Some worry safe injection sites encourage drug use, so why are so many countries opening them?
The last decade has brought an explosion of deaths by drug overdose, particularly by heroin and opioids like fentanyl. Other countries around the world have tried an interesting and controversial option for handling this tragic trend: clean injection sites.
Also called safe injection sites, safe consumption spaces, or supervised consumption services, these are sterile places to take opioid medications and other addictive drugs under professional supervision. They don’t necessarily reduce the number of people taking opioids or heroin, but they reduce the dangers of doing so for people who are already addicted. In other words, safe injection sites are a harm-reduction strategy. It's about addiction treatment, not drug prohibition.
Countries like Canada, Portugal, Australia, France, and Norway have already opened clean injection sites: Should the U.S. follow suit?
Clean injection sites sound counterintuitive, and it’s not surprising they’ve garnered so much controversy. Many fear that legalizing clean injection sites in the U.S. will normalize and increase drug use among Americans. They also worry it could increase drug-related crimes and lower property values near the safe injection sites.
However, the countries that have tried clean injection sites say these fears are unfounded. Instead, these countries claim there are some surprising perks to safe injection sites, such as:
Increasing public safety: Contrary to the fears, safe injection sites actually lower crime by taking drug use off the street. At one injection site, over 90 percent of the visitors said they would have otherwise injected in a public bathroom, park, or parking lot, according to a 2017 study in American Journal of Preventive Medicine.
Providing clean and sterile needles: Sharing needles increases the risk of dangerous infections like HIV and hepatitis C. Clean injection sites ensure that people have safe syringes, and that they are safely disposed afterwards, keeping used needles out of public spaces.
Increasing entry to treatment programs: Clean injection sites don’t promote drug use—they acknowledge addiction and promote getting help. As a result, countries who have legalized and opened clean injection sites actually see an improvement in admission rates to drug treatment programs.
Preventing fatal overdoses: Opioid overdose caused nearly 48,000 deaths in the U.S. in 2017, according to the National Institute on Drug Abuse, contributing to a phenomenon known as the “deaths of despair.” Safe injection sites aim to curb this number by having supervised staff on site to assist in the event of overdose. The sites are stocked with the medications that reverse overdose, such as naloxone.
Reducing costs: Surprisingly, clean injection sites actually save the community money. That’s because emergency medical services for drug overdose are incredibly costly.
The controversy of clean injection sites will likely continue, but unfortunately, so will the opioid crisis. Many states and individual communities are enacting effective options to treat and prevent opioid addiction, but there is still an urgent need for out-of-the-box actions to save human lives.
Kral AH, Davidson PJ. Addressing the nation’s opioid epidemic: lessons from an unsanctioned supervised injection site in the U.S. Am J Prev Med. 2017;53(6:919-22.
Opioid overdose: preventing and reducing opioid overdose mortality. Geneva, Switzerland: World Health Organization, 2013. (Accessed on September 6, 2019 at https://www.unodc.org/docs/treatment/overdose.pdf.)
Overdose death rates. National Institute on Drug Abuse, 2019. (Accessed on September 6, 2019 at https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates.)
Supervised consumption services. New York, NY: Drug Policy Alliance. (Accessed on September 6, 2019 at http://www.drugpolicy.org/issues/supervised-consumption-services.)