As drug overdose deaths continue to rise, devastating communities across the country, some cities are exploring a new, controversial approach to saving addicts’ lives: Creating safe spaces for people to use heroin.
So-called “supervised injection sites,” which have had some international success, could save thousands of lives. But gaining federal approval for this type of program may be a long shot. That’s why mayors and community organizations are working so hard to experiment on a local level.
Injection sites can provide users with a safe environment and sterile needles, as well as employ medical staff to keep an eye on users in case a high goes south or to provide information about addiction treatment programs. These spaces could tackle both overdose deaths and life-threatening diseases caught from sharing needles, like Hepatitis C or HIV/AIDS.
Twenty-seven cities — including Vancouver, British Columbia and Sydney, Australia — have successfully run these centers for decades. But there aren’t any injection sites in the United States. Svante Myrick, the mayor of Ithaca, New York, is hoping to end this national dearth by leading the first U.S. city to open a injection facility inspired by Vancouver’s model.
“My father was a drug addict. He split from the family when I was 5, 6 years old,” Myrick told the Associated Press after announcing his proposal in February. ‘”I have watched for 20 years this system that just doesn’t work. We can’t wait anymore for the federal government. We have people shooting up in alleys. In bathroom stalls. And too many of them are dying.’”
Non-governmental organizations in other major cities have also been pushing for similar models. And their city officials are listening.
“I’m up for trying anything when it comes to addiction and active using,” said Boston Mayor Marty Walsh, reacting to the announcement that Boston Health Care for the Homeless Program will open a facility later this month. Unlike Ithaca’s approach, the program’s “safe space” will ban drug use inside the facility, but will offer comfy chairs for often-homeless users to ride out a high — and keep nurses on hand to monitor them.
"If we can help some folks — homeless folks in particular — we should try anything," said Walsh.
In Seattle, a city that welcomed clean needle exchange programs more than 25 years ago to help prevent the spread of HIV, Mayor Ed Murray appears equally welcoming to opening an injection facility. Murray compared the current opposition to these facilities to the historical pushback to his city's exchange program.
“In the late ’80s early ’90s, handing out needles to people so they could inject seemed wrong to so many people at the time," Murray told the Seattle Weekly. But the program saved lives, he said. And there are now more than 200 needle exchange programs throughout 33 states and the District of Columbia.
Safe injection sites could be the next frontier. “I absolutely would be very interested in exploring it,” Murray said.
Current opponents to supervised injection sites carry the same fear as those once against needle-exchanges: Won't this just encourage drug use?
But data on international programs shows the exact opposite. In 2014, the results of 75 research projects found that supervised injection facilities greatly reduced the rate of overdoses. A 2008 study found that patients who were monitored by a nurse while they injected heroin were more likely to enter addiction treatment. And other studies found these programs can successfully decrease the spread of HIV in a community.
These results have yet to impress conservative lawmakers. Shortly after Myrick announced his Ithaca plan, New York State Assemblywoman Linda Rosenthal introduced a similar program on the state level. She was quickly rebutted by state Republicans, who made clear that they "do not support supervised drug dens."
Another major roadblock may be the most obvious one: existing law.
Dubbed "crack house statutes," federal laws have made it a crime to "knowingly open, lease, rent, use, or maintain any place… for the purpose of manufacturing, distributing, or using any controlled substance." If caught, those involved could face up to 20 years in prison.
However, federal law experts say this would operate no differently than the federal approach to regulating marijuana. Technically, it's a federal offense to be caught with marijuana -- but multiple states have clearly bypassed that law, legalizing marijuana use in the hopes the feds won't interfere. In an interview with NPR, Leo Beletsky, a professor of law and health sciences at Northeastern University in Boston, put it simply: "Basically, if you play your cards right you can potentially do things that are illegal and yet are tolerated."
With growing bipartisan support for legislative solutions to address the drug overdose crisis -- including funding addiction recovery programs, distributing overdose-reversing medication to law enforcement, and restricting patient's access to opiate-based painkillers -- advocates are hopeful for change.
"I think we’ve come a long way," said Joanne Peterson, lead of a Massachusetts group called Learn to Cope. "There’s a lot more talk and a lot more compassion and understanding because there’s been so many deaths. This is an enormous epidemic."