Between September 2003 and July 2008, the site operated under a special exemption of Section 56 of the Controlled Drugs and Substances Act, granted by the Liberal government via Health Canada.

[11] A constitutional challenge was heard by the Supreme Court of British Columbia to keep Insite open after Federal Health Minister Tony Clement refused to renew the exemption beyond July 2008.

[16] The research indicates an array of benefits, including reductions in public injecting and syringe sharing and increases in the use of detoxification services and addiction treatment among patients.

[14] Additional research in the Canadian Medical Association Journal suggests that the site has reduced public injections, neighbourhood litter, and needle sharing.

[21] A study in the journal Substance Abuse Treatment, Prevention, and Policy revealed that local police facilitate use of Insite, especially among high-risk users.

[24] An editorial in the Canadian Medical Association Journal noted that after three years of research "a remarkable consensus that the facility reduces harm to users and the public developed among scientists, criminologists, and even the Vancouver Police Department.

"[16] In 2011, the Lancet published a study by a team of researchers from the University of British Columbia (UBC), claiming 35% decreases in overdose deaths around Insite due to its presence.

[27] The site drew criticism from the Bush administration; the director of the White House Office of National Drug Control Policy called Insite "state-sponsored suicide" on its opening.

[29] In 2006, the Canadian Police Association voted unanimously to encourage the federal government to stop funding Insite and instead invest in a national drug strategy.

[30] The RCMP in British Columbia had agreed to announce their support for Insite in 2009 at a joint news conference with the BC Centre for Excellence in HIV/AIDS; they planned to note "an extensive body of Canadian and international peer-reviewed research reporting the benefits of supervised injection sites and no objective peer-reviewed studies demonstrating harms", and they were to admit that reports commissioned by the RCMP criticizing Insite "did not meet conventional academic standards."

[37] In answer to an op-ed in National Post by Thomas Kerr, one of the co-authors of the Lancet study, the President for Drug Prevention Network of Canada, Gwendolyn Landolt, maintained her organization's view that the research on Insite is flawed.

Gwendolyn Landolt also maintained that data shows that deaths from drug overdoses have actually increased in the vicinity of Insite most years since its inception, contrary to the point made by the allegedly biased Thomas Kerr in his preceding commentary.

[38][39] The next day the Provincial Health Officer Dr. Perry Kendall said he had never heard of the data Ms. Landolt refers to and confirmed Thomas Kerr's assertion that death from drug overdoses have indeed declined in the preceding years – especially so in the vicinity of Insite.

In reviewing the matter, Mark Wainberg of McGill University found that "the allegations that have been made by ‘Drug Free Australia’ are without merit and are not based on scientific fact.

In contrast, it is my view that the work that has been carried out by the team of Thomas Kerr et al is scientifically well-founded and has contributed to reducing the extent of mortality and morbidity in association with the existence of the safer injection facility.

Former Conservative Prime Minister Stephen Harper voiced opposition to the injection site in the past, saying, "We as a government will not use taxpayers' money to fund drug use.

"[43] In mid-July 2006, Conservative Member of Parliament David Fletcher stated that the government would let Insite's special exemption lapse before deciding whether to continue the project.

[44] During the XVI International AIDS Conference, held in Toronto, two high-ranking Liberal MPs (Bill Graham and Keith Martin) put their support behind the centre, and criticized the Conservative government for delaying their decision.

[45] On August 13, 2007, the Portland Hotel Society and two clients of the facility filed suit in the BC Supreme Court to keep the centre open, arguing that its closure would be a violation of the Charter right of Insite users to "security of the person.

While this ruling does not take effect until next year, Justice Ian Pitfield also granted Insite an immediate exemption to federal drug laws, giving it legal grounds to continue operating.

[59][60] After the Supreme Court decision in 2011, the ruling majority Conservative party tabled a bill titled "The Respect for Communities Act", which would create a federal regulatory framework for supervised injection sites such as Insite.

[62] Once this legislation passes, Insite will have to meet new requirements in order to continue operating, and it will have to report on how the facility has affected local crime rates, and both public and individual health.