Supervised Injection Sites
Supervised injection sites aim to reduce health and safety issues related to public consumption of illicit drugs by providing people a place where they can use drugs under the observation of trained staff. Supervised injection sites are rooted in principles of harm reduction, which focuses on reducing the unnecessary harmful effects of drug use for people who use them (and for others). The users cannot obtain the drugs at supervised injection sites, and the staff at these sites do not handle the drugs or assist in their administration; but these staff members can provide sterile supplies (thus preventing the spread of infectious diseases such as HIV), are trained to give emergency medical care when it is needed (such as administering doses of naloxone, in cases of overdose), and are able to provide users with connections to social services, drug treatment programs, and medical professionals. These sites are thus intended to complement existing programs and policies that focus on drug treatment and prevention.
Supervised injection sites are available in several countries around the world: Australia, Canada, Denmark, France, Germany and more [1]. While there are currently no supervised injection sites in the United States, several cities and states, including Seattle, San Francisco, Philadelphia, Denver, Vermont, and Delaware, are considering establishing them. However, the United States Department of Justice has recently asserted that it will take “swift and aggressive action” against any such efforts [2].
Most research about the effects of supervised injection sites is based on a few specific sites, including Insite in Vancouver, B.C., Canada, which has been in operation for 15 years. A recent review of 75 studies concluded that supervised injection sites “promote safer injection conditions, reduce overdoses and increase access to health services. Supervised injection sites were [also] associated with less outdoor drug use, and they did not appear to have any negative impacts on crime or drug use” [3]. In fact, many argue that these sites encourage their users to seek treatment for substance abuse. However, these findings are not universally accepted.
Given disagreement about the efficacy of supervised injection sites, some argue that money spent on them would be better directed elsewhere, such as to programs that aim to prevent drug use in the first place. In addition, detractors argue that drug users with access to supervised injection sites still have to participate in the illegal drug trade, and that such sites do nothing to protect the safety of users while purchasing drugs. Further, staff are not able to verify the content or dosage of any given drug, making it difficult for them to support users when they have taken more or different drugs than they thought they were taking. Additionally, critics argue, by facilitating the use of illicit substances, these sites put people at risk, do nothing to address the causes of addiction, and normalize substance abuse. Moreover, public support for these sites is low: A 2018 survey conducted by the Johns Hopkins Bloomberg School of Public Health found that only 29% of Americans support legalizing safe injection sites in their communities [4].
DISCUSSION QUESTIONS
Should the U.S. government allow the establishment of supervised injection sites? Why or why not?
How are harm reduction and prevention related when it comes to substance abuse? Which is more morally pressing?
What obligations do we have to help those who suffer from addiction? To what extent does the establishment of supervised injection sites promote and/or conflict with those obligations?
References
[1] Drug Policy Alliance, “Overdose Prevention Centers (OPCs)”
[2] NPR, “Cities Planning Supervised Drug Injection Sites Fear Justice Department Reaction”
[3] NPR, “What's The Evidence That Supervised Drug Injection Sites Save Lives?”
[4] Clinical Pain Advisor, “Supervised Injection Sites: Facts, Information, Pros, and Cons”
