Street Roots • Aug. 31-Sept. 6, 2018
O p in io n
Despite federal threats, injection site movement must move forward
Z |
Ahis week, U.S. Deputy Attorney General
Rod Rosenstein penned an opinion piece
-L in the New York Times in response to
the momentum building around safe injection
sites for intravenous drug users.
Specifically, the column came on the heals of
one of the strongest state legislative actions
toward harm reduction in addressing the opioid
crisis: California State Legislature’s passage of
a bill that will create a pilot program in San
Francisco that includes opening a safe injection
site to reduce opioid
overdoses and encourage
treatm ent As of press
time, the bill was awaiting
Gov. Jerry Brown’s
signature.
Controversial and
unconventional, safe injection sites are breaking
through the puritanical “war on drugs”
attitudes that have failed us for decades - and
continue to stifle real discussions around
addiction. There’s no question that addiction is
an incredibly challenging problem that seldom
delivers us to comfortable answers, but we also
don’t have to live with the tragically dismal
status quo, which is clearly where Rosenstein
and the federal government want to keep us.
First, safe injection sites are not new, just
new to us.
The Drug Policy Alliance recognizes 120 safe
injection sites, or SIFs, operating in 12
countries, including Australia, Switzerland,
Norway, Spain, Denmark, France and Germany.
They’re also referred to as safe consumption
sites or overdose prevention sites. .
The first SIF to open in North America is in
Vancouver, B.C. Insite opened in 2003, and in .
its 15 years has been credited in numerous
studies for saving lives, reducing the spread of
HIV and hepatitis C, and saving millions of
dollars in police and other service expenses.
Worldwide, numerous studies back up the
beneficial role these facilities have in
preventing deaths, the spread of disease and
shepherding users toward treatment.
Instead of reviewing the global analysis,
Rosenstein instead lists several reasons to
condemn SIFs, starting with the big federal
bugaboo: it’s illegal. And for that reason, “cities
and counties should expect the Department of
Justice to meet the opening of any injection site
with swift and aggressive action”
The line in the sand isn’t about the best or
most effective way to end addiction and treat
people and communities that are suffering. It’s
about enforcing federal law, without question.
Criminalization is not, and never has been, the
answer to a health crisis.
His next premise is that injection sites create
serious public safety risks, connecting the
infiltration of fentanyl in the street drug supply
with these facilities. He offers no correlating
evidence between the two, and in fact the lethal
consequences of fentanyl, and other dangerous
concoctions, are shown to be best monitored in
an injection facility.
He also discredits the impact SIFs have on
helping drug users overcome addiction. He
sites a statement from a November 2017 article
where the chief medical officer for the company
running SafePoint, a facility in Surry, B.C.,
estimated that about 10 percent of SafePoint
users enter treatment (as if that’s a bad thing).
It’s worth noting that at the time of that
article’s publication, SafePoint had been open
for less than five months.
And then there’s the claim that injection
EDITORIAL
sites “destroy the surrounding community.” His
example is the neighborhood where InSite is
located - Vancouver’s Downtown Eastside,
which since at least the 1990s has been
notorious for having one of the highest
concentrations of drug users in North America.
It was also ground zero for the spread of HIV
and hepatitis C infections, which is precisely
why InSite opened there in 2003. (It’s also
telling that he has to describe InSite to his
readers through the eyes of a visitor from
Redmond, Wash., casting doubt that Rosenstein
has ever even visited a SIF before concluding
they destroy communities.)
This commentary from Rosenstein is
important because it explicitly threatens federal
aggression against the increasing number of
communities looking for real answers. The
federal bureaucracy is pushing a black-and-white
scenario, while local communities are forced to
explore the complicated gray areas of addiction
and harm reduction.
Last year, King County Board of health
voted to support opening two sites in the
Seattle area, and in Ju ne, announced it
intended to launch a mobile medical van
for safe injection use. Earlier this year,
Ithaca, New York, announced plans to open
multiple injection sites. Philadelphia is
hosting community forums on the issue
and hopes to compel a private company to
open a S IF there. Among Philadelphia’s
leading arguments is the economic
savings: A safe injection site is expected to
save the city $2 million a year in
emergency and direct health care costs.
For Portland and Multnomah County, the .
issue has lingered on the periphery long
enough. It’s time for Portland to seriously
explore the options an injection site could (
provide. Of course this would have to be in
tandem with adequate and effective treatment
programs and related legal and health care
efforts to help people who are struggling with
addiction heal.
David Bangsberg, founding dean of the joint
Oregon Health & Science University-Portland
State University School of Public Health, told
Street Roots that the “epidemic of overdoses”
from opiates is entirely preventable with safe,
effective medical intervention. The data from
Vancouver suggests that this is a very, very
effective intervention - harm reduction strategy
- to prevent the harm related to overdoses,
particularly death.”
He pointed out that “it also creates an
opportunity to get people from using drugs on
the streets into a safe supervised site which has
a number of other positive social effects in
terms of getting needles off the street, to create
safe sites for people to use clean equipment,
and also the opportunity for people with
substance use disorders to have easy access to
treatment for when they are ready to ask for
help to lessen their drug use.”
There are people already exploring such a
facility in Portland, and it should move forward
with a community-wide discussion and
education process. Even further, we should be
networking with other cities who are exploring
the same option, dealing with the same
challenges.
The opioid crisis is in full swing on our
Streets. Let’s use every tool in the box.
Page 3
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