A public health emergency was declared in the
Downtown Eastside in September 1997. Injection drug use had reached crisis levels with epidemics of HIV/AIDS and hepatitis C soon following. Owen initially opposed drug reform. Further criminalization and the AIDS epidemic were seen as potential ends to the cities drug user problem. But following a change of heart while Mayor, Owen became noted for his championing of
drug policy reform in his later years. According to
Insite co-founder Liz Evans, “He started to watch people dying like flies from heroin overdoses, and at the time no-one was interested in having that conversation (about safely injecting drugs)." she continued, "He was a very decent man, a very kind man, and also a man who was not afraid to learn new things,” After four years of research, Owen led a local and national debate to fight
drug addiction problems in Canadian cities. An 85-page action plan was passed unanimously by Vancouver City Council in May 2001. This new policy had the support of over 80 per cent of Vancouver's residents, as well as the
Federation of Canadian Municipalities' Big City Mayor's Caucus. As a result, Vancouver opened
Insite in 2003, the first legal
safe injection site for intravenous drug users in North America. Owen used his position in the media to attempt to change the narrative on drug addiction away from crime and towards health policy, however, public opposition to Insite's opening was immediate and loud. Upon opening, it drew criticism from the
Bush administration with
John Walters, the director of the
White House Office of National Drug Control Policy, calling it "state-sponsored suicide." The
Harper Government called Insite "a failure of public policy and ethical judgement" In 2008, Minister of Health
Tony Clement failed to renew Insite's exemption under the
Controlled Drugs and Substances Act (
CDSA) and publicly cast doubt on Insite's ability to operate any further. The stark differences in defining addiction as either: a crime, or as a health condition needing treatment, lay at the heart of the public perception differences attempting to be changed within the Four Pillars approach. Under the Canadian Constitution, matters of criminal law are under both the jurisdiction of Federal and Provincial governments, but matters of Public Health are considered within the Exclusive Powers of
Provincial Legislatures. This division of powers, and the conflicting definitions launched
Canada (Attorney General) v PHS Community Services Society a Canadian Supreme court case that began in 2011, seeing Insite defend its right to existence in court against the powers of the Federal government intent on closing and barring further safe consumption sites from opening in Canada. The case lasted 141 days before the supreme court, with 3 prior cases referenced, 5 Respondents including: Dean E. Wilson, Shelly Tomic, the
PHS, and the
BCAG. 15 Interveners including the:
Canadian Nurses Association, British Columbia Nurses Union,
QCAG,
VCHA,
CCLA,
IHRA,
RNAO, ARNoBC,
CPHA,
CMA,
BCCLA, and
REALWoC. The courts ruling was a 9-0 unanimously dismissal of the
Harper Government's appeal and cross-appeal stating: "The
Minister of Health is ordered to grant an exemption to Insite under s. 56 of the
CDSA forthwith" and following:
"The Minister’s decision thus engages the claimants’ s. 7 interests and constitutes a limit on their s. 7 rights. Based on the information available to the Minister, this limit is not in accordance with the principles of fundamental justice. It is arbitrary, undermining the very purposes of the CDSA, which include public health and safety. It is also grossly disproportionate: the potential denial of health services and the correlative increase in the risk of death and disease to injection drug users outweigh any benefit that might be derived from maintaining an absolute prohibition on possession of illegal drugs on Insite’s premises." [...] "The evidence indicates that a supervised injection site will decrease the risk of death and disease, and there is little or no evidence that it will have a negative impact on public safety, the Minister should generally grant an exemption." In
Insite's first 20 years of operation, facility's staff administered 11,856 overdose reversals, made 71,103 referrals to off-site services (such as rehab), and never saw one overdose death. ==Criticism==