By CHHS Extern Edward Miller
Photo Credit: THE CANADIAN PRESS/Darryl Dyck
This past year, more people died from opioid overdoses than died in the entirety of the Vietnam War. States and local agencies have reacted in various ways in their development of emergency response tactics to combat the epidemic. With an ever increasing overdose fatality rate due to the increased levels of synthetic opioids in local heroin, some jurisdictions have looked into creating Safe Injection Sites that would give citizens suffering from opioid dependency a place where the drugs would be screened for synthetic opioids, clean needles for usage, naloxone in case of overdose, first aid kits to treat small skin contusions, continued observation of injections by public health officials and volunteers, and a clear push to enter rehabilitation center that are often located on the premises. An unauthorized safe injection site in California managed to supervise 2,574 injections, safely dispose of an estimated 1,725 syringes, and be on hand to reverse a total of two overdoses in a two year period while only being open 5 days a week for 4-6 hours per day. The overall goal of safe injection sites in harm reduction and treatment, not criminality of an addiction.
In Vancouver, B.C., supervised injection sites have greatly reduced the overdose death numbers in the city, lowered the HIV infection rates due to providing opioid dependent citizens with clean needles, and increased the percentage of opioid users who have entered rehabilitation, all while not having a significant impact on overall addition rates. These extraordinary results required continued activism at all levels of the local government, including members of the local police force and county public health officials who were often the people referring addicts to the site and injecting them with their desired drug at the site.
While San Francisco, Philadelphia, and New York City have all started to study the feasibility of safe injection sites, King County, Washington, the county that encompasses Seattle has come the closest to realizing the completion of a safe injection site based off of the Vancouver model. However, such an approach is not without its critics. This past summer, a ballot initiative, Initiative 27, which would ban Safe injection sites in the County, received the required 47,443 valid signatures from registered voters to qualify for the ballot in the upcoming local election. Many of the supporters of Initiative 27 see the safe injection sites as a way of legalizing heroin use and could potentially bring undesirable individuals to their community. To the dismay of the leaders of Initiative 27, a King County Superior Court Judge ruled this past month that letting voters decide whether to ban safe-injection sites would infringe on the power of the King County Board of Health.
Not in My Backyard (“NIMBY”) ovements are opposition protests and/or petitions by local citizens against civic projects, like drug rehabilitation centers, that though would greatly benefit the greater community, may cause decreased property values or other unwanted results in the location of the site. Although NIMBY movements against Safe Injection Sites have gained momentum in other Washington jurisdictions, as Renton, Bellevue, Federal Way, and Auburn have created and passed legislation that would ban the sites within their jurisdiction, it must be stressed that these very jurisdictions suffer the highest opioid overdose rates in the State and would greatly benefit from the King County Safe injection site model.
The success of the Vancouver safe injection site, as well as other facilities in Canada, and unauthorized sites in the United States show the possibility for higher rates of recovery, lower rates of overdose fatalities and HIV transmittal, and is clearly better than continuing down the same path of condemning individuals combatting addiction to a life time of jail sentences or even worse, death.