‘Safe’ drug sites no Recovery Road
AS YOU WERE SAYING ...
Safe injection facilities for heroin users have operated in Europe since the 1990s and in North America since 2003 as a response initially to the AIDS epidemic. As the opioid crisis grows — drug overdoses now surpass car crashes as the No. 1 cause of death among Americans under 50 — such facilities have gained attention as a harm-reduction strategy.
It’s a discussion worth having, but only if those who question it are not marginalized or excluded from the discussion.
Opposition to safe injection sites grows out of what I have observed over the years in the neighborhood that is slated to be the site of the newest injection facility here, the so-called Methadone Mile. And, no, calling it Recovery Road isn’t going to change its reputation.
The inspiration for the proposed injection site, which would be staffed by a local medical and/ or academic institution, hails from Canada: The Vancouver Project, in Downtown Eastside, is now entering its second decade. However, it remains an area high in theft, assault, drug dealing and a hot spot for stolen goods. The city council has even gone so far as to reduce the speed limit to 18 miles an hour to protect addicts unable to tell the road from the sidewalk. Does this sound familiar? Supporters are right on one point; the services do prevent people from dying inside the site itself. Beyond that, it is difficult to assess the claims of effectiveness. For example, data are used to support the benefits of the sites, but those numbers are based on mathematical modeling and assumptions about needlesharing, disease transmission and overdoses.
I see safe injection sites as one of the highest forms of enabling — of essentially giving up hope on people who use IV drugs. One might even call this end-of-life or hospice care. The sites provide no motivation to consider giving up drug use.
I am however willing to entertain alternatives that may impact the current opioid crisis seen throughout Massachusetts. For example, a van — which would at least eliminate the nasty Not in My Back Yard, or NIMBY, aspect — could be situated once a week in different areas where the OD rates are high. On this van, yes, you may have an area to inject safely under the watchful eye of a health care professional. But there will also be harm-reduction materials available — and opportunities to be tested for HIV and for recovery interventions.
Volunteers from Learn to Cope could be available to family members, recovering people among the volunteers. There can be access to buprenorphine, methadone and naltrexone. The van can make the point that this opioid crisis is more than the addict; it is the family, the community. And all must be educated, alerted and supported.
Perhaps the politicians from the community being visited by the van will also show up to field questions. This is a public health issue that needs interventions on multiple levels.
We need to stop treating addicted persons as if they were some kind of sick creatures who don’t know any better. If we keep telling them that they have no control over stopping, then they don’t and they never will.
I see medically monitored injection sites as one of the highest forms of enabling — of essentially giving up hope on people who use IV drugs.