Supervised Injection Sites Hotly Debated
According to the Centers for Disease Control and Prevention, more than 30,000 opioid-related deaths were recorded in 2015 alone — devastating many communities across the country. Officials worry that current prevention methods are failing to curb the death roll. Now, many institutions are reevaluating their strategies. One idea put forward has been the introduction of supervised or safe injection sites, where addicts can go to inject street drugs in a clean, secure environment. WAMC News Intern John Cossee spoke to a number of medical professionals and campaigners to find out more about the contrasting opinions regarding safe injection.
Cortney Lovell is a 28-year-old addiction counselor and recovery coach from Columbia County, NY, who spoke recently at an exhibition for safe injection sites at the Empire State Plaza in Albany.
“My addiction progressed really quickly. What started as just drinking on the weekends at parties turned into trying pills that the doctors gave out, and they were harmless and safe and it was something that was prescribed, so I would try it and my friends were all doing it and when I put that first pill in my body, it flipped a switch in me that I would have a really terrible time trying to figure out how to turn back off,” Lovell said.
Lovell has a common story during this national epidemic, which has seen families torn apart and local law enforcement overwhelmed.
She added, “ I just kind of resigned to the idea that I was going to live the rest of my life and die a drug addict, and I was OK with that, because I was at least I was numb. At least I didn’t have to feel the pain that I was feeling anymore.”
Lovell’s addiction progressed to the point where she contemplated suicide:
“I had no more friends I had become so isolated that I was just detached from life, and I tried to end my life in my car, I overdosed. At 19.”
Addicts like Lovell are abusing everything from legal prescription opioids like morphine and codeine to banned substances, such as heroin, which can often be cheaper and more accessible.
In 2012, 259 million opioid prescriptions were given out, more than one for every adult in the United States. According to the National Institutes of Health, an estimated 2.1 million people suffered from substance abuse disorders related to prescription opioids, and an estimated 467,000 were addicted to heroin.
Furthermore, fatalities from overdosing have quadrupled since 2010.
One proposal to tackle the rising death toll is the introduction of supervised injection clinics. The sites, which can be found throughout Europe and Canada, offer a safe place where addicts can legally inject street drugs under the supervision of trained professionals. They provide clean needles and other sterilized equipment, as well as counseling to the people who use their services. The idea has even been discussed in upstate New York cities like Ithaca.
Liz Evans is the executive director of two harm-reduction organizations in Manhattan and was involved with the opening of the Vancouver-based supervised injection clinic, Insite – the first of its kind in the North America. At the Albany exhibition, she described how the service works.
“They’re using all sterile, clean equipment so there’s no risk of contracting any diseases. And also because they’re in an environment where they’re using safely, they’re less likely to contaminate themselves or get an abscess or an infection. And then if somebody overdoses there’s staff right there to intervene,” said Evans.
With no deaths after almost 2.5 million injections at Insite, Evans says that the evidence to support the model is “exhaustive.”
Evans continued, “ there are 33 incredibly high-profile publications, each of which indicates that Insite and injection sites have a role to play in an otherwise comprehensive system of care. It’s not a panacea, it doesn’t fix everything, but it prevents people from dying of drug overdose and when they come in, they don’t die, over 2 million, almost 2.5 million injections have taken place in that site since it opened in 2003 and no one has died. And each time a person comes into that site there is an opportunity for them to get connected to care.”
Such clinics aim to meet drug users at the root of their problem to minimize the harmful effects of drug use, whereas rehabilitation services attempt to cure their addiction.
At Incite, around 800 people use the booths daily, with some coming to inject up to three times a day. Some believe that this is a more realistic solution than forcing individuals who are not ready to receive treatment into programs only to watch them relapse.
Evans says the sites prevent the spread of disease, reduce the number of overdose deaths, and provide a vital point of exposure for drug users who are poorly connected to health care services to begin their path to recovery.
Others are not convinced. Toronto City Councilor Steven Holyday recently voted against a proposal from the Canadian Board of Health that approved the opening of three new sites in the city.
“I don’t anticipate that we’ll be tracking the individuals that come in, I don’t anticipate that we’ll have clear records about who’s been visiting, where they’re from, and whether or not the provision of a safe injection site has been a success from a public health perspective,” Holyday said.
“The answer in my mind is not to treat the symptom but treat the overall disease. And, you know, given the choice, you know, I would rather have people put into healthcare programs that would get them off all substances, not just heroin, might be able to counsel them to get their life on track.”
Skeptics worry about allowing such clinics into their communities, and wonder whether they simply enable addiction. Republican New York state Senator George Amedore of the Capital Region is the co-chair of the Heroin Task Force, and chair of Alcohol and Substance Abuse Committee.
Lawmakers included $213 million in the new state budget to address the crisis, providing funding for law enforcement, health care professionals and experts throughout the state.
Senator Amedore said that he thought supervised injection sites were “the absolute wrong approach when it comes to the crisis that we’re facing in the state,” before adding, “we want to help them, every individual, overcome their addiction, but we cannot and should not enable them, who are bound by an addiction, to go to an injection site to continue to use illegal drugs.”
Lovell, the addiction counselor and recovery coach, believes continuing with current strategies is misguided.
“As a society we need to do so much more to create those access points for people like myself who are so sick and so isolated that no other messages are getting to them, that are giving up on life. We need to tell them that they’re worth it and that they’re capable of recovery, and we’re not hearing that. The policies and the laws and the treatment system that we have today isn’t giving that to people who need it most,” she said.
After initially opposing supervised injection sites, she is now a firm supporter of the model:
“The idea of having somebody go someplace and shooting up was just asinine to me, but the more I started to learn about the effects, the statistics, the evidence behind this practice, it’s inarguable. I’m losing friends and peers constantly, constantly… constantly people that I used with, that I grew up with, that I know, that I cared for, that I worked with in recovery are dying because they are not getting whatever help it is that they need to get well.”
Advocates may be split over the best methods for curtailing the addiction crisis, but one thing they agree on is the importance of eliminating the stigma that surrounds drug addicts.
After attempting to end her life, Lovell managed to conquer her addiction and made a full recovery. She now lives just outside of Albany and travels the country helping others recuperate. But statistics show that addicts are more likely to relapse than not – making Lovell’s work an ongoing struggle.
“It’s our responsibility to find whatever the most innovative approaches are that actually can make an impact and save their lives, and help them to save their own lives. Because we’re all worth it,” Lovell said.
WAMC News Intern John Cossee is an exchange student from Manchester, England, studying journalism at the University at Albany.