Canada’s highest court unchains injection drug users; implications for harm reduction as standard of healthcare

“The philosophers have only interpreted the world in various ways; the point, however, is to change it” [1].After a long legal and cultural battle, North America’s only supervised injection facility, Insite, is finally safe from arbitrary political interference. This was a case where personal experience, activism, advocacy, medicine and science stood side-by-side to protect the rights of even the most marginalized members of the community to life-saving healthcare. The case began at the Supreme Court of British Columbia and eventually made its way to the Supreme Court of Canada (SCC). At the centre of the case were the personal stories of people who relied on supervised injection to stay alive together with testimony from scientists, physicians, healthcare officials and the operators of Insite. On 30 September 2011, Supreme Court of Canada drew a legal line in the sand that highlights the rights of people with addictions to the security of their person under section 7 of the Charter of Rights and Freedoms (Charter of Rights) [2]. The Charter enshrines the values of Canadian culture regarding the rights of individuals with respect to the provincial, federal and territorial governments. The judges of Canada’s highest court are appointed from a wide variety of political backgrounds. The decision was unanimous and reinforced the foundation of our understanding of addiction as a healthcare matter in Canada.As a caveat, I am not a distant academic examining supervised injection from the point of view of a removed observer. I am part of the senior management of the non-profit organization that founded and operates Insite, the PHS Community Services Society (PHS) and, as such, I have been intricately involved in the development, set-up, management and advocacy for Insite. I am a participant observer and so this commentary is written from the point of view of my personal experience.The journey for Insite has been wrought with challenges because it confronts our inner web of