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safe injection sitesWith the ongoing opioid crisis in the U.S., lawmakers and experts alike are searching for solutions to reduce deadly opioid overdoses and prevent further addiction and abuse of opioid drugs. Some people believe safe injection sites are an effective way to prevent drug overdoses and other negative effects associated with opioid addiction, but not everyone is in agreement.

What is a Safe Injection Site?

Safe injection sites go by many names, including supervised consumption services, overdose prevention centers, fix rooms, medically supervised injection centers, and drug consumption rooms. However, they all provide the same basic service: medical supervision for people who want to inject pre-obtained drugs.

At safe injection sites, drug users are provided with sterile injection equipment and medical oversight by trained staff members. These facilities also have overdose-reversal medication on-hand to use if someone overdoses.

There are about 100 different safe injection sites operating worldwide and they have been a success in Canada. As of January 2018,  just a few cities in the U.S. allow them (Philadelphia, San Francisco, and Seattle) but others are considering it.1,2

Are Safe Injection Sites Effective?

According to the American Medical Association, studies from other countries where safe injection sites are operating legally have reported that they are effective in several different ways:

  • They reduce overdose deaths.
  • They decrease infectious disease transmission (primarily HIV and hepatitis C).
  • They increase the number of individuals initiating treatment for substance use disorders.
  • They don’t increase drug trafficking or crime in the areas where facilities are located.3

According to Penn Wharton Public Policy Initiative, one safe injection site that has been operating “underground” in the U.S. since 2014 in an undisclosed urban area. Between 2014 and 2016, it provided medical care to about 100 opioid addicts and assisted with more than 2,574 injections. Within these injections, there were two overdoses, but both were reversed with naloxone.4

Additionally, each patient at the underground facility was given a survey before injection. Survey findings revealed 67.4 percent of users at the site disposed of their used syringes unsafely in the past 30 days. Since all syringes are disposed of safely at the facility, the safe injection site prevented 1,725 public disposals of syringes and prevented 92.2 percent of injections that would have occurred elsewhere in public, such as a public bathroom.4

Safe Injection Site Pros and Cons

Safe injection sites in the U.S. are highly controversial due to the various positive and negative consequences associated with them. The debate also begs the question of whether drug abuse prevention or harm reduction is more feasible and effective. Experts on either side of the issue don’t seem to have any solid answers.

Here are some of the most commonly disputed cons of safe injection sites.

CONS OF SAFE INJECTION SITES

  • They may encourage drug use: One popular argument opposing safe injection sites is that they encourage drug abuse by not reporting the use of illegal drugs like heroin to law enforcement. Essentially, drug abusers get away with an activity that has been deemed illegal in the U.S.
  • They may challenge federal laws on drug abuse: A lack of legal consequences associated with injecting drugs at a public facility could create a culture in the U.S that challenges federal laws and regulations regarding drug abuse.
  • The studies on safe injection sites may not be reliable: Although there are several research studies that claim safe injection sites are effective and save lives by preventing deadly overdoses, some experts argue these studies are flawed and biased.5
  • They may bring crime to surrounding communities: Some studies show opening a safe injection site does not increase arrests for drug trafficking, assaults, or robberies in the surrounding communities, but many experts argue that the validity of these studies is unknown. There may not yet be enough research out there to support the claim.6,7

Conversely, according to the Drug Policy Alliance, there are several benefits of implementing safe injection sites in the U.S.8

PROS OF SAFE INJECTION SITES

  • They may give addicts a safe place to inject drugs: Instead of injecting drugs in a public place like a restaurant bathroom or on the street, drug abusers have a safe and private place to use. This, in turn, protects the public from exposure to drug abuse and potentially dangerous situations.
  • They may increase access to health and social services: Operators of safe injection sites may be able to establish relationships with addicts, which could be a valuable way to help drug abusers get into an opioid addiction treatment program or detox.
  • They may prevent overdose deaths: Safe injection sites provide overdose-reversal drugs like naloxone to prevent overdose deaths. So far, no deaths have been reported at any safe injection site.8
  • They may reduce the stigma of addiction: Some experts believe safe injection sites may reduce addiction stigma by presenting addiction as a disease that requires ongoing medical treatment.9 Medical professionals at safe injection sites can provide medical monitoring while drug users inject, and they may also be in an optimal situation to provide treatment referrals when the user is ready.
  • They may decrease the spread of disease: By preventing needle-sharing and unsafe disposal of used needles, safe injection sites may reduce the transmission of diseases like HIV and hepatitis C.
  • They may save cities money: Cities may save money by opening and operating safe injection sites due to the reduced health care costs and the increased use of addiction treatment programs. For example, one 2016 cost-benefit analysis found that the city of San Francisco could save about $3.5 million annually by opening a safe injection site.10

Safe Injection Sites and Rehab

Naturally, you may be wondering what safe injection sites have to do with rehab. The two seem very much opposite, as safe injection sites encourage “safe” drug abuse and drug rehab encourages ongoing abstinence. However, some supporters of safe injection sites argue that medical workers within these facilities may have a very unique advantage. These facilities could provide more opportunities to reach addicted individuals.

For example, some of the drug users utilizing safe injection sites may return on a regular basis, which may result in ongoing relationships between the medical workers and the drug abusers. In this scenario, the medical workers may be in an optimal position to present addiction treatment options like detox and rehab when the drug abuser is ready.

When someone asks for addiction help, it’s essential that effective support and assistance are provided right away, otherwise, the person may change their mind, relapse, or overdose. Some experts say trained professionals at safe injection sites have the ability to provide immediate referrals to drug rehab programs and/or detox programs. In theory, a safe injection site could provide essential social and health services where they are needed most: in the midst of addiction.

Following a two-year study of the undisclosed “underground” U.S. safe injection site mentioned above, addiction researchers found that its patrons were able to reduce the personal and social risks of their drug use, and take steps toward their recovery.11 Although the verdict is still out and the use of safe injection sites is still very much a controversial matter, some addiction researchers believe they hold potential.

If you or a loved one is ready to begin your journey to sobriety, call Nova Recovery Center today for more information on our addiction treatment programs for adults.

 

References:

  1. https://www.buzzfeednews.com/article/azeenghorayshi/philadelphia-safe-injection-site
  2. http://www.ktvu.com/news/task-force-for-san-francisco-safe-injection-sites-to-begin-work
  3. https://www.ama-assn.org/ama-wants-new-approaches-combat-synthetic-and-injectable-drugs
  4. https://publicpolicy.wharton.upenn.edu/live/news/2192-safe-injection-facilities-are-they-effective
  5. http://mynorthwest.com/1093100/seattle-heroin-injection-study/
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5685449/
  7. http://www.ktvu.com/news/task-force-for-san-francisco-safe-injection-sites-to-begin-work
  8. http://www.drugpolicy.org/issues/supervised-consumption-services
  9. https://www.health.harvard.edu/blog/safe-injection-sites-reducing-stigma-addiction-2017060211826
  10. https://www.npr.org/sections/health-shots/2018/09/07/645609248/whats-the-evidence-that-supervised-drug-injection-sites-save-lives
  11. https://www.forbes.com/sites/janetwburns/2018/01/02/research-finds-signs-of-recovery-community-at-underground-safe-injection-site/#c2992405d237