Health Canada has granted permission to the Downtown Eastside’s supervised-injection site to operate for another four years.

Yesterday (March 17), Insite was granted an exemption from Section 56 of the Controlled Drugs and Substances Act. The facility has received permission to operate on an annual basis every year since it opened in 2003. Now Health Canada has said it can continue to do so without it going through the reapplication process again until 2020.

The move by Health Canada marks a significant departure from policies of the former Conservative government. Under Stephen Harper’s leadership, Ottawa actively tried to shut the facility down, even pursuing the matter all the way to the Supreme Court of Canada, where, in 2011, a judge ruled in Insite’s favour.

B.C. health minister Terry Lake applauded the change in attitude.

“We are encouraged by Health Canada’s willingness to voluntarily move to a multiyear exemption for Insite,” he said, quoted in a media release. “It reflects an understanding of the tremendous value the facility has, and signals that Insite is an important part of health services within the Vancouver community in the eyes of the federal government.”

The release notes this was the first time Insite’s operator, Vancouver Coastal Health (VCH), had applied for the exemption since the former Conservative government passed Bill C-2, the so-called Respect for Communities Act, last year. That legislation made it significantly more difficult for supervised-injection sites to receive the exemption they require, adding 27 conditions to the application process.

“In order to meet the 27 new conditions for exemption, VCH was required to submit additional volumes of information,” the release reads. “In practical terms, these new requirements make it onerous for Insite and other supervised injection services to obtain an exemption. VCH is hopeful the federal government will review and change the legislation developed under the previous government.”

Last January, a West End clinic called the Dr. Peter Centre became the second supervised-injection facility in North America to receive government approval to operate. After the former Conservative government delayed making a decision on its application for nearly two years, the new Liberal government approved it shortly after taking office. The Dr. Peter Centre received approval for a two-year period.

(There is one important distinction between supervised-injection services offered at the Dr. Peter Centre and those provided by Insite in the 100 block of East Hastings. While Insite allows anybody to bring illicit narcotics into its building, the Dr. Peter Centre requires that a drug user accessing its services be a member of its foundation and living with HIV/AIDS.)

VCH used news of the four-year exemption granted to Insite to officially announce plans to open additional supervised-injection facilities in Vancouver.

“VCH plans to seek further exemptions under Section 56 of the Controlled Drugs and Substances Act to incorporate supervised injection into other existing health care services for those suffering from addiction,” the release states.

The Straight first reported on those plans in June 2014. Interviewed for that story, VCH’s chief medical health officer, Dr. Patricia Daly, suggested that the Dr. Peter Centre could serve as a model for other clinics interested in offering supervised-injection services. (Earlier this month, Toronto said it was doing just that.)

Instead of hosting such services at a stand-alone facility with significant startup costs and high administration fees, the Dr. Peter Centre was built to include a small injection room. That allows nurses already providing a range of health services to simply offer one more, Daly explained.

“That’s very inexpensive,” she said at the time. “That’s the kind of model that we’d like in order to be able to expand this service.”

Quoted in the March 18 media release, Daly said the need for harm-reduction services remains great.

“Overdose deaths in Vancouver are on the rise, as is the presence of fentanyl in the illicit drug market in Vancouver and throughout B.C.,” she said. “Supervised injection services, like those provided at Insite and the Dr. Peter Centre, are needed now more than ever because they save lives and reduce the harms of drug use for people who are actively addicted to injectable drugs.”

The release notes that since Insite opened in 2003, its staff have supervised more than two million injections, intervened in more than 1,500 drug overdoses, and never seen one death.