Are supervised drug injection sites a wild idea?

published on April 3, 2016 by Dr. Thomas Kerr in The Seattle Times

Since Vancouver, BC, injection site opened, the city found more drug users entered detoxification programs, and overdose deaths in the area around the facility dropped.

As Seattle and other U.S. cities struggle with escalating overdose epidemics, some policymakers are considering taking the radical step of creating safe places where people can inject illicit drugs under supervision.

Sound wild or perhaps asinine? Maybe. But if one takes the time to learn about experiences with supervised injection sites, it might seem crazier not to implement this very simple public-health intervention.

In the mid-1990s, the city of Vancouver, BC, was in the midst of explosive epidemics of HIV infection and overdose in its impoverished downtown core. In response, local health officials declared a public-health emergency.

But then very little happened in the short term, except that city police continued to launch crackdowns in the drug scene, which had no lasting effects and actually pushed drug users away from public-health programs that reduce infection and overdose.

Realizing that there was no way to enforce one’s way out of a public-health crisis, city officials spearheaded what was called the Four Pillar Drug Strategy, which sought to balance enforcement, prevention, treatment and harm-reduction efforts.

The harm-reduction part included plans to establish a supervised injection site where local drug users could inject drugs under the supervision of nurses. In 2003, the new mayor of Vancouver, Larry Campbell, a former police officer and chief coroner, worked with the local health authority to open Insite, North America’s first supervised injection site.

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