Policy Options Task: Evaluating Safe Injection Sites in Ontario

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Added on  2022/11/14

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This essay analyzes the constitutionality of safe injection sites in Ontario within the context of the ongoing opioid crisis. It presents arguments both for and against the constitutionality of these sites, considering their impact on user rights, public health, and government control. The essay explores the pros and cons of safe injection sites for both users and the Ontario government, including the potential for harm reduction, access to healthcare, and challenges to government authority. Drawing on the Supreme Court's 2011 ruling and the current political climate, the essay suggests alternative policy options and reform strategies that a Conservative government might pursue, such as regulating access to approved drugs, influencing prescribing practices, and implementing drug take-back programs. The paper emphasizes the need for a balanced approach that addresses both the immediate crisis and the long-term effects of drug use on society.
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Running head: POLICY OPTIONS TASK 1
Policy Options Task
Student’s Name
Institutional Affiliation
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POLICY OPTIONS TASK 2
Policy Options Task
Ontario is, without a doubt, amidst an opioid overdose crisis. From January to September
2018, more than one thousand individuals in Ontario only died of an opioid overdose. The
number of deaths in Ontario is second to the 1,155 deaths in English Columbia, named the
"ground zero" of the overdose plague in North America (Mahal, 2019). However, without any
indications of the emergency backing off, the Ontario government reported in April that they
would unexpectedly end funding to the safe injection sites. This was a perilous and extreme step
reversing general progress of fighting the crisis.
The site was a questionable health intervention to decrease deaths from opioid overdose
and other dangers associated with unsafe injection by drug addicts such as the transmission of
HIV and hepatitis C from shared needles (Rhodes et al., 2006). Also known as Insite, safe
injection site enables clients to access clean supplies of syringes and inject themselves in a
setting with health experts who can act promptly to manage an overdose. Since its inception in
2003, 3.6 million patients have injected themselves under supervision at Insite alone. There have
been 6,440 overdose mediations and zero deaths (Mahal, 2019).
De-funding these sites violate a user's Charter rights. It is because the sites provide
Canadians with life-saving medical care. The utility has been used as a successful intervention in
reducing and preventing deaths related to opioid overdose (Mahal, 2019). Besides, the site
lowers the expenditure on the emergency response as it has a nurse on site who caters for any
emergencies there and then. Also, the site lower the risk of the general public of acquiring
HIV/Aids and diminishes open drug use making the streets safer (Boeri, 2015). Thus the safe
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POLICY OPTIONS TASK 3
injections sites are more than just a place where drug abusers can use drugs but rather a safe
place where drug users can get help.
Since safe injection sites are facilities where individuals hire space to abuse drugs, their
constitutionality is debatable. Some people feel that these sites are constitutional because they
provide lifesaving medical care, and others think they are unconstitutional because they promote
drug use and promote criminal activity. Thus, the following arguments are in favor of their
constitutionality, and the others are against it.
The people who argue that the sites should be constitutional give different reasons. The
first argument is that it saves lives. Research shows that there has been no overdose death at the
site since it opened in 2003 (Stueck, 2018). Overall, about six hundred injections happen per day
at the site, and a year ago alone there was more than two hundred overdose treatment by Insite
staff by providing oxygen or other medicines to clients who show manifestations of overdosing.
Earlier on, the sites cautioned of a rise in overdose deaths occurring because of potent opioids
being sold throughout the region and asked sedate clients to utilize available resources, for
example, Insite where possible. Besides, general healthcare providers support the organization
because it provides healthcare services to drug addicts and users.
The second reason why people argue that safe injection sites should be constitutional is
that they fill in as an extension to detoxification and treatment facilities for drug addicts (Stueck,
2018). The sites are thought about as a feature of a four-system approach in combating unsafe
drug use. Their approach is harm reduction, aversion, treatment, and implementation. The system
is comparable to projects that existed, for example, in Switzerland and Germany and were used
in the 1990s (Bale et al., 1980). By offering a perfect, safe, non-judgmental condition to shoot
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POLICY OPTIONS TASK 4
up, Insite permits drug users to associate with different administrations, regardless of whether
they are seeking treatment for a medication-related ulcer or dental consideration. Besides, safe
injection sites refer the patients to other healthcare facilities. For instance, a year ago, the sites
made more than five thousand referrals to other social and wellbeing offices, including
rehabilitation centers. To sum up, state-managed injection sites ought to be viewed as one bit of a
higher plan of treating chronic drug use and its related effects on society.
The third argument by supporters of safe injection site is that it benefits the general
wellbeing of the community. Many research studies have concluded that taking opioids and
other drugs at these sites have not led to increased criminal activity. Besides, it is not a negative
impact of those looking to stop drug use but has brought about a drop in open, uncontrolled
injections in back rear ways and entryways. Studies have further revealed decreases in unsafe
conduct, for example, sharing needles, and is related to diminishing the spread of HIV infection.
The law enforcement authorities support the sites. The sites are also environmental friendly as
they have brought about less disposed of needles in neighborhoods. The supporters believe that
the sites should be left constitutional because the medical advantages of the organization are
more critical than jurisdictional issues. Their claim is supported by the high number of addicts
who died unnecessarily in flophouses and the city before Insite was opened (Stueck, 2018).
Lastly, proponents of safe injection sites consider it constitutional based on the Supreme
Court ruling in 2011. The Supreme Court ruled that the Safe injection sites were legal in a case
that involved the Canada attorney general versus the PHS community services. The Supreme
Court ordered the Federal government not to interfere with Vancouver's controversial Insite
clinic. They based their ruling on the fact that these clinics offered a safer environment for drug
abusers who inject themselves with the drugs (Makin, Dhillon, and Peritz, 2018)
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POLICY OPTIONS TASK 5
On the other hand, the people who argue that safe injection sites should not be
constitutional give the first reason as the sites' activities are an attack against government control.
It is because, at its inception, the site got a three-year exclusion from Canada's Controlled
Medications and Substances Act from Health Canada. That exception was broadened twice, until
June 30, 2008. At the point when the government declined to expand the exception. They state
that giving constitutional rights to safe injection sites would open the way to a divided,
interwoven of principles and guidelines that regulate drug use. Since the federal government has
authority in criminal law and the advancement of health and security, it should do away with safe
injection sites. (Stueck, 2018).
The second argument why safe injection sites should be made unconstitutional is because
the Government has a mandate of discouraging drug use. In spite of the research studies
supporting the sites damage decrease approach, there is as yet significant uneasiness for some
with an office that gives addicts the green light to inject themselves with illicit drugs and go
unpunished. Governments, they contend, ought not to be encouraging illegal, perilous exercises
(Stueck, 2018). They believe that the state has no protected commitment to promoting drug use
at a particular place by addicts and other drug users. There have been contentions that the money
spent on these sites would be better spent on rehabilitation and treatment of the addicts (White,
2012). Also, making the site constitutional would send a mixed message to youngsters who may
consider unlawful drug use.
Lastly, the third argument as to why the site should not be constitutional is that they do
nothing to hinder drug abuse or help drug addicts (Stueck, 2018). Some portion of the central
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POLICY OPTIONS TASK 6
government's contention is that laws that regulate drugs are not a nonsensical restriction of
people's freedom. Therefore, the choice of injection, whether safe or unsafe, should not be
debated because the drugs in question are illicit, and the decision is made independently by the
criminal. Besides, supervised injections attract drug dealers who sell illegal drugs freely to
addicts (Malkin, 2001). Opponents of safe injection sites state that making the injection sites
legal legalizes illicit drug use instead of firmly controlling them.
The use of safe injection sites has both advantages and disadvantages to the community
and the government. The first advantage is that it is a safe option that benefits society. Research
has discovered that a sheltered injection site leads to increased safety in a given area. There is a
decrease in dangerous propensities like sharing needles which are associated with the spread of
HIV/Aids. Also, when an injection facility is set up, the number of disposed of needles in the
open decreased significantly (Amethyst, 2019).Further, the utilization of the sites immensely
improves the injection conduct of addicts. Besides, it tackles the issue of unnecessary deaths of
addicts as the site intercedes if there is an occurrence of an overdose. Hence, it reduces the risk
associated with injecting drugs in the streets.
The second advantage of these sites to the government is that they serve as a guide to
treatment of drug addicts (Amethyst, 2019). The safe injection sites are the correct advance
towards detox and treatment. They can be utilized as a way through which recouping addicts can
be rehabilitated and treated.
The third advantage of safe injection sites is to the users. Drug users feel safe and more
secure. Studies have shown that addicts using these facilities felt more physically and mentally
sheltered, rather than those injecting themselves on the in the road (Marshall et al., 2008).
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POLICY OPTIONS TASK 7
Injections on the open accompany a bunch of difficulties. Many drug-dependent ladies
encountered sexual assault when using drugs away from the sites. Also, different drug users were
compelled to share drugs and needles. Also, there is the danger of arrests when found using illicit
drugs. Having a safe injection site guarantees the drug user that the nature of the drugs they are
using is safe.
The first disadvantage associated with safe injection sites is that they support drug use.
The sites are perceived to legalize the use of illicit injectable drugs (Hathaway and Tousaw,
2008). They are a place of refuge for drug users, vendors, and predators. Thus, these
organizations ought not to be permitted to work. Additionally, they infringe on the rights of the
individuals have nothing to do with illegal drugs in society. The sites give addicts the room to
use illicit substances without legal repercussions. The sites make administration to support and
encourage exercises that are a risk to the general public.
Secondly, the sites may challenge government control. The central government would
lose its command over the regulation of drug and substance abuse (Werb et al., 2011). It is
because they prompt an absence of consistency the nation has in controlling the safe injection
sites. The legal challenge of the injection sites may lead to a legal problem that would be solved
by changing the regulation strategy of drugs in the country.
Different policy alternatives and reform options are possible for the ongoing opioid and
fentanyl crisis. These reforms include those aimed at regulating the approved product and those
that are meant to influence prescribing practices. The recommended product can be regulated by
different methods which include regulating/restricting conditions of lawful access to approved
drugs, scheduling drugs under the controlled substances act, restrictions on precursor and
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POLICY OPTIONS TASK 8
essential chemicals, preventing and penalizing diversion of controlled drugs, and drug take-back
programs (National Academies of Sciences, Engineering, and Medicine, 2017). The prescription
culture of opioids can be influenced by the provision of education to the public and medical
personnel.
The lawful access of approved drugs can be regulated when the FDA has affirmed a
narcotic definition (or other controlled substance) for therapeutic use (Lamkin, 2016).
Government and state organizations have the specialist to control the amount, stockpiling, and
appropriation of the medication for commercial purposes. One key motivation behind these
limitations is to constrain access to and utilization of the opioid-containing drugs. Also, the
number of drugs in circulation can be controlled by drug-take-back programs. Various agencies
and associations, likewise endeavor to decrease the supply of narcotics by encouraging the return
of unused prescriptions through medication reclaim programs. Commonly, these are impromptu
or incidental occasions that enable people with unused opioid drugs to get them to be discarded
appropriately (National Academies of Sciences, Engineering, and Medicine, 2017).
The provision of education to the public and medical personnel can also be used to
reduce the prescription of opioids. Decreasing prescription of narcotics reduces the need to use
or abusing these medications (Compton, and Volkow, 2006). Diminished recommending can
influence addiction in two ways: first, by lessening patients' dependence on narcotics by
fulfilling their needs through different types of drugs; and second, by decreasing the number of
patients or other people who get opioid reliance.
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POLICY OPTIONS TASK 9
References
National Academies of Sciences, Engineering, and Medicine. (2017). Pain management and the
opioid epidemic: balancing societal and individual benefits and risks of prescription
opioid use. National Academies Press.
Amethyst. (2019). The Pros and Cons of Safe Injection Sites. Amethyst.
Boeri, M., (2015). Safe injection facilities: more than just a place to shoot drugs. The
Conversation.
Mahal, I. (2019). Without safe injection sites, more opioid users will die. The Conversation.
Stueck, W., (2018). The arguments for and against Vancouver's supervised injection site. The
Globe and Mail.
Makin K., Dhillon S., & Peritz I. (2018). Supreme Court ruling opens doors to drug injection
clinics across Canada. The Globe and Mail.
Compton, W. M., & Volkow, N. D. (2006). Abuse of prescription drugs and the risk of
addiction. Drug and alcohol dependence, 83, S4-S7.
Lamkin, M. (2016). Regulatory Identity: Medical Regulation as Social Control. BYU L. Rev.,
501.
Hathaway, A. D., & Tousaw, K. I. (2008). Harm reduction headway and continuing resistance:
Insights from safe injection in the city of Vancouver. International Journal of Drug
Policy, 19(1), 11-16.
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Werb, D., Rowell, G., Guyatt, G., Kerr, T., Montaner, J., & Wood, E. (2011). Effect of drug law
enforcement on drug market violence: A systematic review. International Journal of Drug
Policy, 22(2), 87-94.
Marshall, B. D., Fairbairn, N., Li, K., Wood, E., & Kerr, T. (2008). Physical violence among a
prospective cohort of injection drug users: a gender-focused approach. Drug and alcohol
dependence, 97(3), 237-246.
Malkin, I. (2001). Establishing supervised injecting facilities: A responsible way to help
minimize harm. Melb. UL Rev., 25, 680.
White, W. L., Kelly, J. F., & Roth, J. D. (2012). New addiction-recovery support institutions:
Mobilizing support beyond professional addiction treatment and mutual recovery aid.
Journal of Groups in Addiction & Recovery, 7(2-4), 297-317.
Bale, R. N., Van Stone, W. W., Kuldau, J. M., Engelsing, T. M., Elashoff, R. M., & Zarcone, V.
P. (1980). Therapeutic communities vs methadone maintenance: a prospective controlled
study of narcotic addiction treatment: design and one-year follow-up. Archives of general
psychiatry, 37(2), 179-193.
Rhodes, T., Kimber, J., Small, W., Fitzgerald, J., Kerr, T., Hickman, M., & Holloway, G. (2006).
Public injecting and the need for 'safer environment interventions' in the reduction of
drugrelated harm. Addiction, 101(10), 1384-1393.
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