Can safe injection sites help curb the opioid crisis?

Mike Bebernes

The 360 shows you diverse perspectives on the day’s top stories.

What’s happening:

Drug overdoses are a major public health crisis in the United States. More than 70,000 people in the U.S. died of drug overdoses in 2017, with most of those deaths related to opioids.

In response to the crisis, a number of cities have considered opening safe injection sites for drug users. Safe injection sites are places where addicts can use drugs under the supervision of trained professionals who can make sure they have clean needles, give them addiction recovery counseling and provide potentially lifesaving medical help in the case of an overdose.

There are currently no formal safe injection sites in the U.S., but the push to establish them cleared a major legal hurdle last week when a judge ruled that a proposed site in Philadelphia would not violate federal law. Other major cities such as Boston, Seattle, San Francisco and New York have considered opening their own locations.

Safe injection sites exist in at least 10 countries. Canada has more than 40 locations, though Prime Minister Justin Trudeau’s main challenger in this month’s election has called the policy “terrible.”

Why there’s debate:

Advocates for safe injection sites believe they save lives by limiting the risks that come along with drug use. If people with drug problems are going to use anyway, some argue, it makes sense to provide them with a safe venue to do it.

Studies from other countries suggest that the sites reduce HIV and hepatitis C transmission, increase the likelihood that a drug user will seek addiction treatment and — most important — decrease fatal overdoses. One large site in Vancouver has reportedly had more than 3.6 million clients inject illicit drugs under supervision by nurses since opening in 2003, without a single overdose death.

Opponents of the sites argue they perpetuate addiction by removing some of the challenges that might push people out of the lifestyle. They worry about an increase in crime in the areas around the sites, since users still have to purchase their own drugs. There is also skepticism about how effective the sites can be, given the limited number of people they are able to help and the massive scale of the epidemic.

What’s next:

Some of the cities that were considering opening safe injection sites may have been waiting for the court case in Philadelphia to be resolved before moving forward. President Trump’s Justice Department is staunchly opposed to the sites and is expected to appeal the decision.



The sites bring numerous benefits

“An abundance of public health research shows that supervised injection sites prevent overdose deaths, do not increase drug use or crime, and decrease dropped syringes in their vicinity.” — Editorial, Philadelphia Inquirer

Safe injection sites allow drug users to be treated like human beings

“Within the walls of a safe injection site, people don’t just get protection from an overdose; they regain, at least momentarily, the dignity of safety and self-respect.” — Michelle Chen, NBC News

The sites could protect users who may not know what they’re injecting

“The number of dead is continuing to climb as people overdose on heroin laced with fentanyl. … That’s where safe injection sites would come in. At more than 90 such locations in Europe and elsewhere, if someone overdoses at one of these sites, a health worker or other first responder quickly administers an antidote.” — Editorial, Scientific American

Safe injection sites save lives

“...studies have shown that supervised injection sites can drive down fatal overdoses. No one has ever died in one of these sites because there’s someone there standing by if somebody does overdose.” — Nina Feldman, NPR

A ‘tough on crime’ approach has been proven over and over to be ineffective

“We’ve spent a hundred years telling these people to go away, to live on the margins, to do this procedure in egregious situations in the most unsafe places in cities. … These places acknowledge the existence of these people.” — Darwin Fisher, a Canadian safe injection site manager, to Governing


Safe injection sites perpetuate drug addiction

“Injection sites normalize intravenous drug abuse, encourage a horrible addiction, and let down the people who suffer from it. Promoters of these sites offer addicts little but failure — medical safety at the time of injection but, overall, mere complicity in a nightmarish cycle of addiction leading to death.” — Andrew Lelling, Boston Globe

Crime would spike in the areas around the sites

“A safe injection site wouldn’t supply the drugs, and so users would still be doing whatever they have to to score a hit, including theft and prostitution for many. We doubt those living and working in the neighborhoods where safe injection sites would be located would welcome the threat to public safety.” — Editorial, Boston Herald

Methods that don’t condone drug use should be used to fight the opioid crisis

“That is not the way to end the opioid crisis. Americans struggling with addiction need treatment and reduced access to deadly drugs. They do not need a taxpayer-sponsored haven to shoot up.” — Former Deputy Attorney General Rod Rosenstein, New York Times

The sites can help only a small number of people

“One problem with supervised consumption sites may come down to scale. The sites have limits in where and when they’re open, how many people they can serve at once, and whom they serve. For a city dealing with potentially thousands of people using drugs — many of whom use drugs multiple times a day — the sites don’t have enough reach to help a lot of the population.” — German Lopez, Vox

The sites could be a slippery slope leading to government programs providing heroin to addicts

“While safe injection sites are designed to provide a medically-supervised location for drug use, that doesn’t solve the problem of drugs laced with deadly chemicals like fentanyl. The question then becomes whether that could lead to state-sponsored distribution of heroin to counter that epidemic.” — Jason Rantz, KTTH, Seattle

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Cover thumbnail photo illustration: Yahoo News; photo: Getty Images