It's Time for Supervised Injection Facilities in the United States

By Lauren E. Smith 11/03/16

Why is it taking the U.S. so long to get on board with a program that has been successful globally?

Insite, Vancouver's Supervised Injection Facility
Insite, Vancouver's Supervised Injection Facility Photo: YouTube

“I want you to shoot up, I need you to know how I feel when I’m high.” He grabbed my hands and smiled. I felt the blood drain from my face. His touch turned ice cold. He continued to talk but his voice sounded muffled as if I was slowly sinking into water. In this moment, someone I considered my best friend, someone I loved, had asked me to try heroin. 

I know nothing about being a drug addict. I know nothing about the actual physical need to inject heroin into my arm. I only knew the heartbreaking pain of loving an addict and the lingering question “Could I have saved him?”

The seductive grip of heroin can consume anyone. Heroin causes parents to outlive their children, siblings to mourn, and young children to lose their parents before they are fully grown. Heroin causes users to steal to support their addiction, and can lead to jail time, homelessness, HIV and hepatitis C. 

Heroin abuse has tripled from 61,000 in 2007 to 435,000 in 2014. Heroin-related deaths have also tripled from 3,036 in 2010 and 10,574 in 2014. Concerns have grown over public usage, HIV and hepatitis C infections, and deaths by overdose. According to the 2016 World Drug Report by the United Nations Office on Drugs and Crime, which examines the health impacts of substance abuse around the world, heroin is the deadliest illegal drug in the world. 

Heroin overdose has become a common news story occurrence. The internet is plagued with articles showing videos depicting people suffering from heroin overdose in their cars, falling on public streets, and even a video recorded by a father telling his young son his mother had died from a heroin overdose. Now America must find a solution to this heart-wrenching epidemic. 

According to We are the Drug Policy Alliance, supervised injection facilities (SIFs) could be the answer. Supervised injection facilities provide not only a cleaner and safer environment for addicts but also health care, counseling and referrals to health and social services such as drug treatment programs. SIFs are present in nine countries and 66 cities around the world. The newest addition is France, which opened their first SIF on October 11, 2016.

Canada’s SIF InSite, located in Vancouver which opened in 2003, has been one the most extensively studied SIFs and has proven that SIFs save lives. Researchers believe the facility has helped lower deaths by overdose by 35%. In 2011, the Canadian Supreme Court stated “InSite saves lives. Its benefits have been proven. There has been no discernable negative impact on the public safety and health objectives of Canada during its eight years of operation.” If SIFs are proven to save lives and help addicts, why does the United States not follow Canada’s lead and open their own supervised injection facility?

Many critics of SIFs believe it is ludicrous for taxpayers to pay for addicts to shoot up. “It’s beyond ridiculous to ask Americans to pay for drug addicts to inject themselves with heroin,” stated South Carolina Senator Jim DeMint and he’s not alone. When Ithaca, New York’s Mayor proposed to open a SIF, Republican state legislator, Tom O’Mara, called it “preposterous” and asinine.” Another critic, William Jacobson, a Cornell law professor stated in his blog Legal Insurrection, the SIF would be a “government-run heroin shooting gallery.” 

While there are many concerns over SIFs, it is hard to ignore the massive amount of success SIFs have had in other countries. Supervised injection facilities have been studied for years and show strong evidence of reducing HIV and hepatitis C, preventing overdose-related deaths, reducing public injections, provides safe syringe discard, and increases the number of users who enter into rehab. If an addict does overdose while at the facility, the nurses are able to deliver the antidote Narcan which quickly reverses the overdose. 

While the debate is heated over whether supervised injection sites should be in the United States, there has been a lack of discussion among the presidential candidates. In each of the three presidential debates none of the moderators asked either candidate how they plan to end the heroin epidemic.

Donald Trump has proposed building a wall on the Mexican border to stop the inflow of opioids and stated the U.S. will “spend the money” to get addicts out of heroin addiction. Trump has only addressed the issue a few times but has failed to go into any further details. During the third presidential debate, Trump stated one of his first acts as president would be to deport the drug lords to prevent heroin from streaming across the southern border. He still has yet to address concerns over heroin overdoses. 

On the other hand, Hillary Clinton has developed the “Initiative to Combat America’s Deadly Epidemic of Drug and Alcohol Addiction.” Her plan would allocate $10 billion over the course of 10 years to help combat drug abuse. Similar to President Obama, Clinton wants to make sure the anti-overdose drug naloxone, also known as Narcan, is readily available to the public, police, and first responders. Clinton is also calling to create naloxone training programs for first responders.

Since supervised injection facilities are not on either candidate’s radar, it is more important than ever to bring light to this issue. Given the success rates of SIFs in other countries, it is hard to ignore the progress SIFs have made in reducing the harms associated with heroin abuse. While SIFs may not be the cure-all to heroin eradication, research shows that they do have some positive effects which the U.S. cannot ignore. 

Lauren Smith graduated Grand Valley State University in 2013 with a Bachelor of Science and is currently in her third year of law school at Valparaiso University School of Law.

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