Over the past three years, a non-profit organization has been running a secret site where drug users can inject themselves under the supervision of trained professionals, The Washington Post reports. The staff provides clean needles and monitors users to prevent overdoses.
The operation is illegal under US law, but 98 facilities like it exist in 10 countries around the world which have adopted harm reduction approaches toward drug use. As overdose deaths in the US continue to rise, California, New York City, Boston, and Ithaca, NY are considering permitting the opening of similar sites. King County, in which Seattle is located, has passed legislation allowing harm-reduction facilities to operate within it.
The National Center for Health Statistics, which counted 52,000 overdose-related deaths in the US in 2015 and expects that figure to rise to around 60,000 when data is available for 2016, asked Alex Kral, an epidemiologist for RTI International, to collect data on the aforementioned clandestine injection site. Kral reported his findings Tuesday in a paper published in the American Journal of Preventative Medicine.
The facility operates 4-6 hours a day, 5 days a week, and is open by invitation only to users with whom the staff is familiar. “There are no formal exclusion criteria,” according to the paper, but at the moment membership is kept below 60 so as to minimize lines. The building itself consists of two rooms: one dedicated to injection, which contains five individual injection stations, one with couches used “for post-injection monitoring/supervision,” per the paper.
Kral surveyed more than 100 users who “gave themselves a combined 2574 injections” over the first two years during which the facility was active, according to The Washington Post. 91% of those users were men, 80% were white, and 80% were homeless. 79.3 injected heroin, 16.4% used meth, 13% injected speedballs (generally a mix of an opiate such as heroin and a stimulant such as cocaine), and 5.4% used opiate pills. Each user injected him/herself 114 times per month, on average.
Two overdoses have occurred at the site; staff revived both by administering naloxone, an opioid overdose-reversal medication.
The paper offers statistics suggesting that supervised injection sites can protect users as well as the general public by limiting public injections. 92.2% of users polled at the injection site said they would have shot up in a public restroom, a street, a park, or a parking lot had the site not been available. 83.8% said they either “always,” “often,” or “sometimes” rush an injection in a public place (doing so can lead to complications).
Common sense reveals that by providing clean needles, supervised injection facilities reduce the transmission of diseases caused by needle sharing, such as hepatitis and HIV.
Many believe supervised injection sites can also reduce increase users’ contact with health and social services, thereby increasing the number of users who pursue recovery, employment, and other positive social actions.
“It’s really hard to create any space or time for anyone to focus on anything else when they’re worried about not getting arrested or dying alone,” said Taeko Frost, western regional director of the Harm Reduction Coalition, per the Post.
“We really applaud the work they’re doing,” Frost added in reference to the covert injection site. “It’s extremely courageous to operate a lifesaving service like this.”
Still, the Post points out that when North America’s first safe-injection facility, Insite, was opened in Vancouver in 2003, law enforcement and the public alike opposed the facility, raising concerns that it would harm communities.
Kral says that, with rates of incarceration and overdose sky-high and climbing, it is time to explore new strategies of managing drug use. “The whole country knows this is a crisis. We need some new solutions,” he told the Post. “We need innovation at this point. This is not innovation out of thin air. This is innovation that’s been proven.”