunity to speak and to respond to some of the statements made here today.
As Parliamentarians, we have a common desire and duty to understand our country, examine options on future public policy choices and then recommend or make decisions that will be in the best interests of Canadians. It is no different with this Committee's work, nor in my work as Health Minister.
We are all here because we want the best for all Canadians. This includes those who are addicted to drugs and who need our help and support and those who are not involved with drugs and seek to protect their kids, their families, and their communities from the crime that inevitably accompanies the development of a drug culture.
You've heard from numerous witnesses today who no doubt hold strong views regarding the topic of harm reduction and how we can best help people addicted to drugs as they work to get their lives back on track.
Earlier this week we received a decision from Justice Pitfield of the B.C. Supreme Court, who has deemed Canada's Controlled Drugs and Substances Act in violation of section 7 of the Charter of Rights and Freedoms and has declared Vancouver's supervised injection site a “health centre”. With his decision, Justice Pitfield has provided an exemption for Insite to continue operating until June 2009.
At this time I would like the record to show that I respectfully disagree with Justice Pitfield. While I understand and share the desire to show compassion, this is a misplaced compassion. Addicts need treatment. This is why I have announced over $150 million in treatment funds in the past few months. I am convinced of the value of treatment because as health minister I have spoken with people addicted to drugs, people who were formerly addicted, researchers both at home and abroad, mayors, councillors and other elected officials, police officers, advocates of all persuasions, and of course parents and kids who desire only to be free of the scourge of illegal drugs in our society.
When I visited Insite over a year ago, I also visited other facilities in the downtown eastside to examine how they do things, why they do them, and what the impacts are.
If there's one thing I've learned, it's that people believe what they believe, earnestly and resolutely.
This is an area of public policy without very much mushy middle.
So given the significance of the decision to appeal or not to appeal, I would like to offer this committee my assessment of Insite, based upon the factors that are, in my opinion, the most relevant. Those factors are twofold: science and public policy.
Science helps guide public policy, no doubt, but public policy takes into account a wider scope of issues, including society's criminal justice aspirations, as well as the principles and ethical framework with which we hope to animate our policy decisions. All of these are relevant in our examination of Insite and all need to be considered.
On the question of science, let me assure you I've read many of the studies that have been published on Insite. These studies have the weight of publication as well as some articulate proponents who insist that their positions are the correct ones. Many of the studies are by the same authors who, quite frankly, plough their ground with regularity and righteousness. Indeed, while in our free society scientists are at liberty to become advocates for their position, I've noticed that the line between scientific views and advocacy is sometimes hard to find as the issue on Insite is developed.
When these papers were reviewed by the expert advisory committee that served at arm's length to the government and by Health Canada and by science authorities in Canada and around the world, the results can only be described as mixed. For example, Insite did cause an uptake in treatment; yet from 2004 to 2005, only 3% of Insite clients were referred to long-term treatment. The studies were so inconclusive that the report suggests a number of new research directions, but no one can say whether another five years of study would provide any more answers.
Second, the expert advisory report concludes that research on Insite is uncertain. For example, after five years of intensive study, researchers still aren't sure whether Insite makes any difference at all in the transmission of blood-borne diseases, including HIV/AIDS, or whether Insite's benefits with respect to injection are greater than the $3 million annual cost. Throughout the expert advisory report, there are numerous caveats on the limitations of the research.
Finally, what do we know specifically about supervised injections at Insite? Here we must set aside the other services provided by Insite, such as needle exchange or condom distribution, which take place, quite frankly, in many other settings across Canada and are irrelevant to supervised injections.
But we know this: Insite is dominated by a group of about 500 regular clients. Up to 97% of injections, or 4.4 million injections per year, occur outside of Insite. Since Insite opened, there have been 50 overdose deaths per year in the downtown eastside. There is no direct evidence that the SIS influences overall death rates. In fact, according to the expert advisory committee, Insite saves about one life per year.
My job as health minister is to balance that one life against any possible negative effects of supervised injection that might take one life elsewhere, and it is a difficult job. Some read these statements and think they are clear victories for supervised injection, but I think we can do better than saving one life per year. And we must do better.
Furthermore, there are other studies that cast doubt on supervised injection. Garth Davies of Simon Fraser University concluded in a recent peer-reviewed article:
Previous studies [on safe injection sites] are compromised by an array of deficiencies, including a lack of baseline data, insufficient conceptual and operational clarity, inadequate evaluation criteria, absent statistical controls, dearth of longitudinal designs, and inattention to intrasite variation. This review suggests that much of the commonly-cited evidence regarding the effects of SIFs cannot be substantiated.
And in a feasibility study last year of an SIS in Victoria, the Centre for Addictions Research of B.C. said “there is to date no epidemiological evidence of reduced infectious disease transmission...among clients” in supervised injection sites; that “the cost-effectiveness of [SISs] is difficult to ascertain”; and that the evidence of the effectiveness of SISs is “less conclusive than supporters...might have wished”.
In that report, one drug user stated, “I think it's ridiculous to have a Supervised Consumption Site when people need housing, shelter, and basic needs first.”
Let me now consider the public policy, for while the science is mixed, the public policy is clear.
Let me turn now to the issue of public policy, in particular crime and crime prevention. Some advocates have claimed that Insite has made crime in the downtown east side either better or at least, no worse.
It is true that the total crime rate has not escalated with Insite, but it is also true that Vancouver police added 65 beat officers to the streets of the downtown eastside simultaneously with Insite's establishment. Many police officers feel this is the real reason crime statistics have not skyrocketed. In fact, the EAC report noted that addicts typically need to spend about $35,000 per year to support their habit and that about $350,000 worth of crime needs to be committed to obtain that $35,000. So, ladies and gentlemen, we are talking about hundreds of millions of dollars worth of crime against the law-abiding members of the public.
We, as parliamentarians, are also sworn to uphold the rule of law. We would lay down our lives for it, and when we speak the plain truth, call crimes what they are, we are standing up for and showing respect for the rule of law. There have always been and there always will be people who break the law. That does not mean, however, that we abandon the law. Chaos would reign if we did.
Inspector John McKay from the Vancouver Police Department, a duty officer in the downtown eastside, which houses the SIS, has written of the chaos occurring as a result of the opening of the SIS, and he also clearly sees the slippery slope and warns us of what may come next. Inspector McKay writes, and I want to quote him somewhat extensively:
In 2001, the City of Vancouver rolled out their strategy called the Four Pillars Approach, which included the federal government providing an exemption to the Controlled Substances Act for an SIS in the downtown east side.
To support the enforcement pillar of the four pillars and realizing the potential for complete chaos, VPD assigned 65 police officers to a five-block area around the SIS. They eventually became known as the beat enforcement team.
I was assigned as the officer in charge in September prior to the SIS opening.
The SIS opened in September 2003. Lattes and t-shirts were given out to addicts. A portion of the facility was designed to be able to be used as a drug inhalation centre.
Upon the opening of the SIS, Vancouver Police Department agreed not to arrest and charge anyone going to the SIS with illegal drugs in their possession within a five-block radius of the SIS. Instead, police were to walk the addict to the SIS from anywhere within the five-block area.
This no-charge policy creates a culture of entitlement with the addicts who simply have to say they are going to the SIS and are now immune from prosecution.
The culture of entitlement was supported by the Vancouver Union of Drug Users, which holds an annual anti-police rally outside the 312 Main Street station where the beat enforcement team personnel work.
In 2006 the culture of entitlement was so bad that addicts were openly using drugs at bus stops, school grounds, and business fronts. With the support of the crown, Vancouver police advised Vancouver Coastal Health personnel and the SIS that anyone caught using drugs, inhaling or injecting, at these locations would be charged criminally. This was loudly supported by the public however VCHA accused the VPD of not supporting harm reduction.
In 2004, Mayor Campbell held the Mayor's Conference on Drug Prevention Strategies. The prevention strategy that was arrived at was to legalize all psychoactive drugs so that addicts wouldn't be harmed by a criminal conviction and stigmatization. In 2004, I attended the SIS steering committee meeting which included the VCHA, the RCMP, the Portland Hotel Society, and the authors of the four pillars strategy. Vancouver Coastal Health wanted to activate the inhalation portion and proceed with assisted injections. This motion was quashed by me and my position was supported by the VPD executive. In 2005, I attended one of several monthly scheduled meetings with the Vancouver agreement people. This meeting is to determine the vision in 2006 and beyond for the DTES; their vision includes a place where certain Criminal Code sections and the Controlled Drugs and Substances Act do not apply.
Inspector McKay is not writing in an ivory tower. He is the duty officer responsible for the five blocks around the SIS. He is not out to win any popularity contests. He speaks the plain truth. He sees the slippery slope that we step onto when we decide to ignore the rule of law.
In 2006, Vancouver had the second-highest rate of violent and property crimes of any major city in the United States or Canada. Law-abiding Vancouverites are beginning to see that what has been presented as a “victimless crime”—the drug trade—is not victimless at all.
Canada's approach—looking the other way while crimes are committed—is now becoming an international issue. The International Narcotics Control Board, an agency of the United Nations, has named Canada in its annual report for several years now as being in violation of a number of anti-drug treaties and conventions.
Let me now speak of how our government sees harm reduction and how it fits into our new national anti-drug strategy. We see harm reduction as being represented within the other three pillars of enforcement, prevention, and treatment.
This is why, for example, I announced $111 million in treatment funding for the provinces and territories last month and $30 million for aboriginal addictions programming. On May 14, together with Mayor Sullivan, I also announced a $10 million fund dedicated solely to Vancouver's downtown eastside—
