Social Policy, Federalism Disputes and the Courts: Vancouver’s Safe Injection Site as a Case Study in Canadian Multilevel Governance [Prepared for presentation at ―Comparing Modes of Governance in Canada and the European Union: Social Policy Engagement across Complex

Insite, established as the first supervised injection facility in North America, was a pilot project developed in 2003 in response to the rampant drug use that marked the Downtown Eastside (DTES) neighbourhood of Vancouver. Once considered a vibrant city centre, the DTES underwent a considerable economic and social downturn through the 1960s and 1970s as the downtown core migrated west. The DTES is marked by high rates of poverty, alcoholism, drug abuse, prostitution, violence, disease, and mental illness. The City of Vancouver did not have the resources or jurisdiction necessary to address these issues on their own. Following a spike in drug-related deaths in the 1990s that were characterized as an epidemic, in 1998 the city approved of a program of strategic actions focused on the DTES. The city then negotiated ―The Vancouver Agreement‖ with the federal government and the province of British Columbia to support plans for economic, social and community development. 1 One of the central elements of the Agreement‘s health priorities was an emphasis on harm reduction, referred to as one of the ―four pillars‖ of the governments‘ anti-drug strategy. 2 In 2002 Larry Campbell was elected mayor of Vancouver after pledging to open a supervised injection facility. Opening Insite required the cooperation of the federal and provincial governments and the local health authority (the Vancouver Coastal Health Authority). Most significantly, in June 2003, the federal minister of health granted the facility a three-year exemption under section 56 of the Controlled Drugs and Substances Act (CDSA) to allow the site to open. The exemption was intended to facilitate scientific research on harm reduction. Insite opened three months later. Health Canada also provided $500,000 per year for the first three years of the pilot project‘s operation. BC‘s Ministry of Health contributed the remainder of the funding to the Vancouver Coastal Health Authority, which, in conjunction with the Portland Hotel Society – a non-profit organization dedicated to social housing – operates Insite. Further, the British Columbia Centre for Excellence in HIV/AIDS was commissioned to conduct research to evaluate the facility. The Conservative Party of Canada won the 2006 federal election, succeeding the Liberal government. Though the new government decided to end federal funding of Insite, Health Minister Tony Clement provided a 16 month extension of the CDSA exemption to allow for further research. In October, 2007 the exemption was again extended, this time until June, 2008.