Author: Justin Mckibben
Back in February of this year the mayor of Ithaca, New York began pursuing a plan that would establish safe heroin injection sites in Ithaca in an attempt to battle the opiate epidemic raging across the country. This controversial harm reduction tactic is getting brought up a lot more lately. Other states are also looking into starting up similar contingencies for their citizens. Now, the Big Apple is set to spend quite a bit of money and resources investigating the merits of safe heroin injection sites. That’s right, New York City is now taking a closer look at how safe heroin injection sites operate, wondering if it might be a decent plan after all.
Talking about the tab…
One of the big things people seem to be focused on right now is the money. Some believe providing addicts with a clean, medically supervised facility to use is a waste. They believe that what it will be doing is promoting heroin addiction while enabling it, all at the city’s expense.
So far, the tab is already pretty steep. The City Council has announced it will be allocating $100,000 to study the practice. This money will go to the Health Department for a nine-month study to determine whether it makes sense to open safe heroin injection facilities.
Shouldn’t be much of a surprise that these desperate times have called for such desperate measures in New York City. The study comes as the Big Apple is still reeling from a record 937 fatal drug overdoses in 2015, a 66% increase since 2010. With 2016 coming closer to the end, it is a wonder if this will be another record year for the five boroughs. Overdose death rates are a huge factor in a lot of new movements for change.
What are safe heroin injection sites?
Safe heroin injection sites are facilities where intravenous drug users are permitted to use the drug intravenously under medical supervision. The sites offer a place where addicts can use without fear of arrest, in case of an overdose. The idea is to have staff trained and available to be able to save lives. At the same time, the hope is to reduce other risks associated with intravenous drug use.
Several safe heroin injection sites already exist in dozens of cities outside the United States. Should America be next? Some of the countries who use this practice include:
Council Speaker Melissa Mark-Viverito commented saying,
“It’s been done and been implemented in other areas [of the world], so we just want to look up what the viability would be in New York,”
This seems like a pretty fair response to the epidemic; trying to explore and educate officials on more options that could help. And beyond reducing overdose deaths, HIV and viral hepatitis transmission, safe heroin injection sites work to connect addicts with drug-treatment options. So it isn’t just about giving them a safe place to get high, but also making them feel safe and supported whenever they try to get help.
Conservatives in opposition
But of course there is a great deal of opposition. Michael Long, the state Conservative Party Chairman, claims the $100,000 could-
“- be put to better use than sending a message that it is OK to use intravenous drugs as long as you use a government-sanctioned place.”
However, the reality is that the money is being utilized in a way that serves it’s initial purpose. $5.6 million is already set aside in the city budget to combat AIDS. The $100,000 for the safe heroin injection site study is coming from that bulk of finances.
So while surely some would not be all for spending the tax-payers dollar on researching “legal drug dens” the truth is the money is going somewhere that could make a huge difference to the effect of what tax-payers originally intended it for.
The safe heroin injection study
According to a council memo, as far as the actual study itself, the researchers will review data that pertains to:
- Health conditions and disease transmission related to heroin and other injected drugs
- Evaluate existing supervised injection facilities
- Assess legal issues
- Input from select “city officials and community experts”
This isn’t the first radical idea on this side of the country. Seattle is also considering safe heroin injection sites. Earlier this year, Boston opened a facility where addicts can use under safe medical observation. However these people have to inject drugs elsewhere. This doesn’t seem like as good of a plan, because it’s basically asking for addicts to use and drive. Still, it is some kind of innovation in a different direction.
Preventing of death and the spread of disease is vital. As the death rate escalates in relation to heroin addiction and infections caused by intravenous drug use, prevention is increasingly important. These programs may be controversial, but the cost of losing lives is a lot higher than spending some money looking into alternatives.
Beyond harm reduction, there is real recovery. Real recovery begins with effective and innovative treatment. If you or someone you love is struggling with substance abuse or addiction, please call now. You are not alone.
CALL NOW 1-800-951-6135
Author: Justin Mckibben
Back in 1971 the brand name Narcan, generic- Naloxone, was introduced to the world. The opiate overdose antidote has become a popular topic of discussion in our world today. With heroin, fentanyl and other dangerous opioid drugs feeding the opiate epidemic and overdose outbreak, these medications are sought after as the life-line pulling addicts back from deaths door.
With the rise in opiate abuse came the rise in demand, and with the rise in demand we were shown a side of Big Pharma that has many in an uproar. Since 1971 the price for Narcan has grown 4,000 percent! Yes, 4 with 3 zeros after it!
I’ve written before about this trend; something I consider to be a disheartening injustice and abuse of power. Today I want to re-emphasize the point by looking into some specifics about the lengths many have to go to in order to provide this life-saving medicine to their citizens. Let’s talk about America VS Big Pharma and the fight for Naloxone funding.
Baltimore’s Battle for Naloxone
In 2014 Baltimore, Maryland was referred to as “Heroin Capital of America” with an estimated 60,000 heroin addicts out of a population of 645,000. While Baltimore may no longer be one of the top states in overdose deaths, the state’s budget shows:
- $33,540 on Naloxone in 2014
- $118,236 on Naloxone for the fiscal year of 2016
So in two years, Baltimore has more than tripled the amount of money spent on Naloxone. Baltimore’s Health Commissioner Leana Wen continues to work at sounding the alarm across the country for Naloxone price gouging since stepping into the position in 2015. In March she called on Congress to enact price controls on the drug in the interest of public safety. In her plea Wen stated,
“The cost of naloxone skyrocketing means that we can only save a fraction of the lives we were able to before… Manufacturers have claimed that this price increase is related to increased demand. However, it is unclear why the cost of a generic medication that is available for much lower costs in other countries will be suddenly so expensive.”
Pennsylvania in Pain
In Pennsylvania drug overdoses tied to opioids rose nearly a quarter last year, yet these communities are still dependent on the goodwill of charitable organizations and health insurance companies. These resources are meaningful, but don’t go far enough!
- Pittsburgh-based Highmark Foundation donated $50,000 in the first quarter of last year to purchase Naloxone to local law enforcement agencies. But it didn’t renew the grant this year.
- Health insurers contributed a total of $500,000 in Pennsylvania alone to fund naloxone distribution.
- Cigna Foundation donated $50,000 this year to fund Naloxone access
- Independence Blue Cross joined the Pennsylvania District Attorneys Association in a providing $50,000 to provide Naloxone to first responders
But most patrol officers still don’t have it! As of 2016 Naloxone kits have only been distributed to about 15% of Philadelphia police officers!
Delaware County has taken extra measures. Officials made it so money seized during drug investigations under asset forfeiture laws could be used to support its Naloxone program.
In case you didn’t know, Pittsburgh doesn’t play either. In July one judge ordered two convicted drug dealers to throw in almost $4,000 for Naloxone funding. Now that is a new brand of justice.
Rhode Island’s Settlement Savings
This was a desperate move indeed, as Rhode Island reached into the $230 million settlement with Google for $40 million to help keep its program alive. This settlement is from when Google facilitated the illegal online exchange of prescription drugs from Canada.
5 Government Interventions
Big Pharma Letters
In June Senate Special Committee on Aging addressed a letter to five leading naloxone manufactures requesting an explanation for increasing drug costs. These companies are:
- Amphaster Pharmaceuticals
Amphaster Pharma’s price went from $12 in 2012 to $41 a dose as of 2015.
- Adapt Pharmaceuticals
Adapt’s Narcan nasal spray costs $63 each dose. Although it does cut price in half for government agencies, community organizations, and patients without insurance
Price went from $375 in November 2015 to $1,875 in February 2016. Now, only 7 months later, it’s up to $2,250 for a single-dose injector!
Most of these companies claimed the price hikes are due to additional burdens they face to meet the exponential demands. Yet, this excuse isn’t flying with many healthcare advocates. The executive director of the Chicago Recovery Alliance, Dan Bigg, has said in response,
“We’re not talking about a limited commodity. Naloxone is a medicine that is almost as cheap as sterile sodium chloride—salt water,”
As far as more help from the powers that be, many state and local governments are reaching into emergency funding to provide Naloxone to first responders. Other government programs have been put in a position to help, but is that help enough?
Rural Opioid Overdose Reversal Grant Program
The Rural Opioid Overdose Reversal Grant Program distributes $1.5 million from government funding, but it had to be split between 15 communities. This has helped some, but left many officials scavenging for financing to be prepared for 2017. Many are calling on the government to assume even more costs.
Substance Abuse and Mental Health Block Grants
States do have authorization to draw on these funds to subsidize Naloxone purchases. However, in the words or Peter Luongo, executive director of the Institute for Research, Education & Training in the Addictions, “That’s not new money.”
What this means is that officials must now move the money out of other programs for addiction prevention and treatment. So instead of getting more help, they are having to pick-and-choose which help is more necessary.
Comprehensive Addiction and Recovery Act (CARA)
This summer President Obama signed for this initiative. It means to call for expanding first-responder access to Naloxone. However, the fact remains that CARA funding has not yet been established by Congress.
Department of Health and Human Services
Supposedly starting this month this office will be providing up to $11 million to fund Naloxone distribution. However even this great contribution will only apply to a dozen states.
The Overdose Oligopoly
The reality is this is a fight we need to talk more about. Despite all these government interventions, why is it we still cannot keep up with Big Pharma pricing?
So far nothing seems to justify the monopolizing and exploitation of the opiate epidemic by Big Pharma. These companies are actively increasing the price of a life-saving medication by over 1,000% in many cases during a period in which tens of thousands of people all over the country are dying!
Whether you know all that much about economics, Big Pharma is making millions upon millions of dollars off of these medications. They claim to be trying to keep up with costs, yet continue to show increasing profit. Call it what it is- extortion via oligopoly.
Naloxone and Narcan may not be the miracle cure for opiate addiction, but for many it is the only reason they are alive. So, how many can say the lack of access is the only reason their loved one is not? Surely, Naloxone access expansion is taking off in a new way. CVS stores, schools and all types of venues are providing kits, training and other resources. The only problem is, they are struggling to maintain those resources.
We, as a nation, should expect better than this.
A bigger part of getting better is beyond the medication used to preserve life. Real recovery begins with the process of working to change a life. Holistic addiction treatment allows people who were once hopeless build the foundation of hope again. If you or someone you love is struggling with substance abuse or addiction, please call Palm Partners. You are not alone.
CALL NOW 1-800-951-6135
Author: Justin Mckibben
I know what you’re thinking… but just set aside that thought for a second. Many of us know the flaws of contempt prior to investigation. So I ask of you to consider the following, and do some investigation yourself, to see what impact this whole idea might have.
You may remember, because I’ve written on the subject of safe injection sites many times, that last September the Harm Reduction Coalition convened with law enforcement and public health experts on an international level to deliberate on the possibility of supervised injection facilities helping to reduce the opiate addiction crisis and overdose death outbreak in American. Since then, officials in several states in America have proposed the implementation of supervised injection facilities, including:
In this discussion, reports were presented with some of the pros and cons of the concept, and with the press and politics focusing so heavily on addressing the epidemic status of heroin and opiate abuse I wanted to revisit the conversation with some information presented. I bring it up again because I have had a few conversations about these facilities; people seem split on the issue and many are misinformed.
What a Supervised Injection Facility IS
Supervised injection facilities (SIFs) are legally sanctioned locations where people who use intravenous drugs can inject pre-obtained drugs under medical supervision.
For those of you who keep implying it makes heroin legal, supervised injection facilities do NOT sell heroin to users OR make heroin legal. It is simply a place where people who are already using can safely use.
They are designed to reduce the health and societal problems associated with intravenous drug use, and have been shown to reduce injection-related risks and harms like:
- Vein damage
- Transmission of diseases like HIV/AIDS and Hepatitis C
Public Injection Alternatives
Now when it comes to drug abuse and recovery from addiction, there is no cookie cutter answer and no express-lane (in my experience) to lasting sobriety. There are numerous programs put in place to provide different treatment alternatives, and one genre of treatment that has been making some come back is harm reduction- which includes supervised injection facilities and needle exchange programs.
As part of the consultation there was a report titled Alternatives to Public Injection in which experts with experience operating supervised injection facilities shared how such services were implemented in their countries. These areas included:
The experts also enclosed in the report how effective supervised injection facilities could be as an alternative solution to public health crises that involve injection drug use. Over the course of this committee there were other entities including:
- Open Society Foundation
- Foundation for AIDS Research
From these reports and discussions there came some relevant information that could be crucial to American policymakers. These points might also cause the everyday skeptic to pause and wonder if these kinds of initiatives can’t do some good.
- People who use SIFs take better care of themselves
- They reduce or eliminate their needle sharing
- Ultimately, participants reduce their drug use all together
- SIF participants gain access to other medical and social services
- Participants have resources to seek addiction treatment
- SIFs do not increase drug use in the surrounding area
- Crime and public disturbances decrease in the areas around these programs
- There has not been a SINGLE overdose death in any of these programs over many years of operation
That last one… that is an especially impressive statistic with all things considered! The simple fact that these sites, which are not yet in America, have been able to treat overdoses and eliminate deaths should at least have people thinking twice about supervised injection facilities.
Long Way to Go
The fact of it all is America has a long road ahead before we ever get to a place where this is a popular idea. Taking into account how many people on the outside of addiction looking in still only have an understanding based on stigma and fear, the reality is that it would be incredibly difficult to get this idea off the ground and make it work because every country in so far operating SIFs have stressed in order to successfully implement supervised injection facilities it is important to have support from all corners, such as:
- The community
- Local law enforcement
Greg Scott is a professor of sociology at DePaul University who has shown a strong sentiment for the need of progressive ideas that promote health and safety over incarceration and punishment. Scott stated,
“SIFs are practical, concrete, humane, and cost-effective.”
“In every respect, SIFs make sense. They represent a logical (and arguably moral) next step in the process of creatively and effectively providing the whole country with far better health solutions for drug users than have ever been available before.”
American families of every demographic and in every community are feeling the damages of the opiate epidemic and the side-effects of unscientific drug policies, causing an upsurge of interest in public health alternatives. No wonder more people are starting to take supervised injection facilities more seriously.
The Recovery Community
When it comes to people in the recovery community, I understand why some people would be cynical about the possibility of government run establishments allowing injection drug use of heroin or other dangerous narcotics.
Even asking people I personally respect in the local recovery community it seems I get answers ranging from one extreme to the other. Some still say that it is just making legal “shooting galleries” that enable addicts to avoid the consequences of their addiction.
Others say with so many people dying every single day, the numbers speak for themselves and no statistically and scientifically supported program should be ignored without at least a conversation.
Once more, I think the preservation of life and promotion of effective addiction treatment is worth some effort.
Now, tell us what YOU think.
Preventing of death and the spread of disease is vital, and getting the right kind of treatment for drug addiction is paramount to progress. If you or someone you love is struggling, don’t wait. Please call toll-free 1-800-951-6135
Author: Shernide Delva
The complexity around homelessness and alcoholism is one that most people choose to ignore. It is easier to ignore the drunken panhandler on the street than consider the possible solutions to reduce the problem. However, for cities that struggle with a large homeless population, advocates fight for policies that will allow the homeless population to seek shelter despite their struggles with alcoholism. The question is, should homeless shelters require sobriety?
While there are people who want to help the homeless population, there are difficulties in helping people in these situations. Policies in communities around how homeless alcoholics are treated and housed in the community have long caused controversy Even if a homeless shelter caseworker can get a housing voucher for an individual; they have to find a landlord who is willing to rent to a street alcoholic. The reality is, according to surveys, 38% of homeless people abuse alcohol while 26% regularly use other drugs. These statistics confirm that drug addiction among the homeless population is significantly higher than the general population.
Let’s say a homeless person acquires access to a homeless shelter. At the shelter, there are very limited support services to help the client adapt and adjust to their new environment. Their alcoholism is rarely addressed nor is the psychological needs of the individual. As a result, they are often evicted which starts the cycle of homelessness all over again.
Whether or not homeless addicts should have access to resources is a complicated problem and no one is entirely at fault. On one hand, a homeless person with substance abuse problems could be a liability to those around them and the staff. On the other hand, this issue must be addressed because some cities spend tens, or hundreds of thousands of dollars a year through crisis services who take care of this population.
But is it Enabling ?
Some feel that homeless people who are under the influence should not be allowed to reside in a homeless shelter or have access to government assistance. They believe that allowing access to these resources could be enabling the person to continue using. After all, if they have access to these facilities while using, why stop? This is the exact reason why numerous shelters do not allow anyone who is under the influence of alcohol (at all) to stay. The thought has always remained to demand abstinence. Anything else just encourages the behaviors.
Other disagrees and offers other solutions. Bob Fowler is the executive director of the Milestone foundation. The facility has been operating out of Portland, Maine since 1967. Fowler believes that providing resources to people in need are better than denying them access at all. Sometimes harm reduction is a goal worth fighting for.
“For me, this is a basic harm reduction approach. The people we serve are dealing with drug and alcohol addiction as well as homelessness. Depriving shelter to these individuals won’t do a thing to help the addiction. Engagement and compassion, on the other hand, just might,” Fowler said in a recent interview.
There are two sides to every argument, and Fowler’s point of view does make sense. Perhaps housing concerns should be addressed before anything else. Instead of a person attempting sobriety before fixing the rest of their life, in this case, it may be better to provide resources prior to achieving sobriety. Finding homeless people a place to live first may provide them with the support they need to tackle their health concerns later. It provides a healthier existence, which could result in them choosing to drink less on their own.
This is an issue that will continue to raise controversy. In the same ways that harm reduction methods for drug addiction continue to raise controversy. Just recently, states like New York has implemented safe injection facilities that some argue are enabling people, rather than helping them in life after sobriety.
Still, there is something to be said about harm reduction programs. If anything, options like this need to be considered. The rates of overdoses continue to soar. If there is a way of reducing these numbers, it should be brought to the table. Options like these can at least be part of the solution. If your or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135.
Author: Justin Mckibben
Almost a month ago I wrote about how one county in New York was considering a new and radical approach to helping heroin addicts in their community avoid the spread of disease and dangerous infections through pushing to create safe injection sites in their area. The question I asked was is this a good idea- and a lot of people responded with very adamant and reasonable answers on both sides of the argument. Some said it was a respectable harm reduction initiative with results in other countries proving its worth, but others insisted it was an appalling and ludicrous concept that promoted drug abuse.
While opinions range from the moderately compassionate to the extremely opposition, it seems still more people are second-guessing the problem and now another state is considering safe injection sites for heroin addicts.
So again, let us talk about the issue and put the question out there- are safe injection sites irresponsible, enabling “shooting galleries” or are they a progressive, optimistic program engaged out of necessity?
Safe Injection Sites in Seattle-King County
The newly formed Seattle-King County in heroin task force in Washington is trying to find ways to expand treatment for heroin addicts in light of what health officials call a heroin epidemic, which has led to skyrocketing overdoses and deaths across every state in America. At this point this new entity is actively considering the creation of a safe heroin injection site as one way to address the growing heroin crisis in Washington State, and as I said this is not the first time this idea has been brought up here in the U.S.
Nor is it the first time safe injection sites have been brought up in North America. Insite is a supervised heroin injection site located in Vancouver B.C., the first of its kind this side of the continent. Thus far Insite has been is seen by some on the task force as a progressive step forward in the fight against heroin overdoses and the spread of diseases such as HIV of Hepatitis C. It aims to prevent fatal overdoses by providing supervised injection sites where drug users can legally use the illegal narcotic under the watch of medical professionals. The idea of safe injection sites is that if an addict starts to overdose, medical workers on location can administer naloxone to reverse the process.
The purpose of these sites is not to legalize heroin as many have argued when it comes to safe injection sites, because the drug is still illegal, but these sites are a safe-haven for ingestion which of course can get a little tricky with technicalities.
Another aspect that should be pointed out is that these users would also receive services and counseling, along with information and additional access to addiction treatment if they choose. So while some critics call it a “legal shooting gallery” those in favor of safe injection sites protest that these facilities are meant to save lives and plant the seed that could ultimately inspire a revolutionary change.
Again, I’ll reiterate the statistics of Canada’s first safe injection facility since it opened in Vancouver in 2003, where there are some pretty noticeable changes:
- Every day around 800 users would visit the facility
- 10-20 users overdosed every week
- 0 deaths have occurred in the facility
The idea of a safe injection site in Seattle-King County even has some the most unlikely people listening, such as King County Sheriff John Urquhart. Urquhart was a 25-year soldier of the failed War on Drugs as a narcotics detective, who now openly admits there is no way to arrest your way out of the heroin epidemic, so even he is open to ideas like safe-injection sites. In an interview Urquhart stated,
“The status quo is not working anymore. This is not really a police issue anymore. More cleaner needles, reduction of Hepatitis, all of these things, I’m told have happened in Vancouver. I want to make sure we can replicate that here before I have support for this kind of a program.”
So the Sheriff is still trying to play it smart before doing anything too drastic, and other experts are saying that this kind of program is not meant to make it easier or more acceptable to abuse heroin, but it is meant to provide a resource that saves lives and may eventually lead those in desperate need of help to the right place to get it.
Still there is opposition, and reasonably so for so many have been impacted negatively by the increasing heroin epidemic and opiate outbreak that has been hitting the nation so hard over the past few years. So many people are suffering and so many communities are being damaged from what is happening out there, and so of course people a weary about a program that they think will only fan the flames of the issue.
I have said this before- I used to be strongly opposed to any form of harm reduction because to me the concept of recovery only meant abstinence and an absolutely radical change… but the truth I have come to realize is that was my experience, but it doesn’t mean that is the only acceptable outcome. On a personal level (which is just my opinion) I believe that in the right context whatever keeps people alive long enough to get help is worth having… I think- how can I advocate for expanded naloxone access and not for safe injection sites that promote drug addiction treatment and recovery oriented counseling that inspires change?
So I have to ask again- is it wrong to have safe injection sites in America?
As the number of people who those their lives to heroin addiction and infections like HIV and Hepatitis continues to rise, the nation may have to at least consider options that some may find controversial. Safe injection sites might not be the best answer, but it might make a huge difference to reduce the amount of addicts dying every day and give them another chance to recover. If you or someone you love is struggling with substance abuse or addiction, please call toll-free 1-561-951-6135