Safe injection sites for drug users could be a fixture in some Canadian cities as early as next year. A spokesperson for Health Minister Anne McLellan said the ministry is shaping guidelines under which cities could propose by year-end to open safe injection centers. If approved, the sites would be the culmination of a pilot project first proposed by a consortium known as the North American Opiates Maintenance Initiative, which approached the Canadian Institutes for Health Research and proposed safe injection sites for Vancouver, Toronto and Montreal. CIHR is the country's premier agency for health research and is funded by the federal government.

Dr. Perry Kendall, chief medical officer of British Columbia, believes safe injection sites would reduce the costs of crime, health care, courts and social disruption. Only addicts who have been unable to get better through methadone treatment and counseling would be eligible, he said. Such sites are already in use in the Netherlands and other European countries. Kendall said the program, if approved, would involve 160 chronically relapsing drug users in a clinical program lasting about 18 months.

Kendall said studies have shown that in countries with methadone treatment and counseling, a substantial number of addicts still are not helped by treatment. In the mid-1990s, he said, a Swiss program added heroin to methadone treatment and enrolled about 1,000 long-term, unrehabilitated drug users. "They were surprised that these people's health improved," he said. "They weren't buying heroin on the streets. The use of cocaine plummeted." Acknowledging the idea of giving heroin to addicts leaves some people aghast, Kendall said, "...yes they are still addicted, but they're not dying of overdoses and not getting hepatitis C and HIV."

The Canadian Alliance Party is among those appalled by the idea. "The problem is people who are drug addicts need to get off drugs, not to stay on drugs," said Alliance Member of Parliament Randy White: "It's not harm reduction, it's harm extension." White wants the federal government to concentrate instead on detox centers and rehabilitation, insisting there is something "tragically wrong" with giving out heroin at safe injection sites.

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