Heroin addiction affects millions of people in our country and around the world. Seattle is the first city in the U.S. to offer safe injection sites where addicts can go and receive clean needles, a non-judgmental environment for taking drugs, and access to drugs that reverse overdose. Safe injection sites have been available in Canada and Europe for many years, but not in the U.S. Even with increasing incidences of heroin addiction and overdose, as well as addiction to other opioids such as vicodin and fentanyl (a powerful synthetic opiate) there is much controversy about providing safe injection sites. Seattle is taking the lead in an effort to address the problem of heroin addiction and deaths from overdose. Arguments both for and against safe injection sites include:
Benefits of Safe Injection Sites
- Save lives of addicts by providing a place where medical attention is readily available in case of overdosing.
- Build relationships with addicts that can lead to accepting help.
- Provide clean needles that prevent spread of diseases. (This same concept was used in the 1980’s and 90s to limit the spread of hepatitis C and HIV.)
- Offer resources such as health care, medical staff, counseling, referrals to treatment centers.
- Reduce public disorder associated with neighborhood drug abuse such as needle trash and public display of drug use.
Negative Aspects of Safe Injection Sites
- Tolerates illegal drug abuse and offers no incentives to ask for help in stopping drug use.
- ‘Invites’ drug abusers into the neighborhood of the safe injection sites.
- Perception that a safe injection site condones drug abuse and that money would be better spent on treatment.
How safe injection sites work with heroin addiction
Safe injection sites don’t sell drugs; people come with their own drugs for safe monitoring. The InSite Clinic in downtown Vancouver has been open since 2003. They have 600 to 900 visitors a day. When a person checks in, they provide a name and tell the staff what drug they have with them. They get the supplies they need from the clinic, such as a syringe, cooker, alcohol swab, and/or tourniquet. Then they take the supplies to a booth that has mirrors and is in plain sight of staff and nurses. The staff is available to provide suggestions on techniques that reduce risk, but they don’t perform injections. Clients of the clinic may stay for a while after injecting. The clinic offers addiction treatment and a detox facility for when or if a person is ready to end his or her heroin addiction.
Understanding the heroin addiction cycle
Men and women in heroin addiction are living lives of survival and desperation for the next fix. The need to stay ‘medicated’ overwhelms all other priorities. Addicts may come from trauma or abuse, or they may have been swept into the cycle through legitimate pain killers that were prescribed after surgery or injury. When the prescriptions run out, they ‘need’ drugs to continue to function and not experience opiate withdrawal. Heroin is the next step for meeting the need. Because the addiction lifestyle leads to a lack of trust, it takes treatment to rebuild healthy relationships. Safe injection sites provide an opportunity to save lives so that the heroin addicts have a starting point. Some will take the opportunity, others won’t. But those who work in the clinics make themselves available for the path of rebuilding lives.