Dr Peter clinic runs a lawful injection site, says director

A Supreme Court of Canada decision on the fate of Insite near Hastings and Main will have major repercussions for the Dr. Peter Centre in the West End where the country’s other safe injection site is open seven days a week.

Maxine Davis, the executive director of the Dr. Peter AIDS Foundation, which oversees the day health program and residential care centre for 350 patients with HIV and AIDS, says she is optimistic supervised injection clinics will finally be granted the right to operate in Canada without a ministerial exemption.

“I would be stunned if it didn’t win,” she said. “It’s appalling that the federal government of this country is going as far as the highest court it the land to prevent this service from happening,” said Davis this week before travelling to Ottawa for the May 12 hearing for which the foundation has legal intervenor status.

“I am relieved that this is going to the Supreme Court,” she continued. Determining what jurisdiction governs Insite - whether it is a provincial health service or an infringement of federal drug law - is “an opportunity” to depoliticize drug treatment and recognize supervised injection as legitimate health care, she said.

A courtroom loss would be devastating.

“It would be a choker for me. That, yet another arm of Canada’s democracy has failed very vulnerable people in this country. There aren’t any more vulnerable people in this country than the people who seek the support of Insite.”

At the Dr. Peter Clinic, the injection site is a small but crucial part of care. Approximately 50 people visit the clinic, some up to five times a week, to inject drugs with a sterile syringe under the supervision of a nurse.

“People are coming on a daily basis,” said Davis. “They invest in walking in the door so they can get help. Why would you want to turn around and say, ‘No, you have to go out in the alleys to use."

Insite operates under an exemption of the Controlled Drugs and Substances Act. The Dr. Peter Centre has never applied for that same exemption but opened in 2002 more than a year before Insite opened in September 2003.

Davis is adamant the clinic operates lawfully.

“We are upholding provincial law through making sure that nurses can practice according to their standards and we do everything reasonably possible to uphold federal law. Nurses do not touch the drugs, nurses do not inject the drugs and they do not provide the drugs,” she said.

The colleges of registered and psychiatric nurses that confirmed supervised drug injection was a form of harm reduction within their ethical and professional scope. Denying the treatment, on the other hand, was seen as a breach of those standards of care.

The centre is operated by a non-profit foundation that relies on donations and government funding to run a 24-suite nursing clinic around the clock in addition to a day program that includes basic wound treatment to palliative care, counselling and therapeutic services.

The male and female patients all have HIV or AIDS and are admitted because they are severely at risk for deteriorating health. Participants, as the clinic calls its patients, live with multiple personal challenges, including physical disability in some cases, and have limited financial or family support and unstable housing.

The centre’s late namesake and founder, Peter Jepson-Young, would not be accepted as a patient today because, at the time of his death in 1992, he was capable of self-care and had a supportive family network.

In March, the provincial health officer cited the Dr. Peter Centre as a model for other clinics to emulate. “The individual and health system benefits of supervised injection have been clearly demonstrated and access to supervised injection services should be expanded in BC, ideally by incorporation into routine public health services,” wrote Dr. Perry Kendall.