A Clean, Well-Lit Place to Shoot Dope — In Your City, Soon?
Photo Credit: Shutterstock.com/Ruggiero Scardigno
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The only existing supervised injection site for hard drug users in North America is Vancouver's Insite, but panelists at a session of the International Drug Reform Conference in Denver last month said activists in a number of US cities are working to be next. (Plans are also afoot in a couple of Canadian cities.)
Supervised injection sites (SIS) are a proven public health and harm reduction intervention that can save lives by preventing overdoses, bring a measure of stability to the sometimes chaotic lives of addicts, reduce the spread of bloodborne infectious diseases such as HIV/AIDS and Hepatitis C, and reduce crime and disorder in the community.
SISs also exist in a number of European countries and Australia, but face both legal and political hurdles in the US. Still, advocates are ready to push the envelope here in a bid to bring the life, health, and money-saving innovation here.
Donald Macpherson, executive director of the Canadian Drug Policy Coalition and former head of Vancouver's Four Pillars drug policy program explained the prehistory of Insite, offering hints of possible courses of action in the US.
"We had a public health disaster," he said, referring to the city's escalating heroin problem in the 1990s. "Drug users themselves opened an SIS in 1995, and the police watched it, but didn't shut it down. A second opened in 2002. A year later, another non-sanctioned injection site opened up. It was really messy and it took years."
But in the end, Vancouver ended up with Insite and has managed to keep it open despite the best efforts of the Conservative federal government in Ottawa.
"Insite survives because it has an exemption from Canadian drug laws," Macpherson explained. "We won in the British Columbia courts, we won in the Canadian Supreme Court, which instructed the health minister to issue a permit. But we still barely have Insite, and though other cities are working on it, there is a big chill in Canada right now and we're just trying to hang on to what we've got."
Photo: Client at Vancouver's Insite supervised injection site (vch.ca)
Plans for SISs in the US face similar obstacles, but that isn't stopping advocates in a number of cities -- notably Austin, New York City, San Francisco, and Seattle, as well as somewhere in New Mexico -- from pressing forward with plans to open them there.
"I don't know if we'll be first, but we'll be one of many," said Robert Cordero, president and chief program officer of Boom! Health in the Bronx.
Boom! Health, which resulted from the merger of Bronx AIDS Services and Citiwide Harm Reduction, is a multi-service organization with a three-story building that includes a pharmacy, pharmacists with a harm reduction orientation, and a seven-day-a-week drop in center.
"Safe injection would be embedded with all these other services," he said.
"I don't know if we want to be first, but we want to be one of many," said Olivia Sloan, outreach and education associate for the Drug Policy Alliance (DPA) in New Mexico, which has been working patiently to bring cutting edge programs like SISs to the state. "We passed harm reduction, including needle exchange, through the state legislature, but it's not working," Sloan said. "We have overdose deaths at four or five times the national average."
Advocates in New Mexico have been and continue to lay the groundwork for SISs, Sloan said.
"We took a political and academic approach, and our conversation about injection facilities started a few years ago," she explained. "We have mobile syringe exchanges. We drafted legislation last year and the Senate passed a memorial to require we study the feasibility of SISs in New Mexico. We have partnered with the University of New Mexico and are looking for a principal investigator."