The global opioid epidemic has brought the previously underground drug world to the forefront of the media. The most popular problem-solving technique seems to be the use of safe using sites. Also known as safe injection sites, these facilities are popping up in urban centers across the United States and Canada; however, these safe using sites were already in place across the globe. Switzerland was responsible for spearheading this concept, opening the first safe injection site in 1986. Canada’s first site opened as a response to an overwhelming increase in Hep-C and AIDS infections in 2003 in Vancouver. With the passing of Bill C-37, things are changing. This bill will simplify the process of applying for an exemption that would allow certain activities to take place at a supervised consumption site, meaning that these sites can have a simpler operating process. Recently, Canada has opened three safe using facilities in Toronto, one in Ottawa, one in Surrey, and one in British Columbia.
Controversy and conflict surrounds these locations; a number of different opinions and thoughts run rampant in government, social media, and private conversations, some in favor of and some opposed. These legally protected locations are facilities where drug addicts can bring their own drugs, step into an injection booth, and inject themselves. They are provided with clean water, clean needles, sterile equipment, and medical staff is on hand to step in during the event of an overdose. The theory behind these facilities is to assist in preventing overdose and give a safe format for addicts to ask questions to receive help with recovery.
Many people are concerned that these facilities are enabling addicts rather than helping them, and so I interviewed recovering addicts as well as those immersed in active addiction and asked them what their thoughts are on safe using sites. The general consensus seems to be that addicts will use anywhere and everywhere; whether you have a safe place or not, they are going to indulge in their drug of choice. Using dirty water, dirty equipment, and injecting in public places presents addicts with a number of problems including but not limited to no safe disposal of their equipment, no place to inject where they can be sure they will not affect anyone else, and the reusing of possibly infected needles. Although safe using sites assist in overdoses, they are also able to help in protecting the public from accidentally steeping on a needle, children from accidentally witnessing someone injecting or seeing an overdose, lowering the spread of HIV, HEP-C and other transmittable diseases by providing clean equipment, and in these ways, they are keeping our streets safe as well as our addicts.
Addiction is a tricky business. If you manage to survive your addiction and enter into recovery, you have the potential to become once again a productive member of society. Recovering addicts have a strong will to survive, the ability to overcome great obstacles as well as to think outside the box. Getting there is not as simple as a non-user may think — just wanting to stop using will not make it so.
The injection sites also plant seeds about recovery options, where you can access help and treatment and how to do so. Treatment facilities are stretched and waiting lists are long, the idea of help and recovery is astronomically unstable in our country’s current state. To even be considered in most treatment facilities you must call every day, which can be overwhelming, especially if you have no phone, no financial way of calling, and your ambition to call is lacking. These safe using sites may help the user to survive at a street level until help can be sought.
In 2003, it was estimated that a safe injection site would cost $3 million a year to operate; now, in 2017, with the changes that bill C-37 has brought forward, it is costing closer to $1.9 million. However, the reality is that medical emergency services being utilized for overdose calls and to attend to the difficulties inherent in drug addiction cost taxpayers much closer to $12 million a year.
American Society of Addiction Medicine estimates that there were 52,404 lethal overdoses in 2015, but the bigger problem may be that 259 million opioid scrips were written legally in 2012. Harm reduction sites have been in use for years distributing suboxone and methadone legally as an over-the-counter medication although they do not allow people to start while in a penitentiary, leading to a number of prison released overdoses. Harm reduction sites that distribute suboxone and methadone are also met with controversy and conflict, but that, my friends, is a story for another day.
I am not sure on which side of this debate to stand, as I am sure many of you are not as well. What I can tell you is the word on the street is that these centers are saving lives, and out there somewhere there is a mother, a daughter, a father, and a son who are grateful that they or one of their loved ones has that chance.