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Linda Rosenberg

Former President and CEO, National Council for Behavioral Health

Safe Injection Sites: Good Idea or Bad Idea?

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In the game of “good idea, bad idea,” it seems no one is neutral about supervised consumption facilities, also called safe injection sites.

Proponents say people can’t recover from a substance use problem if they’re dead, and supervised consumption facilities have been proven to keep them alive. Safe injection sites are facilities where people can use clean needles to inject drugs under the supervision of medical personnel, who can revive them in case of an overdose. Site users also have access to wound care, HIV education and referral to addiction treatment. San Francisco, Seattle, Philadelphia, and Ithaca, NY, among other cities, are racing to open the first such facility in the United States.

A supervised consumption facility says, “You may be a heroin addict, but you are still a human being,” notes Brad Finegood, assistant division director for the King County Behavioral Health and Recovery Division. Finegood will present a TED-style talk called “Safe Injection: The Idea That Doesn’t Make Sense Makes Perfect Sense” at NatCon18.

Opponents say safe injection sites will encourage addiction and discourage treatment, despite mounting evidence to the contrary. In Seattle and King County, Washington, opponents mobilized a ballot initiative against the creation of safe consumption facilities that was eventually struck down by a federal judge.

Harm Reduction

The first supervised consumption facility opened in 1986 in Switzerland and, today, some 100 sites operate in 66 cities across Europe and Australia. Insite, the first safe injection site in North America, opened in Vancouver in 2003. More than 3.6 million people have used the facility, and though 6,400 people have overdosed, not a single person has died.

Research on supervised consumption facilities in cities that include Vancouver and Sydney, Australia, has shown that they:

  • Reduce overdose deaths in the area immediately surrounding the facility.
  • Reduce drug use and connect users to addiction services.
  • Do not increase crime, nuisance or drug use in their communities

Safe injection sites may also save money. Public health officials in San Francisco believe that 85 percent of the city’s intravenous drug users would use safe injection sites, saving the city $3.5 million in medical costs.

The battle over safe injection sites is the latest salvo in the war on harm reduction efforts, argues Temple University economist Abraham Gutman. He points to arguments against needle exchange programs meant to stem the spread of HIV and AIDS, and more recently, fears that widespread access to the opioid overdose reversal drug naloxone would promote drug use. Every city already has a well-identified area where people are using drugs, Gutman says, but supervised consumption facilities will allow them to do so safely until they are ready to seek help.

Safe injection sites may face an uphill battle in the U.S. with a federal government focused more on law enforcement than treatment to stem the drug overdose crisis. “But so far,” concludes The New York Times, “most of America’s past policies have failed catastrophically, and the regions that have tried these sites have saved people.”

One thing is clear – with more than 64,000 drug overdose deaths annually, solutions like safe consumption sites must be considered. Where do you stand on this debate? Let me know, and then come to NatCon18 and join the conversation!