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A decade after Insite, drug policy landscape is still being shaped in B.C.

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VANCOUVER – In 2021, the Vancouver-based Drug User Liberation Front approached Health Canada with a proposal.

It wanted permission to buy heroin, cocaine and methamphetamine on the dark web, before having the drugs tested for contaminants and selling them to users through its “compassion club and fulfilment centre.”

Health Canada rejected the application for exemption from drug laws, saying DULF’s plan presented too many public health and safety risks — but the group went ahead with it anyway, saying it would save lives.

The unsanctioned operation would trigger a political firestorm, arrests and constitutional challenges.

Lawyers for DULF are now waiting to hear if a judge will agree that Health Canada violated drug users’ Charter rights when it refused to grant the exemption, while DULF prepares a second Charter challenge as part of its defence of its two co-founders, Eris Nyx and Jeremy Kalicum, who were arrested and charged with possession for the purpose of trafficking.

The court cases keep British Columbia on the cutting edge of the legal landscape around drug use and understanding of Canadians’ constitutional rights, more than a decade after a landmark Supreme Court of Canada decision that kept Vancouver’s Insite safe injection site open.

But one expert says that while the 2011 Insite decision set some key precedents, applying that decision to the DULF case is not necessarily straightforward.

Margot Young, a professor at the Allard School of Law at the University of British Columbia, said it’s difficult to know how the Insite decision will affect the DULF cases, particularly since Insite did not address selling of drugs.

She said the Insite ruling is often seen as site-specific to the work Insite does.

“That’s been of some concern with respect to opening other safer injection sites across Canada, although it has happened, and Insite does lead the way for that,” she said.

“But to say that there’s an easy, transference of Insite to this circumstance, I think is probably not right.”

The DULF cases come amid a growing push in B.C. for new approaches to a drug toxicity crisis that has killed more than 14,000 people since the province declared a health emergency eight years ago. Both provincial health officer Dr. Bonnie Henry and former chief coroner Lisa Lapointe have called for alternatives to street drugs to be made available without a prescription.

A report from Henry last week cited DULF’s compassion club, and academic research on its outcomes.

Young, who focuses on the intersection of social justice and constitutional law, said the DULF cases are among the latest to explore what it means to have the protected right to “security of the person,” beyond the risk of criminal prosecution.

“How can we say someone has security as a person, if they can’t access a safe supply of drugs that they need for the health condition of addiction?” she said.

In the Insite ruling, the Supreme Court of Canada ordered the federal minister of health to continue exempting Insite, which allows users to inject their own drugs under the observation of trained professionals.

The country’s top judges ruled the risk of death for Insite users if the program were to stop “is grossly disproportionate to any benefit that Canada might derive from presenting a uniform stance on the possession of narcotics.”

Young said courts had repeatedly rejected the moral blame that traditionally attaches to individuals who use drugs.

“The (Supreme Court) recognized that addiction is a health issue. It’s not an issue of moral culpability, or a wilfulness or individual choice. It’s a health issue,” she said.

“And that means that this larger context is one not of where you’re dealing with individuals who have a particular lifestyle, or they’re just making bad choices, but you’re dealing with individuals who have health issues.”

PUSHING ‘BARRIERS’ in B.C.

DULF’s work was not conducted in secret. The group described what it was doing on its website, issued press releases and held news conferences.

In a press release issued on Sept. 20 last year, the group said: “For one year the Drug User Liberation Front has operated an illegal heroin, cocaine and methamphetamine compassion club pilot study.”

It said on its website it had sold three kilograms of the drugs to compassion club members “for up to 80 per cent cheaper than they would (pay) on the street.”

It said that among 42 participants there had been zero known deaths resulting from the substances provided by the club.

Subsequent peer-reviewed research was published in the International Journal of Drug Policy, with Nyx and Kalicum as co-authors. It said enrolment in the compassion club was associated with a 49 per cent reduced likelihood of non-fatal overdose, and a 63 per cent reduced likelihood of non-fatal overdose involving naloxone administration.

But the announcements by DULF triggered criticism in the B.C. legislature from the Opposition BC United — DULF’s operations had been funded, at least in part, by government money. Solicitor General Mike Farnworth said the contract granted to DULF was to save lives, not to buy drugs, and when the government found out it had been doing so, the contract was cancelled.

He said the contract was for “drug testing.”

On Oct. 26, Vancouver police shut it all down.

Officers raided the compassion club and arrested Nyx and Kalicum. The pair would later be charged with multiple counts of possession for the purpose of trafficking.

Tim Dickson, who represents DULF, said its request for a judicial review of the Health Canada decision represents a “highly practical application of constitutional law” at a time when the politics around drug use are “very, very difficult.”

“We have seen a sort of coalescing of views of some political parties, a number of political parties, in clamping down on harm reduction and putting the convenience of the public first, and not prioritizing methods to protect the lives and safety of drug users,” he said.

“And in that kind of political environment, constitutional rights obviously become far more important, because they set up limits on the policies that can be implemented by the government,” he said.

He argued in Federal Court in March that the exemption rejection violated the Charter rights of people who use drugs because it impeded their right to life and liberty, and punished people who are addicted.

In an interview, Dickson said the Insite ruling established that it is constitutional to prohibit possession and trafficking of drugs only if there is an exemption process.

He argued that in DULF’s case, Health Canada ruled out any possibility of a compassion club without taking a close look at the various interests, including those of people who use drugs.

“It can’t draw just these such bright lines without actually considering the merits of what is being proposed,” he said.

“And it definitely has to take into account the constitutional rights issue and it didn’t do those things.”

Dickson said he is also preparing to make a Charter challenge related the criminal charges against Nyx and Kalicum.

Young said a Charter challenge in the criminal case would argue that illicit street drugs are so toxic that putting people at risk of jail for providing uncontaminated drugs would infringe upon the life, liberty and security of drug users.

In a situation where there was no guarantee street drugs were not toxic, “to prevent remedy of that, which is what the compassion club is trying to do, is actually contrary to the stated goals of the (law), which is public health,” she said.

Both Henry and Lapointe have said B.C. cannot prescribe its way out of the toxic drug crisis, and support consideration of non-prescribed access to drugs including opioids.

Their calls were swiftly rejected by the provincial government. Premier David Eby said last week there was a “zero per cent chance” the recommendations would be implemented.

But Dickson said B.C. has a history of finding new ways “for reducing the harms of drugs, and there are people willing to push those barriers.”

He said the province had long been “ground zero for overdose epidemics” leading to various court challenges in response.

“(The) Insite (court challenge) came out of an earlier overdose crisis in the ’90s and DULF is coming out of this current overdose crisis,” he said.

This report by The Canadian Press was first published July 18, 2024.

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Judge tells Florida’s top doctor not to threaten TV stations over abortion-rights ads

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TALLAHASSEE, Fla. (AP) — A judge has blocked the head of Florida‘s state health department from taking any more action to threaten TV stations over an abortion-rights commercial they’ve been airing.

U.S. District Judge Mark Walker’s ruling Thursday sided with Floridians Protecting Freedom, the group that produced the commercial promoting a ballot measure that would add abortion rights to the state constitution if it passes in the Nov. 5 election. The group filed a lawsuit earlier this week over the state’s communications with stations.

“The government cannot excuse its indirect censorship of political speech simply by declaring the disfavored speech is ‘false,’” the judge said in a written opinion.

He added, “To keep it simple for the State of Florida: it’s the First Amendment, stupid.”

State Surgeon General Joseph Ladapo and John Wilson, who was then the top lawyer at the health department before resigning unexpectedly, sent a letter to TV stations on Oct. 3 telling them to stop running an FPF ad, asserting that it was false and dangerous. The letter also says it could be subject to criminal proceedings.

FPF said about 50 stations were running the ad and that most or all of them received the letter — and at least one stopped running the commercial.

The group said the state was wrong when it claimed that assertions in the commercial were false. The state’s objection was to a woman’s assertion that the abortion she received in 2022 after she was diagnosed with a terminal brain tumor would not be allowed under current state law.

The state hasn’t changed its position. In a statement Thursday, a spokesperson for the health department again said that the ads are “unequivocally false.”

The judge’s order bars further action from the state until Oct. 29, when he’s planning a hearing on the question.

The ballot measure is one of nine similar ones across the country, but the campaign over it is the most expensive so far, with ads costing about $160 million, according to the media tracking firm AdImpact. It would require the approval of 60% of voters to be adopted and would override the state law that bans abortion in most cases after the first six weeks of pregnancy, which is before women often realize they’re pregnant.

The administration of Republican Gov. Ron DeSantis has taken multiple steps against the ballot measure campaign.

The Canadian Press. All rights reserved.

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With brain injuries a growing problem, the US military tests how to protect troops from blasts

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WASHINGTON (AP) — The blast shook the ground and its red flash of fire covered the doorway as U.S. special operations forces blew open a door during a recent training exercise.

Moments later, in their next attempt, the boom was noticeably suppressed and the blaze a bit smaller, testament to just one of the new technologies that U.S. Special Operations Command is using to limit the brain injuries that have become a growing problem for the military.

From new required testing and blast monitors to reshaping an explosive charge that reduces its blowback on troops, the command is developing new ways to better protect warfighters from such blast overpressure and to evaluate their health risks, particularly during training.

“We have guys lining up to volunteer for these studies,” said retired Sgt. Maj. F. Bowling, a former special operations medic who now works as a contractor at the command. “This is extremely important to the community. They’re very concerned about it.”

The Defense Department does not have good data on the number of troops with blast overpressure problems, which are much harder to detect than a traumatic brain injury.

Traumatic brain injuries are better known and have been a persistent problem among combat forces, including those subjected to missile strikes and explosions that hit nearby.

According to the department’s Traumatic Brain Injury Center of Excellence, more than 20,000 service members were diagnosed with traumatic brain injuries last year. More than 500,000 have been diagnosed since 2000.

Josh Wick, a Pentagon spokesperson, said emerging information from evaluations of both acute blasts and repetitive low-level exposures shows links to adverse effects, such as the inability to sleep, degraded cognitive performance, headaches and dizziness.

“Our top priority remains our forces’ long-term cognitive well-being and operational effectiveness as warfighters,” said Gen. Bryan Fenton, head of U.S. Special Operations Command. “We are committed to understanding and identifying the impacts of blast overpressure on our personnel’s brain health.”

Fenton said research with academics and medical and industry experts is helping find ways to mitigate and treat overpressure. He said cutting-edge technologies are key to reducing the effects of repeated exposures, such as those many of his troops experience.

Out in a remote training area for Army special forces at Fort Liberty in North Carolina, commandos used what they call a Muchete breaching charge, specifically formed into a shape that more precisely directs the blasts and limits the harmful waves coming from an explosion. A small number of journalists were allowed to watch the training.

“The reduction on the blast overpressure coming back on the operator on average is generally between 40 and 60%,” said Chris Wilson, who leads the team at the command that oversees clinical research and other performance-related initiatives. “It really also depends on where somebody is standing. But it’s certainly a pretty dramatic reduction in the exposure. So I think that’s a win.”

Wilson said development and testing of the refined charge is ongoing but that units are using this one now in training until one gets final approval and can be more widely distributed.

Because of the extensive amount of training for special operations forces — both to hone their skills and to prepare for specific operations — troops may practice breaching a door dozens or hundreds of times. As a result, training is where they are most likely to have such repeated exposures. The command wants a better sense of how each person is affected.

During the demonstration, a number of the Army special forces soldiers were wearing small monitors or sensors to help leaders better understand the level of blast pressure that troops are absorbing. The sensors allow officials to compare readings based on where troops were standing and how close they were to the blast.

The command is evaluating a number of blast sensors on the market, and some higher risk troops are already using them. Testing and other studies are continuing with the goal of getting them out across the force in the next couple of years.

According to Wilson and Col. Amanda Robbins, the command’s psychologist, there are distinct differences between acute traumatic brain injuries and what is called long-term blast exposure or blast overpressure.

Traumatic brain injuries, they said, are acute injuries that are relatively well documented and diagnosed. They said repetitive blast exposure needs more attention because there are lots of questions about the impact on the human brain. The damage is far more complex to diagnose and requires more study to establish links between the repetitive blasts and any damage or symptoms.

To aid the research, Special Operations Command is looking at doing more routine testing throughout service members’ careers. One test is a neurocognitive assessment that the command does every three years. Officials also want warfighters to be assessed if they have had a concussion or similar event.

The Defense Department more broadly will require cognitive assessments for all new recruits as part of an effort to protect troops from brain injuries resulting from blast exposures. New guidance released in August requires greater use of protective equipment, minimum “stand-off distances” during certain types of training, and a reduction in the number of people in proximity to blasts.

The other test being done by Special Operations Command is a more subjective comprehensive assessment that catalogs each person’s history of injuries or falls, even as a child. It’s done early to get a baseline.

Robbins said what they have seen is that new, younger operators and those with 20 or more years of experience are more amenable to doing the testing.

“The challenge is going to be in the midcareer operators who may be more concerned about self-reporting potentially having a perceived negative impact,” she said.

She added that the assessment is a way to take into account incidents that may not be in their medical records, so that problems can be identified early on and people can get treatment.

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Judge delays order in antitrust case requiring Google to open up its app store

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SAN FRANCISCO (AP) — A federal judge on Friday delayed an order requiring Google to open up its Android app store to more competition until an appeals court decides whether to block the shake-up because of legal questions surrounding a jury’s verdict that branded Google as an illegal monopolist.

The delay granted during a court hearing in San Francisco comes less than two weeks after U.S. District Judge James Donato issued a decision that would have forced Google to make sweeping changes to its Play Store for Android smartphones starting Nov. 1.

The mandated changes included a provision that would have required Google to make its library of more than 2 million Android apps available to any rivals that wanted access to the inventory and also distribute the alternative options in its own Play Store.

Google requested Donato’s order be stayed until the Ninth Circuit Court of Appeals could examine the handling of a monthlong trial that led to the December 2023 verdict, which framed the Play Store as an illegal monopoly that stifles innovation and drives up consumer prices.

In Friday’s hearing, Donato scoffed at the notion that Google could succeed in overturning the trial verdict. “The verdict in this case was amply supported by a mountain of evidence about Google’s anti-competitive conduct,” the judge said.

But he decided the Ninth Circuit should be given a chance to consider a postponement until a panel of judges can decide can consider Google’s appeal of the 2023 trial focused on antitrust claims lodged by video game maker Epic Games.

Donato said he wouldn’t be surprised if the Ninth Circuit imposes an even longer delay on his ruling, “but that is for someone else to decide.”

In a statement, Google said it was pleased Donato hit the pause button while it tries to extend the delay even further.

“These remedies threaten Google Play’s ability to provide a safe and secure experience and we look forward to continuing to make our case to protect 100 million U.S. Android users, over 500,000 U.S. developers and thousands of partners who have benefited from our platforms,” Google said.

Epic pointed to Donato’s critical comments about the merits of Google’s appeal in a statement that described the stay as a “procedural step.”

It’s unclear how long the Ninth Circuit will take to decide on Google’s request for a permanent stay of Donato’s ruling while its appeals unfolds — a process that could take more than a year.

In 2021, the Ninth Circuit delayed a provision of another federal judge’s order mandating that Apple allow links to alternative payment systems with apps made for the iPhone as part of another antitrust case brought by Epic.

Although Apple avoided being labeled an illegal monopolist in a trial involving the iPhone app store, it unsuccessfully fought the provision requiring the company to allow alternative payment links within apps. But delaying that requirement preserved Apple’s exclusive control of a payment system that has generated commissions ranging from 15% to 30% on some e-commerce occurring within apps. Apple exhausted its avenue of appeals in the U.S. Supreme Court earlier this year.

Google also pockets billions of dollars annually from a similar commission system within its Play Store for Android phones — a setup that is allowed to continue as long as Google can prevent Donato’s ruling from taking effect.

In its arguments for delaying Donato’s order, Google said it wasn’t being given enough time to make the drastic changes it framed as “a Herculean task creating an unacceptable risk of safety and security failures within the Android ecosystem.” In its Friday statement, Epic blasted Google’s tactics as “fearmongering.”

Google also argued the shake-up would saddle it with unreasonable costs, a contention Donato also brushed aside during Friday’s hearing.

“I don’t want to be glib about it, but the expense that Google might incur appears to be a drop in the bucket compared to the profits it reaps annually from the Play Store,” Donato said.

The Canadian Press. All rights reserved.

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