Rebuffing the Conservative government of Prime Minister, the Canadian Supreme Court Friday ruled unanimously that Vancouver's safe injection site for heroin addicts can stay open. Known as Insite, the Downtown Eastside facility is the only safe injection site in North America.

The Downtown Eastside, centered on the intersection of Main and Hasting, streets, has one of the highest concentrations of injection drug users in the world. An overgrown Skid Row flush with prostitution and destitution, most of its residents live in decaying SRO hotels lining Main Street. Out of 12,000 residents in the area, some 5,000 are estimated to be drug addicts.

At Insite, drug users are provided clean needles and sterilized water with which to mix their drug. Insite does not provide the drugs; users must bring their own. The users inject under medical supervision at one of 12 injecting alcoves.

Insite operates under the auspices of the British Columbia Ministry of Health and the local public health authority, Vancouver Coastal Health. Numerous research reports on Insite have found that it has reduced fatal drug overdoses, reduced HIV and Hepatitis C transmission rates, reduced crime rates in the neighborhood, and increased the number of drug users entering treatment.

It has operated since 2003 under an exemption to Canada's drug laws, but since coming to power, the Harper government has attempted to shut it down, claiming it "enables" drug users. Friday's decision by the Canadian Supreme Court is the final chapter in that effort.

The Harper government argued that the federal drug law took precedence over British Columbia's public health policies. British Columbia and other Insite supporters argued that because Insite is providing a form of health care, its operation is a provincial matter. The federal government's concerns did not outweigh the benefits of Insite, the court said.

"The grave consequences that might result from a lapse in the current constitutional exemption for Insite cannot be ignored," the court said. "Insite has been proven to save lives with no discernible negative impact on the public safety and health objectives of Canada."

Hundreds of Insite supporters gathered at the facility at dawn and broke out in cheers after the decision was announced. As the news spread, harm reduction, public health, and drug reform groups in Canada and around the world lined up to applaud it.

"We are absolutely delighted that we finally have a clear decision on the legal framework for Insite," said Dr. Patricia Daly, Vancouver Coastal Health Chief Medical Health Officer. "Since 2003, Insite has made a positive impact on thousands of clients, saved lives by preventing overdoses, and provided vital health services to a vulnerable population. Today's ruling allows us to continue the outstanding work Insite, its doctors, nurses, staff and partners provide."

"This represents a victory for science," said Dr. Julio Montaner, Director of the BC Center for Excellence for HIV/AIDS. "Prior attempts from the federal government to stop the activities of Insite have been ruled unconstitutional. We are thankful for the continued and unwavering support from the provincial government that has allowed us to set an example in Canada and the world for how to deal with addiction which is, indeed, a medical condition."

"We applaud today's landmark decision by the Canadian Supreme Court to uphold the human rights of all Canadians by allowing Insite to remain open," said the Canadian HIV/AIDS Legal Network, CACTUS Montreal, and Harm Reduction International in a joint statement. "We are heartened the Supreme Court of Canada has recognized that criminal laws on drugs must give way to good public health practices and harm reduction."

"This is a victory for science, compassion and public health -- and, given the fiscal benefits of such programs, the Canadian taxpayer. The Supreme Court of Canada recognized that Insite saves lives, and that that should be a guiding principle in deciding drug policy," said Laura Thomas, California deputy director for the Drug Policy Alliance. "Congratulations to the advocates, drug users, researchers, nurses, and elected officials who have campaigned for Vancouver's supervised injection facility for so long. This is a complete validation of their work."

The Supreme Court of Canada's Insite ruling applies only to Insite. Other Canadian localities seeking to establish safe injection sites must win permission from the federal government. Canadian activists urged them to do so.

"In light of today's Supreme Court decision, jurisdictions Canada-wide should act fearlessly on evidence and make harm reduction services modeled on Insite available to those in need in their locales," said the Canadian groups. "The Minister of Health must respect the court's decision and grant similar exemptions to other sites so that people across Canada will be able to access the public health services they desperately need."

There are 67 safe injection sites operating today, with one in Australia, Insite in Vancouver, and the rest in Europe. There are no safe injection sites operating in the United States, although a move is afoot in San Francisco to get one underway there. The Drug Policy Alliance's Thomas said it is time to start pushing harder.

"For communities in the US which have been hard hit by drug use, it is time to look at the evidence from Canada and start opening supervised injection facilities here," she said. "We look forward to implementing the same desire to save lives in the US."

Members of Britain's Liberal Democratic Party overwhelmingly adopted a resolution Sunday supporting the decriminalization of drug possession and the regulated distribution of marijuana and calling for an "impact assessment" of the 1971 Misuse of Drugs Act that would provide a venue for considering decriminalization and controlled marijuana sales.

The resolution calls for an independent panel "to properly evaluate, economically and scientifically, the present legal framework for dealing with drugs in the United Kingdom." Citing the Portuguese decriminalization model, the resolution called for consideration of reforms so that "possession of any controlled drug for personal use would not be a criminal offense" or that "possession would be prohibited but should cause police officers to issue citations for individuals to appear before panels tasked with determining appropriate education, health or social interventions."

The resolution also calls for the review to consider "alternative, potential frameworks for a strictly controlled and regulated cannabis market and the potential impacts of such regulation on organized crime, and the health and safety of the public, especially children."

The resolution includes a call for "widespread provision of the highest quality evidence-based medical, psychological and social services for those affected by drugs problems," including the widespread use of heroin maintenance clinics for hard-core addicts.

The resolution also offers support for the Advisory Council on the Misuse of Drugs (ACMD), whose scientific integrity has been under attack first by the former Labor government, which resulted in a number of high profile resignations, and then by the Conservatives, who have put forth a plan to no longer require a certain number of scientists to sit on the council. The council should "retain a majority of independent scientific and social scientific experts in its membership," and no changes to the drug laws should take place without its advice, the resolution said.

The Liberal Democrats are the junior partner in Britain's coalition government, having brokered a deal with Conservatives after the last parliamentary elections. The resolution will put the party in conflict with the Conservatives, who are opposed to any liberalization of Britain's drug laws.

It also puts them at odds with Labor, which after a brief dalliance with downgrading marijuana offenses in 2004, overrode the advice of the ACMD to restore the old, harsher penalties the following year. The Liberal Democrats can continue to boast of having the most progressive drug policy position of any of Britain's major parties.

The resolution was introduced by Ewan Hoyle, delegate from Glasgow South and founder of Liberal Democrats for Drug Policy Reform. Politicians have tip-toed around drug policy reform because of "cowardice, pure cowardice," he said. Instead of panicking over what the tabloids might say, Hoyle added, "It's time politicians looked voters in the eye and attempted to explain complex concepts. I want [Liberal Democratic leader] Nick Clegg to walk into [Prime Minister] David Cameron's office and say: 'This is part of what is needed to get the country out of a hole.'"

While most party front-benchers stayed out of the debate, MP Tom Brake, co-chair of the Home Affairs Parliamentary Party Committee, congratulated delegates on passage of the resolution.

"Today, Liberal Democrats reaffirmed our support for an evidenced based drugs policy, calling for an independent panel to review current drug laws," Brake said after passage. "We want to ensure the Government has a clear focus on prevention and reducing harm by investing in education, treatment and rehabilitation, and moving away from criminalizing individuals and vulnerable drug users. We need proper regulation and investment if we are to get to the root of the battle with drugs. Liberal Democrats are the only party prepared to debate these issues."

The Conservatives were quick to go on the attack. The resolution "sends out the message that taking drugs is okay, but it is not," Tory MP Charles Walker told the tabloid Daily Mail. "If the Liberal Democrats think taking heroin, cocaine and smoking skunk is okay, then that is up to them, but the government and I think most people in Britain do not agree with them."

While Labor continues to back away from drug reform, at least one Labor MP congratulated the Liberal Democrats on the resolution.

"The resolution passed should be acceptable to all but the most prejudiced MPs," said MP Paul Flynn, a long-time supporter of drug law reform. "But what next? Will someone take the campaign forward in Parliament?" he asked. "I've tried several times with bills and debates. I still have the scars to prove it. But, contrary to popular belief, advocating the end of drug prohibition is not an electoral liability. If it was I would have been rejected by the voters twenty years ago. This is an era when there is respect for strongly held independent views that challenge accepted foolishness."

Flynn could not resist a chance to jab at Prime Minister Cameron -- who supported drug legalization before he opposed it -- and the Liberal Democrats as well.

"An additional reason why drugs reform may be successful is that we have a Prime Minister who understands the argument," Flynn noted. "He wrote a great column in 2002 setting out the alternatives. The vote was practically unanimous this afternoon. Will the Lib Dems have the cojones to implement their conference policy?"

It may not be just a matter of cojones, but also of numbers, said Steve Rolles of the Transform Drug Policy Institute.

"This is Liberal Democratic policy only, and they are the minority partner in the coalition government," he noted. "They have had a pretty strong drug policy position for years, but the problem has been that it has been a shield issue for them rather than a sword issue. They have not wanted to take the lead on it because the leadership sees it as a potential liability rather than a strength. They have made the intellectual journey, but are afraid to commit on the political side."

But now the Liberal Democrats have passed their resolution, even if party leader Nick Clegg has been noticeably silent on the issue, and that puts the issue squarely before the public again. That's a good thing, said Rolles.

"The Tories will certainly need to respond, and will be made to look trenchant, anti-evidence, and dogmatic as a result," the analyst said. "Labor may move slightly, but I think they are biding their time to see what the public reaction will be. All the parties know that drug policy reform must happen at some point, but none want to move on it until they are more confident it will play well politically," he said.

"This pushes the debate into the political mainstream, which is always helpful, not least because it provides cover for others to take a public position on reform," Rolles continued. "We know that exposure to informed debate on this issue tends to move opinion in a positive direction so that is also a positive.  This isn't a seismic moment but it is another step in the right direction. Undermining the creaking edifice of prohibition is an attritional process."

The Liberal Democratic Party has had its say on drug policy reform this past weekend. Now, the question is how the party leadership responds and whether Labor and the Conservatives can be moved on the issue. It looks like the drug debate is heating up again in Britain.