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
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: Justin Mckibben
Harm reduction is one method of addressing the nation’s drug issue that may seem to some as a philosophy of enabling, while to others it makes sense to offer safe alternatives to individuals who abuse drugs because these strategies can prevent the spread of disease and the damage to the community. It was estimated that 2015 would be a big year for harm reduction, as many suspected that drug policy reform would reshape the landscape in the wake of the “failed war on drugs” while there were efforts being actively put forth to alleviate the suffering caused by the opiate epidemic.
Needle exchange programs are one way that harm reduction can be implemented in a community. Supplying clean needles and safe disposal sites for addicts to use keeps them from sharing needles infected with disease, and now one kind of needle exchange program is changing the game.
In Seattle the volunteers behind a needle exchange are now handing out meth pipes to drug users for free as well. So is this the same kind of harm reduction being utilized to keep people safer, or is this just negligence at an all-time high?
Meth Pipe Program
It seems some think harm reduction means catering to more than just needles. This strange meth pipe program was launched by a group called The People’s Harm Reduction Alliance about 2 months ago, and is offered 5 days per week off an alley next to a church in Seattle’s University District.
About 25 to 30 meth pipes are handed out each day, and according to the executive director of the alliance Shilo Murphy, the demand for the free meth pipes has been growing ever since. The theory behind the program is that by handing out the pipes, some drug users will rely less on needles, which in turn helps to cut down on the risk of certain diseases in the community. Murphy stated:
“People kept coming to our program and saying that they were getting syringes because they didn’t have access to a pipe.”
So in essence this program has tried to circumvent the whole needle issue by giving users access to another method of ingesting their drugs that put them at a much more decreased risk of infection.
Many former addicts are actively involved in these movements to try and help change things in the community. Some even say that this program also helps those who have never used needles, because it is still possible to spread diseases by sharing pipes if there are open wounds in the mouth present. Regg Thomas, a drug user for the past 20 years who currently works with the Urban Survivors Union stated:
“Whatever the reason is why both parties don’t have their own… They wind up sharing. Well, this program has prevented that because all it takes is a cut orally and you’ve transmitted a disease possibly,”
Whether the theory for the program actually works is still up for debate.
So we have seen how harm reduction can help, and I can even begin to understand how this might actually be a useful tactic for addressing a local drug issue, BUT according to state law handing out drug paraphernalia like the pipes is still illegal in Seattle. And Murphy said he knows that, but he disputes that so was syringe exchange 25 years ago. And yet Seattle has syringe exchange programs and it’s proven to be one of the biggest advantages they’ve had for fighting HIV infections through injection drug use in the state.
Even though it’s illegal under state law to give someone certain kinds of drug paraphernalia, police said they’re more concerned with what’s put into the pipes and not necessarily the pipes themselves.
Making a Real Difference
It isn’t all about the bureaucracy for those involved in this movement. It seems this is more about making a real difference and less about placating to the drug users to enable them. Murphy said this is the first program of its kind in the nation, and he believes it has not just reduced risk behaviors, but it has helped get various users tested for Hepatitis C.
But Murphy does not stop with handing someone a pipe and telling them have fun. The program lets drug users pick up wound care kits and get crucial information about treatment options. Murphy insisted:
“By engaging them, we gave people self-worth… Give back people’s desire to live better in life and live better in society,”
It seems that even though it is technically outside the realm of the law, this program could actually inspire similar changes as far as officials and organizations stepping up to keep citizens safer and more informed as drug addicts instead of labeling them all criminals and locking them up.
I have to say, harm reduction programs to me always seem like an awful idea at first because I believe in abstinence and a program of recovery, but these programs aren’t ever meant to be permanent solutions, only temporary effective vehicles to get individuals the help they need and provide safe and educational support for them until they are willing to get the help. It may sound like it is enabling, and it some ways I guess it is, but it’s saving lives and at least offering an opportunity most would never know about. Maybe harm reduction has more potential than we are currently using.
Enabling addicts to keep using is not a good personal decision, but at the same time putting in place a system to keep the community safe from the spread of disease or more dangerous circumstances is important, especially if it gets people the help they need. If you or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135
Author: Justin Mckibben
This past February there was news from state health officials that changed all optimism regarding the decline in prescription drug abuse and heroin in southeastern Indiana, informing us that at least 26 people in the region were diagnosed with HIV in just a 3 month period, and most of them contracted it after injecting drugs.
The first case that has been considered part of the outbreak in southeastern Indiana was diagnosed in early December according to the deputy commissioner and director for health outcomes at the Indiana State Department of Health Dr. Jennifer Walthall. By January 23rd the total of newly diagnosed HIV cases had already spiked to 11 in a region that typically experiences less than 5 new cases annually. There have been around 90 cases reported thus far, the most in Indiana’s history.
The HIV outbreak among intravenous drug users in this part of the state prompted local health care officials to take a harm reduction approach more seriously, and they began work to start a needle-exchange program. With addicts using and sharing needles to inject drugs, a lot of infections are easily passed around, and hopefully this program can change that.
What is Needle Exchange?
Just a little background on what this all means, a needle and syringe program (NSP) or syringe-exchange program (SEP) is a social service that allows injecting drug users (IDUs) to attain hypodermic needles and related paraphernalia at little or no cost, but often requiring users to turn in used syringes for new ones.
Needle exchange programs are built on the philosophy of harm reduction, and the idea is to reduce the risk factors of spreading diseases such as HIV/AIDS and hepatitis.
A comprehensive 2004 study by the World Health Organization (WHO), which was later supported by the American Medical Associate (AMA) found a determined that needle exchange programs substantially reduce the spread of HIV among IV users, and do so without evidence of exacerbating injecting drug use, and they have proven to be cost effective and efficient.
Breaking the Ban in Indiana
Last week the ball got rolling when Republican Governor Mike Pence signed an emergency executive order in an attempt to control Indiana’s most intense HIV outbreak the population has ever seen. The executive order actually suspended Indiana’s ban on needle-exchange programs for the next 30 days. The ban has only been localized to Scott County, just 30 miles north of Louisville, Ky.
According to the local news sources in Jerome Adams, Indiana’s Health Commissioner, Governor Pence has clearly expressed that he does not support needle exchange as anti-drug policy on an ongoing basis. However those reports suggest that Pence has been adamant about his concern over this recent HIV outbreak, and has taken a critical step to end it.
While Pence voices his concerns about such programs, it doesn’t hurt to look at the evidence from several NIH funded studies that consistently reveal a 33% decrease in the frequency of HIV cases where people participate in needle exchange programs.
A Trial Run
30 days is 30 days, and while to some it may not seem like much, 30 days can be plenty to make a dent in an addiction issue when properly utilized. The 30 day needle-exchange program is based in the Community Outreach Center located in Austin, Indiana. Strategically officials chose this location based on the fact that this may very well be ground-zero in terms of where the most HIV cases have been reported, with 84 confirmed cases of HIV.
As part of this trial run, there are some regulations in place to keep a controled grasp on the program. Each individual will be able to receive:
- 1 week worth of clean syringes
- Access to free HIV screenings
- Hepatitis A and B vaccinations
- Drug treatment referrals
Health Commissioner Adams reiterated that one should not feel ashamed to seek help as this is now an issue of public health. But with the governor seemingly unsupportive of this program, it may seem like needle exchange in southeastern isn’t being used to its fullest potential. The executive order is able to be extended if needed, and if it proves to make a difference then hopefully this program will get the time it needs to help curb the epidemic, as well as provide the drug users in the area with adequate information to get drug treatment.
Harm reduction has been speculated to be a huge part of the new wave in the war on drugs in America, and while it may not be an indefinite solution, it can surely save lives and improve the quality of others in an effort to get more people the treatment they need for the recovery they deserve. If you or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135
The anti-drug stance and policies that have come from the “war on drugs” are to blame for rising rates of hepatitis C all over the world, according to a new report by the Global Commission on Drug Policy (GCDP).
The cost of enforcing drug laws totaled approximately $545 billion over the past 40 years – and that was just in the US. That doesn’t take into account the billions more spent the world ‘round.
Experts argue that resources being poured into this futile “war” are better redirected towards treatment and prevention for the estimated 16 million people worldwide who use drugs intravenously. Of that number, 10 million are living with hepatitis C.
Increase in Hepatitis C Infection Related to the War on Drugs
Hep C is an infectious liver disease that is often contracted by sharing needles. The Global Commission—which includes seven former presidents, ex-UN chief Kofi Annan and other world leaders—says that, by criminalizing drugs, it only makes it harder for IV drug users to get public health services, and therefore increases the spread of hep C infection.
“The war on drugs is a war on common sense,” says commissioner Ruth Dreifuss, who is also the former president of Switzerland. “Repressive drug policies are ineffective, violate basic human rights, generate violence and expose individuals and communities to unnecessary risks. The hepatitis C epidemic, totally preventable and curable, is yet another proof that the drug policy status quo has failed us all miserably.”
The GDCP’s report revealed that the highest number of Hepatitis C infections are in the US, China and the Russian Federation – which just so happen to be some of the countries that are the strictest when it comes to their drug policies.
People who inject drugs are still one of the main sources of hepatitis C infection, according to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). In fact, they just might be the leading source of the potentially fatal, highly infectious (read: contagious) liver disease.
A recent report from the agency estimates that as many as a million people who have injected drugs may be living with hepatitis C. In addition, anywhere from 40% to 90% of European IV users in a given population are infected. Even worse, the EMCDDA estimates that 30% of patients with untreated hep C go on to develop cirrhosis of the liver in later years.
And injecting drug users are more frequently infected with hepatitis A, B, and D viruses as well.
Then you have proactive countries that have employed harm reduction strategies in order to address what they recognize as a public safety issue. The Commission has lauded Scotland’s Hepatitis C Action Plan, launched in 2006, which has shown to have decreased the rates of infection by offering health services and sterile injecting equipment to users.
“If you compare rates of hepatitis C in drug users in countries with good harm reduction and more enlightened drug policies with those in countries without, it is clear that regarding drug use exclusively as a criminal justice issue is a health disaster,” says a spokesperson for the World Hepatitis Alliance. “Hepatitis C, its prevention, care and treatment must be addressed and must be addressed as the health issue it is.”
Harm reduction strategies like needle exchange programs can be just one way to combat the spread of all types of hepatitis. Furthermore, the EMCDDA also recommends a combination of opioid substitution treatment, such as methadone maintenance or buprenorphine (Suboxone), and needle exchange programs.
If you or someone you love is struggling with substance abuse or drug addiction, there are ways to stop the cycle and begin to heal. If you have contracted Hep C or another disease, there are new treatments that can improve your health, along with recovering from your substance abuse disorder. Please call toll-free 1-800-951-6135.