In keeping with Vancouver's history of innovation in response to drug misuse, Vancouver Mayor Sam Sullivan and the Vancouver City Council voted last week to support two public health-oriented drug policy measures. One would extend the operation of the city's safer injection site, the first in North America, for three and a half years. The other would create a research trial to transition people struggling with addiction from using illegal street drugs to using legal prescription drugs. This would have international significance as a program that does substitution not only for heroin--which is currently being done in both Vancouver and Montreal--but for stimulant drugs.

Insite, the safer injection facility, is similar to programs already in operation throughout Europe and in Australia, but met a great deal of opposition in Canada when it sought to open its doors more than three years ago. With support from Vancouver's past mayors, the facility opened and has since been incredibly successful.

The current mayor of Vancouver, Sam Sullivan, has also strongly supported Insite in the face of pressure from Canada's Conservative government. The facility operates thanks to a federal exemption to Canada's drug laws, and last week's resolution called for the government to extend that exemption, set to expire this year.

Insite provides a sterile environment with clinical supervision for people injecting drugs. A recent study in the British journal Addiction indicated that Insite is reducing public drug use, lowering the spread of HIV/AIDS, reducing overdose deaths, and getting more people into treatment. The City Council resolution references this study and notes that the facility is in keeping with the city's Four Pillars strategy for addressing drug issues: harm reduction, prevention, treatment and enforcement.

The other measure the City Council voted to support is a research trial called Chronic Addiction Substitution Treatment (CAST). The trial would target people for whom traditional treatment methods have not worked, helping them switch from illegal street drugs, including stimulants, to legally available, orally-administered prescription medications. The program would put participants in contact with counseling and housing services.

The ultimate goal of the trial is ending drug dependency, but the proposal also articulates the measurable outcomes of reducing the open air drug market, lowering property crime, and improving health, housing access, and employment options for drug users.

"If there’s a leader in North America when it comes to drug policy, it’s Vancouver,” said Ethan Nadelmann, executive director of DPA.  "It’s truly an outpost of European pragmatism in North America, which DPA is working hard to replicate in our own country. Vancouver has led the way in introducing safer injection sites and heroin maintenance trials on this continent, and now they’re demonstrating global leadership with the CAST research trial.  Mayor Sam Sullivan and his two predecessors as mayor, Philip Owen and Larry Campbell, deserve great credit for spearheading a bipartisan consensus in dealing with the city’s tough drug problems."

The implementation of CAST and the continuation of Insite would both require exemptions granted by Health Canada, the federal health agency.