Sydney and Vancouver are two drop-dead gorgeous harbourside cities with the largest concentration of injecting drug users in their respective countries.

In both cities, concern about the large number of deaths from drug overdose led to the establishment of a medically supervised injecting centre against vehement and relentless opposition. In both countries, a conservative Federal government tried to close down the centre despite strong support from the respective state government, local health authorities and local residents. In both countries, opponents ignored impressive scientific evidence of benefit and cost-effectiveness and the absence of serious unintended negative effects.

Insite, the medically supervised injecting centre established in 2003 in Vancouver, Canada, was given a reprieve on 27 May by the British Colombia Supreme Court. Canadian researchers have published more than twenty scientific papers evaluating Insite in leading peer-reviewed national and international medical journals.

The ruling by BC Supreme Court judge Ian Pitfield gave the Federal government one year to pass legislation making it clear that the facility should be exempt from prosecution.

Judge Pitfield declared that the facility is a place where health care takes place and that drug addiction is a health care issue, making it immune from federal drug prosecution.

The centre was due to close on June 30 when its exemption from federal drug laws runs out.

Judge Pitfield ruled that the policy of harm reduction trumps the illegal possession of heroin and cocaine by persons using the centre. He declared that the country’s drug laws conflict with health concerns and that constitutionally they are a responsibility of Canada’s Provinces, as well as conflicting with the Canadian Charter of Rights and Freedoms.

In a 59-page decision, the judge said people dependent on illicit drugs deserved the same kind of health care as those dependent on alcohol or tobacco. Judge Pitfield concluded that national laws blocked drug users from a health care facility that could reduce or eliminate their risk of death from an overdose or from contracting an infectious disease, thereby violating their right to life and security.

“While there is nothing to be said in favour of the injection of controlled substances that leads to addiction, there is much to be said against denying health care services that will ameliorate the effects of their condition,” said Judge Pitfield.

The federal Conservative government of Stephen Harper has announced that it will appeal the judgment while the Province of British Colombia says that it is considering joining the defence.

Sydney’s Medically Supervised Injecting Centre has a licence to continue operating until 2011, but only as a research project. With the next NSW elections due in March 2010, the future of Sydney’s Medically Supervised Injecting Centre may well turn on judgments made in Canadian courts.