A hot button topic in the recovery community is safe injection sites. They are called by different names: safe injection sites, supervised injection sites, supervised consumption facilities, or drug consumption rooms. These government-sanctioned facilities allow drug addicts to shoot up in a clean, safe environment without fear of arrest. Users bring their own drugs, and are provided needles, cotton, and other supplies for the consumption of the drugs. They are not allowed to share drugs in these facilities. Medical professionals supervise the sites and are on standby to administer naloxone in the event that someone overdoses. Staff members do not handle any drugs and are not allowed to provide assistance to users shooting up. Staff is allowed to offer advice and discuss treatment options with addicts who want to get help.
In Europe, Canada, and Australia, safe injection sites (SIS) have been operating for years. The first one opened in Switzerland in 1986. Here in the U.S., as of 2022, they are still illegal but several cities are considering opening them. With overdose deaths numbering in the tens of thousands each year, public health officials are looking for new ways to try and combat overdoses. Studies on existing SIS have shown that they decrease deaths, emergency medical calls, and state health care costs. The European Union has an agency similar to our National Institute on Drug Abuse (NIDA), the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). Their findings show success with SIS in EU countries. Australia’s only SIS, located in Sydney, has also reported positive results for addicts and the community where it is located. There are over 100 SIS in operation in several countries.
There is a lot of opposition in the U.S. to proposed SIS. The Justice Department is opposed on a national level, stating that health care workers at these facilities could face criminal charges. State and county levels of government have blocked efforts for SIS in the past, even in traditionally liberal and progressive cities like San Francisco and Seattle. Local citizens are divided on the issue as well. One expert thinks that cities are holding off until some other city opens an injection site first. They want to see how the Justice Department will respond before they open themselves up to criminal or civil charges. This brings the battle for addiction treatment to a state’s rights issue as well making it even more complex.
Behind the legality of SIS in the U.S. is the moral issue these sites present. There are valid arguments on both sides of the argument for Safe Inject Sits. Advocates of safe injection sites say the goal is harm reduction. The main purpose is to prevent overdose deaths and diseases from dirty needles. It isn’t to try to get people to quit or force them into treatment. Addicts cannot be forced into treatment and for those who aren’t ready, SIS offers them somewhere to safely use drugs until they are ready. Their argument is that addicts can’t get into treatment if they’re dead from an overdose. Safe Injection Sites prevent addicts from having to shoot up in abandoned buildings or stairwells or in parks where no one can save them from an overdose. They don’t have to share or use dirty needles which can spread blood borne infections like Hepatitis C and HIV. Additionally, staff at these facilities can provide information that can lead to addicts entering treatment. SIS are a way to keep contact with a portion of the addict community that we might not otherwise be able to contact.
The main argument against SIS is that they enable drug use. Rather than encouraging addicts to get into recovery, the sites encourage them to continue using. Anything that keeps someone in active addiction is not a good thing. Some critics even say that sanctioned safe havens are tantamount to legalizing drugs. Drug users attract drug dealers and an injection site may draw criminal elements and violence around its location. While these sites have an argument that they reduce some types of criminality, they also often provide a safe place for criminal elements to gather. This is a major concern of the neighborhoods where these facilities are placed. Oftentimes you see the NIMBY (Not In My Back Yard) mentality. Many people are for these facilities until they are placed in their back yard. The idea that those who patronize these facilities will simply go in, use, and then leave, without effecting the community is a bit naive.
One addict shared their story regarding addiction in The Atlantic: “There is value in things being horrible.” I believe that to be true. An accumulation of negative consequences from using drugs is what gets people to want to stop and get help. If everything was going along fine in life, there would be no reason to stop using drugs. When things get bad really quickly for an addict it may be a blessing in disguise if it prompts seeking treatment before additional years of long, drawn-out suffering. That’s why, in support groups for the families of addicts like Al-Anon, they teach families to give tough love. Providing money or shelter or otherwise enabling the addict, even with good intentions, just keeps them in their disease. There’s a saying I’ve heard in recovery that “we don’t rob people of their suffering”. It’s the gift of desperation that gets people to want to make a change.
On the other hand, not all negative consequences are created equal. Losing a job or strained family relationships are not on the scale of homelessness or serious prison time. People have different thresholds for pain. For some addicts, incarceration won’t slow them down one bit while others call it quits after their first stint in rehab. Rarely does someone decide to quit because they can’t find a clean needle or place to shoot up.
The debate of these facilities will continue to go on, even after they are legalized. They present solutions to multiple problems to the effects of addiction on people and society. However, they also present multiple problems for enabling addicts to continue in their use of drugs. The answer isn’t easy, but we must continue to discuss all options if we are to help those who suffer from addiction.
If anyone you know is suffering from addiction please call us today. We can help!