This month, that signal for something different came in loud and clear from New York City, where Mayor Bill de Blasio championed a plan to open the nation’s first legal safe injection site for intravenous drug users (Neuman, 2018). While de Blasio’s endorsement made a splash in the new cycle, his city is not the only one to seriously consider the approach. Philadelphia, Seattle, Denver and Ithaca, New York are also making moves towards opening safe injection sites (Lopez, 2018).
What Are Safe Injection Sites, Exactly?
Safe injection sites, also known as supervised injection sites, are legal facilities where users can go to get clean needles, receive health information, access social workers, get connected with treatment, get substances screened for life-threatening impurities like fentanyl and — yes — inject drugs.
Safe injection sites are staffed by qualified professionals trained in how to counsel users interested in seeking treatment. Staff also administer opioid antagonists like Naloxone to stop users from overdosing. The sites are based in the harm reduction approach to addressing public health crises (Drug Policy Alliance, n.d.).
Safe injection sites currently operate in Switzerland, Germany, the Netherlands, Spain, Norway, Canada and Australia. As of 2009, there were 92 supervised substance use facilities operating in 61 cities around the world (Dagmar Hedrich; et al., 2010).
Historically speaking, the resistance to such sites in the United States has been strong. Detractors argue that supervised injection sites encourage or enable drug use and act as an official government sanction for the use of illicit drugs. Others worry that such sites will bring increased crime and violence to surrounding neighborhoods. Some even go so far as to allege that safe injection sites will woo new users into the fold by encouraging the normalization of substance abuse in the popular imagination.
Actually, Supervised Substance Use Facilities Are Backed by Some Pretty Impressive Research
While detractors’ concerns are understandable, especially given the way Americans have been taught to think about the disease of addiction, the research that’s been done on supervised substance use facilities abroad paints a very different picture.
Studies consistently show that supervised injection sites work. Cities with supervised injection sites enjoy fewer drug overdoses and emergency care calls, which not only saves taxpayers thousands but also, more importantly, saves lives (Lopez 2018). Cities with the sites also saw a reduction in the instances of risky behaviors that lead to blood borne disease transmissions and even fewer nuisance complaints associated with drug use (Lopez 2018). This translates into fewer people sharing needles and fewer discarded needles littering the sidewalks.
In short, supervised injection sites don’t make things worse — they actually solve the very problems that detractors allege they will cause. Cities with supervised injection sites don’t see spikes in problems related to drug use, they see an overall reduction in the harm caused by substance abuse.
If You’re Losing the War, Try a Different Approach
More than half a million people in the US died from opioid overdoses between 2000 and 2015 (Understanding the Epidemic, 2017). That’s roughly 91 Americans dying everyday from opioid overdose.
How long will we sit on the sidelines of the opioid crisis, talking a big game about “meeting people where they’re at” while refusing to provide spaces where people with SUD can show up, disease and all, and be treated like human beings?
Only 10% of all people struggling with SUD make it into treatment in any given year (Lipari, R. N., Park-Lee, E., and Van Horn, S 2016). With tragic numbers like these, it’s clear we’re not doing a good enough job of reaching people who are struggling with this disease in order to get them the help they deserve.
A willingness to enter treatment begins with trust. Historically, users have had good reasons to be fearful and avoidant of medical professionals, social workers and law enforcement because these “helpers” — however well-meaning — often represent anything but help to people with SUD. In the past, an encounter with one of these “helpers” might result in jail, institutionalization or other harmful intervention. People with SUD have a problem, yes, but under abstinence-only programs, many people with SUD were made to feel that they are the problem.
At a supervised injection site, users can begin to develop trusting relationships with people in the helping professions which can act as a powerful bridge for those in need of help and exponentially increase access to treatment for those who need it most.
It’s fantastic that other harm reduction programs, like needle exchanges, are becoming more accepted in the United States. It’s time we faced the facts and embraced the research that plainly demonstrates that safe injection sites are the next step in creating a safe and sane response to our national drug problem.
Dagmar Hedrich; et al. (April 2010). “Chapter 11: Drug consumption facilities in Europe and beyond”. Harm reduction: evidence, impacts and challenges. EMCDDA.
Lipari, R. N., Park-Lee, E., and Van Horn, S. America’s need for and receipt of substance use treatment in 2015. The CBHSQ Report: September 29, 2016. Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Rockville, MD.
Lopez, G. (2018, May 3). Why Some US Cities Are Opening Safe Spaces For Injecting Heroin. Vox. Retrieved from https://www.vox.com/science-and-health/2018/1/25/16928144/safe-injection-sites-heroin-opioid-epidemic
Neuman, W. (2018, May 3) De Blasio Moves to Bring Safe Injection Sites to New York City. New York Times. Retrieved from https://www.nytimes.com/2018/05/03/nyregion/nyc-safe-injection-sites-heroin.html
Supervised Injection Facilities. (n.d.). Retrieved May 4, 2018, from Drug Policy Alliance website: http://www.drugpolicy.org/issues/supervised-injection-facilities
Understanding the Epidemic | Drug Overdose | CDC Injury Center. (2017, August 30). Retrieved May 4, 2018, from cdc.gov website: Understanding the Epidemic | Drug Overdose | CDC Injury Center