Teaching Resource Compiled by Josephine Savarese St Thomas

Teaching Resource Compiled by Josephine Savarese, St. Thomas University THE VANCOUVER SUPERVISED INJECTION SITE HUMAN RIGHTS AND HARM REDUCTION

Did you know… � That Vancouver is home to North America’s first legal supervised injection site? � Established in September 2003.

The Vancouver Si. S � Operates under an exemption granted by Health Canada �Section 56 of the Controlled Drugs and Substances Act � the Si. S is necessary for: �a medical and scientific purpose �and is in the public interest

A Personal Story � http: //www. youtube. com/watch? v=RV 2 T q. BFNTac&feature=related

Overview: Connections to Criminal Justice � What is a safe injection site? �Where do they operate? �Why? �How? � What international human rights laws are relevant to the safe injection site?

Background � What is a supervised injection site?

�A health setting monitored by professionals where: ○ Drug users (who supply their own drugs) inject under supervision ○ Receive health care, counseling and referrals

Why were the sites established? Harm reduction model Public health issues

The Scope of the Problem - Vancouver � 1. 3 million residents: �About 12, 000 were intravenous drug users. �Nearly 40 percent of drug users had HIV or AIDS. � 90 percent had Hepatitis C. � 2, 000 people had died from drug overdoses since 1993. 2003 Vancouver figures – BC Health

Costs to the Health System � Each HIV case costs between $150, 000 and $225, 000 � Ambulance costs

Evaluation of Si. S’s: Vancouver: One Year Evaluation - 2004 Served over 3000 clients q Averages ~ 600 injections per day q Heroin and other opiates most common q Clients rate the staff highly q Site is “well managed” q Over 100 interventions in drug overdoses q ~ 300 referrals to treatment and withdrawal management services q

The World � Reports are positive reduce injection-related risks and harms, including vein damage, overdose and transmission of disease � They are successful in reducing public order problems associated with illicit drug use, including improper syringe disposal and public drug use

Video prepared by: Insite/Vancouver Coastal Health http: //www. youtube. com/watch? v=d. Qp. RM Jac. Ti. Q

Global Context There are 27 supervised injections sites in the world � In cities including: �Geneva �Zurich �Frankfurt �and Sydney (Australia)

SI/Sites and International Law �Key concepts �Sovereignty �Treaties

Si. S - Relevant International Laws Human Rights Obligations World Health Organization – Constitution The enjoyment of the highest standard of health is one of the fundamental rights or every human being without distinction of race, religion, political belief, economic or social condition.

Human Rights Obligations Con’t The Universal Declaration on Human Rights – Article 25 “Everyone has the right to a standard of living adequate for health and wellbeing, including medical care and necessary social services. ”

Human Rights Obligations Con’t International Covenant on Economic, Social and Civil Rights - Article 12 State parties recognize. . . “the right of everyone to the enjoyment of the highest standard of physical and mental health. ”

Drug Control Treaties 3 treaties – Canada is a party: Single Convention on Narcotic Drugs (1961 - amended by 1972 Protocol) § Convention on Psychotropic Substances (1971) § United Nations Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances (1988). §

Emphasis law enforcement and criminalization � Harm reduction approaches correspond with the goals of treatment, education, rehabilitation and re-integration, also in the treaties � The Swiss Institute of Comparative Law (2000)

The Issue in International Law International Narcotics Control Board (INCB) • • • Created 1961 (under the SCND) 13 -member independent board Monitors the implementation of drug control treaties Connected to the United Nations Commission on Narcotic Drugs Prepares annual report

2004 Report: Cited the Vancouver Si. S It "violate[s] the provisions of the international drug control conventions. " Recommended closure of the safe injection site

Class Discussion Imagine yourself: As a team of international law experts and policy advisors to the Vancouver Coastal Health Authority. § The VCHA want to respond to the INCB’s criticisms. § !

In small groups: The team has convened behind closed doors to review the information Consider: 1. What are the strongest arguments for safe injection sites?

Groups Con’t 2. Compare and contrast the human rights approach with the drug control philosophy.

Conclusions Recommendations: • How would you challenge the arguments that the supervised injection site be closed? • What research can you find? • If there were one voice in the room, what would it be saying?

Please check out: www. thisisus. ca drug use reality project