In September 2003, the PHS forced Vancouver Coastal Health to found Insite by constructing and opening the site illegally.
On September 29, 2011, the Supreme Court of Canada ruled unanimously in Canada (AG) v PHS Community Services Society that the federal government's failure to renew Insite's exemption under the Controlled Drugs and Substances Act was arbitrary, undermining the very purposes of the CDSA, which include public health and safety.