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Every few years, a news story pops up about ‘supervised injection sites’.

They’ve been around in Europe since the 1990s, but the first-ever legal supervised injection program in the US was established in NYC just two years ago.

The program has directly prevented over 1,000 potentially fatal overdoses with opioid overdose drugs like Narcan. It has also connected people to much-needed social services and addiction treatment resources in the city.

Research from other countries that have experimented with supervised drug consumption sites has shown that they reduce drug mortality rates and public drug use.

But now, even though the National Institute of Health (NIH) has committed millions to studying the NYC program’s efficacy, federal prosecutors are looking to shut the program down on the grounds that it violates state, federal, and local law.

So, what are supervised injection sites?

The idea: supervised injection sites (SISs) give drug addicts a safe and secure place where they can inject drugs like heroin. They provide clean needles to prevent the spread of HIV and other diseases, and have healthcare professionals standing by in case of overdoses.

The logic is simple: the addicts will be shooting up anyway, and allowing them to do so in a controlled and safe setting can save lives and reduce the number of costly emergency room trips and hospital visits if they’re found overdosing in a park or other public place.

SISs can also connect addicts — many of whom may be homeless or dealing with severe psychological issues — to social services that can potentially help them.

Key facts:

• Nearly a million Americans have died of drug overdoses since 1999.

• Researchers estimate that the opioid crisis cost the U.S. over $1 trillion between 2001 and 2017.

Arguments against SISs

Critics of safe injection sites argue that they will only encourage illicit drug use.

Community members in the areas where they have been set up have spoken out against them on the grounds that they will bring drug users and dealers to their neighborhoods.

Finally, some argue that these centers infantilize drug users by catering to — and even normalizing — their addictions.

Some supervised injection sites have created problems in the areas where they are situated.

Example: One SIS in Alberta, Canada, which was at one time the largest SIS in North America with over 800 client visits per day, was shut down after the surrounding area experienced an increase in opioid-related emergency calls and calls to police.

A local government official said that this was a:

Arguments for SISs

Proponents of SISs argue that they are good policy for two reasons: because they save lives and because they save the government money on emergency healthcare costs.

Research shows that the presence of an SIS in an area reduces the rate of drug overdose deaths. It also lowered the number of ambulance calls for overdoses and reduced the spread of HIV infections.

While the humanitarian and moral argument for allowing addicts to use SISs is clear, the financial argument is worth explaining in greater detail.

One study found that an SIS in Vancouver saved the city over $2.3M over the 2.25-year lifespan of the program by reducing the number of ambulance rides and emergency services visits needed for people who overdose on drugs.

Public health vs. politics

The idea of supervised injection is complex, and it’s unsurprising that the politics around it are contradictory and counter-productive.

As the NIH pledges money to studying SISs in NYC, another arm of the federal government spends its own money fighting to shut the program down for violating the law.

U.S. Attorney Damian Williams explained the Justice Department’s pushback against the program:

The idea of supervised injection sites inspires different moral responses: anger or even revulsion toward the normalization of self-destructive and anti-social behaviors, and sympathy towards addicts who have almost always been let down by society.

As we learn more about the science and sociology of addiction, hopefully we can determine collectively whether supervised injection sites should be part of a broader toolkit we have for addressing the root causes of addiction and solving the problems that it creates for individuals and communities.

ART OF THE DAY

Thank you for reading. Please reply to this email if you have any thoughts or feedback.

Yours,
Dan