Why "Safe Injection Sites" are the Wrong Answer to the Opioid Question

Drug addicts need treatment, not assistance in furthering their addiction. The government and the private sector should be helping addicts shake their addiction — not giving them a "safe place" to continue destroying themselves.

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Late last week, it was reported that proponents of a proposal to open so-called "safe injection sites" — facilities where drug users would be able to shoot up in an enclosed environment supervised by medical professionals on the lookout for signs of overdose —gave a demonstration in San Francisco of what such a facility could look and feel like.

The prototype site — installed at the world-famous Glide Memorial Church — popped up less than 24 hours after the State Assembly signed off on a final round of amendments to Assembly Bill 186, a piece of legislation that would allow San Francisco to create a pilot program for "safe injection sites" through January 2022.

Police across the country are watching events unfold in Fog City because they know well that the credo, "as goes California so goes the nation" may apply here.

Other cities — Baltimore, Denver, New York, Philadelphia, Seattle, and others — are talking about opening their own safe injection facilities. Such facilities already exist in places like Australia, Canada, and Portugal.

Advocates say these facilities would save lives that would otherwise be lost to overdoses and provide an avenue for addicts to get treatment and break their addiction. They argue that by providing access to meal services, showers, dental care, mental health and medical referrals, they can help guide people away from their addictions and toward more stable environments.

But not everyone in San Francisco likes the idea.

Rick Andreotti — vice president of the San Francisco Police Officer's Association — told KRON News that while he's happy the city is concerned for people's well-being, he doesn't think this is the right way to stop the drug epidemic.

"Is this the proper solution? We don't believe so," Andreotti said. "We are concerned that an increase, or influx of addicts in San Francisco, will cause an increase in petty crimes, quality of life issues and we all know that's a major issue in San Francisco."

Holes in the Plan

On paper, these sites seem like a good idea — in practice, probably not so much.

In theory, if drug users really did go to these facilities to shoot up — and there's no guarantee that they would — then they are necessarily off the streets. They would not be camped out in doorways or hiding out in bushes throughout the city, thus ending one of the worst problems facing San Francisco — the blight of drug-addled idiots infesting every corner of the city. And all those needles would theoretically disappear from the gutters.

I've been saying for years that cops should not have to be drug counselors and medical workers — jobs for which they are not sufficiently trained to be truly effective, nor did they sign up for.

Ostensibly, these sites would fix that problem.

In the event of an overdose, the police would be relieved of their obligation to come to the rescue of the victim — that task would be administered by the "supervisors" at the shoot-up site. Consequently, SFPD would no longer have to as frequently administer naloxone (Narcan) to an overdosing subject, freeing them up to engage in other policing activities.

However, there are some serious holes in the plan.

For starters, such facilities would be in direct conflict with federal law.

The Justice Department said in a statement regarding an effort in Vermont to open such facilities, "It is a crime, not only to use illicit narcotics, but to manage and maintain sites on which such drugs are used and distributed."

Under a 1986 law known as the Crack House Statute, federal law prohibits anyone from knowingly opening, maintaining or managing a "place for the purpose of unlawfully manufacturing, distributing, or using a controlled substance."

United States Deputy Attorney General Rod Rosenstein said in an interview with NPR, "I'm not aware of any valid basis for the argument that you can engage in criminal activity as long as you do it in the presence of someone with a medical license."

And because users would have to supply their own drugs, these facilities would do nothing to reduce the manufacture and sale of illegal narcotics — they would only exacerbate the problem of the illegal drug trade.

Further, one must question the willingness of drug users to actually get off the streets and consume their drugs in a "sterile" environment. We can't even get thousands of non-addicted homeless to get off the sidewalks and into a shelter — how can we realistically think we can reason with the unreasonable man or woman who insists on intentionally poisoning themselves?

Finally, it would not be incomprehensible to imagine that the cities where these facilities are operated to become havens for drug users around the country. I've lived in this town for more than two decades, and in that time I've witnessed a massive influx of drug-addicted wanderers who have somehow found their way to San Francisco — there are an estimated 22,000 intravenous drug users already here.

Opening even more permissive doors to what amount to being drug dens would only make matters worse.

The Wrong Answer

According to the National Institute on Drug Abuse (NIDA), more than 115 people die by overdose on opioids — prescription pain relievers, heroin, and synthetic opioids such as fentanyl — every day in the United States. That's roughly the equivalent of one (mostly-full) 737 airliner auguring into the earth every day.

So it's clear that something needs to be done to address the question of how we can lower the number of Americans who die with a needle in their hand.

But opening such sites is not the answer. According to a meta-analysis done by the National Center for Biotechnology Information and U.S. National Library of Medicine, an examination of eight studies of safe injections sites showed that they "were found to have no effect on overdose mortality" and that they had "a significant unfavorable result in relation to problematic heroin use."

Drug addicts need treatment, not assistance in furthering their addiction. The government and the private sector should be helping addicts shake their addiction — not giving them a "safe place" to continue destroying themselves.

These proposed safe injection sites are really just needle exchange and distribution programs on steroids — well, more accurately, on heroin.

Rather than encouraging and normalizing heroin injection, we should be examining ways to marginalize its use — and mitigating the national crisis it has created.

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