Safe Injection Sites

For better or worse, I write most of my posts from the point of view of my own experience. While I carefully cite peer reviewed research to make my points, I usually include some personal anecdote to make my post more relatable and more heartfelt. Because of this I can’t be considered a journalist. I keep my posts informative and filled with objective facts, but they still begin with my own experience.

That’s why I don’t write much about substance abuse. I did have a period of significant meth use in my early 20s, and I had to move from Pennsylvania to Florida to get away from my supply, the crowd I ran with, and the temptations of the drug, but since then drugs, other than the prescriptions I take to manage my bipolar disorder, haven’t been a part of my life.

However, substance abuse remains a significant mental health problem, and many who struggle with mental illness also struggle with addiction.

Opioids have destroyed individuals and communities, and many seek programs that offer compassionate, nonjudgmental care to individuals who are addicted to help them manage their lives, come into treatment if they choose to, and stay alive. One of the most effective, yet very controversial, programs feature safe injection sites. A paper from the Cato Institute, which argues in favor of safe injection, or consumption, sites, describes how they work and the opportunities for change that each addict faces that are offered by these programs:

“Safe consumption sites are an effective means of reducing overdose deaths, the spread of infectious diseases, and of bringing into rehab people with substance use disorder. They offer an advantage over syringe services programs (“needle exchange”), which are federally legal. This is because safe consumption sites bring people inside, safe from the elements and from physical assault (and out of view of children and other members of the community), where they are given clean needles and syringes to inject their drugs under the watchful eye of nearby staff, ready with the overdose antidote naloxone. Unlike in needle exchange programs, the used needles and syringes are then safely discarded by the staff. Clients can return as often as they wish to safely consume their drugs. They are also provided with a place to shower and clean up, as well as to stay inside to “chill” after injecting. Tests are offered to screen for HIV and hepatitis, and fentanyl test strips and naloxone are often given to clients upon departure. As trust builds from this non‐​judgmental relationship, many clients “open up” to staff and are brought into rehab.”

Whenever the establishment of these programs is considered, a raging public debate soon follows. People protest that the government should not be promoting or facilitating drug use, especially with the use of public funds. Safe consumption sites loom as the ultimate “not in my backyard” issue, as even people who support the establishment and operation of these sites often object to placing them in their own neighborhoods. Often, opponents of safe consumption sites go to court and raise the “crackhouse statute, which has been upheld by the US Circuit Court of Appeals for the 3rd District. It prohibits state and local governments from actions to "knowingly open, lease, rent, use, or maintain any place, whether permanently or temporarily, for the purpose of manufacturing, distributing, or using any controlled substance."

This statute has been used to block the establishment of a safe injection site in my hometown of Philadelphia.

Still, in cities where safe consumption sites have opened they have met with great success; fewer people have died of overdose and more people have entered treatment.

In light of this clear benefit, this week Rhode Island became the first state to legalize safe injection sites, and will open two facilities, which they’re more accurately branding Harm Reduction Centers, this year. They address the “crackhouse statute” by fully funding the centers with private money and contracting the services to organizations that have a much better, and much less controversial, record of assisting addicts than the state government.

So before you condemn the state for the legalization and establishment of safe injection sites, or safe consumption sites, or harm reduction centers, whatever you want to call them, consider that they work. People are dying at epidemic numbers from substance abuse. They are addicted and can’t just decide to stop and get on with life. They need help. They need our help. Shouldn’t we offer it to them in ways we know will truly help keep them alive and enable them to make the choice to quit the drugs that destroy them – and enable them to successfully carry out that choice in a real, proven recovery program? We must stop demonizing addicts and include them in the community of people who struggle to overcome mental illness. They can recover. Let’s lend a hand and help them get there.