Should governments allow safe-injection sites for illegal drugs?
Hi there, thanks for joining us for episode 240 of Plain English. I’m Jeff, JR is the producer, as always, and you can find all the episode resources at PlainEnglish.com/240.
Coming up today: The city of Philadelphia was poised to become the first in the United States to offer a safe-injection site for people addicted to illegal drugs—but the plan was scrapped due to objections from neighbors. We’ll talk about what safe-injection sites are and whether they are a good idea or not. In the second half of the episode, I’ll introduce you to the phrase “grapple with” and we have a quote of the week. The video lesson for Plus+ members is about how to use the word “since” when describing cause and effect.
Starts and stops for Philly safe injection site
Should governments allow supervised injection sites for individuals addicted to drugs like heroin?
It’s a question that the American city of Philadelphia is grappling with now. Safe injection sites are places where individuals can bring their own drugs, such as heroin and methamphetamine, and take them with clean needles, under the supervision of trained medical personnel.
It’s a progressive treatment model that has been tried with success in Europe and Canada, but safe injection sites have long been presumed to be illegal in the United States. That’s why we don’t have any safe-injection sites today. Since heroin, for example, is an illegal drug, no private companies or nonprofits can be complicit in its administration. That changed recently, however, when a judge ruled that a safe injection site would not violate federal laws against drug use.
Following that ruling, a nonprofit organization called Safehouse announced plans to open a safe-injection site in Philadelphia. They had found a location, signed a lease with the landlord, and announced their plans to open. That’s when all hell broke loose with the community. People who lived nearby said that a safe-injection site would bring all the city’s drug addicts to their neighborhood, reducing safety on the neighborhood streets and putting their families in danger. The proposed site, they noted, also housed a school and a daycare. They don’t want a long line of drug users waiting to inject themselves in the same building that their small kids go to school.
Some of the objections were based in principle against safe-injection locations, but most of the community members were more specifically worried about the potential negative effects on their streets. It’s an example of a particularly strong tradition in American local politics: NIMBY-ism. NIMBY stands for, “Not in my backyard.” In many cases, local residents don’t object to something in principle—they just don’t want it too close to where they live. In this case, the backlash against Safehouse caused the organization to delay its opening, and caused its landlord to cancel the lease. For now, Safehouse doesn’t have a location.
NIMBY-ism is a problem that any safe-injection site will face. Although it might be a good thing for the community overall, it has to go somewhere—and the people who live nearby will always have a say.
But let’s set aside the NIMBY objections and ask whether safe injection sites are a good idea overall.
Opponents say that there is no safe way to take heroin, and that whether the drug is administered in a safe facility or at home or outside, the effect on your body is the same—which is to kill you slowly. Another argument against these sites is that they normalize drug use. They make it seem acceptable and give it the appearance of being safe. A single injection site would attract all of a city’s drug users, creating a concentration of individuals who all use drugs in the same general vicinity. It would be better, opponents say, to focus our attention on prevention, education, and addiction treatment.
Proponents think differently. They say that safe-injection centers save lives. Untold numbers of people are addicted to illegal drugs and thousands of people die each year due to overdoses in the United States. If someone is going to take the drug, proponents say, it should be in a safe place—not outside or alone at home. It should be with clean equipment and with medical professionals available to intervene in the case of an overdose. Safe-injection sites follow the principle of harm reduction: the behavior is taking place, so the resulting harm to the individual should be reduced as much as possible. There is a time and a place, proponents say, for prevention, education, and addiction treatment. And safe-injection sites often do have related addiction services, such as counseling. But we shouldn’t ignore the people who are in the throes of an addiction and have not yet found their way to recovery.
It is difficult to say for sure whether the sites work, but the evidence that does exist generally supports the idea that the sites save lives. About a hundred safe-injection sites operate worldwide, mostly in Europe, Canada and Australia. Part of the problem is that it’s difficult to collect reliable data on illegal behavior. However, studies of a government-run safe-injection site in Toronto showed that overdose deaths in the area declined, that there was no evidence that drug use increased as a result of the facility, and that people who used the site were more likely to seek out treatment. One observer said that it sounds odd that you can give people a safe and clean place to inject, and afterward they seek out treatment—but that is what has happened in Toronto. A facility in Vancouver has administered millions of doses, without a single overdose death. And studies in Barcelona showed that the number of stray syringes on the street fell dramatically after an injection site opened.
I’m not in the public health field, but I think we should be open to new treatment models, study them, and refine them if necessary. In the face of our country’s opioid crisis, we should be trying a lot of new ideas and sticking with the ones that work.
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