Supervised Drug-Injection Facilities in New York? Yes We Should (and Can)!
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What should be done about the millions of people in the United States and around the world who inject heroin and other drugs?
For 30-plus years, the U.S. has waged a "war on drugs" that is, more accurately, a war on drug users. This war on drugs has not delivered on its promise to keep drugs off our streets or to prevent people from using, but it has successfully filled our prisons beyond capacity and led to far too many cases of HIV/AIDS related to sharing contaminated needles.
Vancouver, British Columbia, adopted a different approach to deal with the city's problems associated with injection-drug use. In 2003, the city established a supervised injection facility where users can take their drugs in a sterile environment and in the presence of clinical staff. The rationale is that as much as we don't want people injecting drugs, some -- often society's most marginalized -- inevitably will.
There are three main areas where injection-drug use occurs outside of the home: 1) public places, like parks and street corners; 2) "shooting galleries" that are often dirty, violent and conducive to the sharing of dirty needles; and 3) a safe, clean facility under the supervision of nurses and public health officials.
In addition to making sure people are using clean needles and are not overdosing, health professionals can use the opportunity to provide treatment options designed to curb and eventually eliminate the use of drugs.
So what are the results of Vancouver's strategy? A study released in 2007 in the esteemed British peer-reviewed scientific journal Addiction found that not only is the Vancouver injection site accomplishing the goals of reducing public drug use, cutting down on the spread of HIV/AIDS and overdose deaths, but is also a bridge to help people get into treatment.
The study found that the city's supervised injection facility increased the rate of injection-drug users entering detox by 30 percent. The study confirmed that all of these concrete benefits are happening without increased drug use. Similar findings were reported in studies of safer injection rooms in Germany, Switzerland, Spain and Australia.
And now the idea of supervised injection facilities are being discussed in cities like New York and San Francisco. Today in New York, the John Jay College of Criminal Justice and the Injection Drug Users Health Alliance convened a one-day conference on the topic.
The conference provided attendees with information on the effectiveness of SIFs, especially their impact on public health and safety. International experiences with SIFs, including a major review of Vancouver’s success, were reviewed. The conference also started initial plans for the development of an SIF in New York.
While there needs to be significant research and planning, there also needs to be movement and action. There is an overdose epidemic around the country. Last year, an estimated 22,000 Americans died from overdoses, second only to motor-vehicle accidents when it comes to accidental deaths. More people died of accidental overdoses in New York last year than from homicide. It is in this context that we need to move to establish SIFs in New York. This will save lives.
While some may hope and pray for a "drug free society," the reality is that there will always be some who will find their way to drugs. We need to do everything we can to make treatment available to heroin users and everyone trying to quit drugs. But we should also study what Vancouver and other countries are exploring. We need to find ways to reduce the death, disease, crime and suffering of people who are unwilling or unable to stop.