But despite these achievements, no other city in Canada or the United States has followed Vancouver’s lead. Political ideology, the illicit nature of injection drugs and a profound misunderstanding of addiction have resulted in thousands of preventable deaths every year in both countries.

Addiction is a chronic, relapsing medical condition, not a lifestyle choice. Those disproportionately affected by it include people with mental illness, brain injury and histories of physical and sexual abuse. In the United States, inappropriate prescribing of opioid painkillers set many on the path to heroin addiction, a cheaper and more accessible alternative. Despite vast investments, law enforcement has failed to keep heroin and other illicit drugs out of the hands of vulnerable addicts.

Those opposed to harm-reduction services like Insite worry that providing a place for safe injection drug use will make it more socially acceptable and lead to more addicts. But research shows the opposite to be true in Vancouver; illicit drug use here has declined since the center opened, and use of alcohol and marijuana among high school students is also down.

Others argue that public funding should be spent on addiction treatment, not harm-reduction services. The truth is that both are needed — addiction is a complex condition, with no easy cure. In Vancouver we invest at least 10 times more resources in addiction treatment than harm reduction, and research on new approaches to treatment is always underway. Harm reduction — helping people even as they use drugs — is needed to keep users alive long enough to give them the chance to be treated. Prevention is also important, but again, there is no simple solution.