Wednesday, February 24, 2016

Proposing Supervised Injection Sites for Heroin Addicts


"One-hundred and twenty-five people will die in America today from opioid overdose; they will die in the streets or will die in their homes or will die in gas station bathrooms."

--Ithaca New York Mayor Svante Myrick

The mayor of Ithaca, Svante Myrick, 28, released a report recommending, among other things, treating heroin addiction by allowing users to inject drugs at supervised facilities. Similar centers have been found to reduce the spread of infectious disease, overdose deaths and improperly discarded syringes.

Myrick said the report is a blueprint for cities struggling to deal with a rise in heroin addiction and overdose deaths. He is frustrated with what he sees as the ineffectiveness of the criminal justice system in responding to the drug scourge in the United States.

Myrick said he hopes to proceed with his proposal by avoiding the state Legislature and asking the state health department to declare the heroin epidemic a health crisis in New York.

"This is a strategy that sounds as outrageous as the strategy that we came up with to provide sexual education to teenagers, something that was unthinkable in the '70s," said Myrick, whose father was a heroin addict.

(Afeef Nessouli. “Upstate N.Y. mayor proposes nation's first drug injection centers.” CNN. February 24, 2016.)

Svante Myrick

About 100 facilities, in some places known as drug consumption rooms, exist in Europe, Australia and Canada.

The world's first official supervised injection site opened in Berne, Switzerland, in 1986, and multiple cities in Europe opened centers in the decades after. Today, the majority of injection rooms continue to be found in Europe.

In Canada, a facility called Insite in Vancouver, British Columbia, in 2003 became North America's first legal drug injection center, according to its website. Insite operates under a special license but without the support of the Canadian federal government. Addicts shoot up as medics watch. Some patients line up two or three times a day to use one of the 12 injection booths. About 800 people use the booths daily.

Among those using the injection rooms, the likelihood of them entering detox increased by 30%, and people are 70% less likely to share needles, according to a study by the British Columbia Center for Excellence in HIV/AIDS.

Myrick convened a municipal drug policy committee a year and a half ago to make recommendations. The group included representatives of the district attorney's office, police department, drug treatment facilities and the local syringe exchange.

In addition to the supervised injection facility, the committee also recommended what is known as "heroin assisted treatment," or medical care in which heroin doses are carefully regulated and controlled for people who have failed other treatments.

Outrageous? Desperate Measures In Desperate Times

Let me draw an analogy. Granted, this analogy is not relevant to illegal substances such as heroin. What I will write is highly illogical and it won't prove a thing. However, with a little imagination on the reader's part, I might draw an interesting parallel.

The U.S. government says alcohol is responsible for one in every 10 deaths of Americans aged 20 to 64. A report from the Centers for Disease Control and Prevention found that excessive drinking not only leads to fatal car crashes and violence but also to deadly cases of breast cancer, and liver and heart disease.

And, according to the National Institute on Alcohol Abuse and Alcoholism, in 2013, 24.6 percent of people ages 18 or older reported that they engaged in binge drinking in the past month; 6.8 percent reported that they engaged in heavy drinking in the past month.

The Centers for Disease Control and Prevention say Nearly 88,000 people (approximately 62,000 men and 26,000 women) die from alcohol-related causes annually, making it the third leading preventable cause of death in the United States.

Now is when you must use your imagination …

Let's pretend that people all over the United States are dropping dead daily due to alcohol overdose. I know this “overdose” claim is irrelevant for alcohol, but let's just “say” that alcoholics are dying from massive quantities of the substance in accidental consumption. In fact, let's assume that 125 people each day die due to this accidental alcohol overdose – the same number of people who die from opioid overdose. (By the way, the facts report alcohol kills a staggering 241 people a day.)

I want to know if the stigma against alcoholics would prevent you from supporting programs that would administer controlled doses of alcohol to alcoholics who would otherwise accidentally drink massive quantities of the substance and essentially drink themselves to death by means of alcohol poisoning.

But, alcoholics are not considered drug addicts by most people. And, alcohol is legal and so accepted in society that many largely ignore the destruction caused by the substance. Alcohol kills alcoholic addicts: they are “addicted” to the substance – there is no other way to put it. But, in the case of alcohol, most of those addicts who succumb to the disease die a slow, measured death.

Yet, once again, let's say that instead of liver disease and all the other ailments related to death by great consumptions of alcohol that large numbers of people did overdose and die of poisoning like addicts on heroin or any other deadly opioid.

I can't imagine people restricting alcohol from those who would be overdosing at such alarming rates if alcohol did cause unintentional deaths due to overdose. I am asking you to consider the difference in the case of opioid overdose. A damaging drug is a damaging drug is a damaging drug.

Just because alcohol is the substance of choice for the majority because of its wide acceptance and falsely touted minor effects, we would likely forge ahead with any program that would save loved ones from accidental alcohol overdose – including supervised consumption sites.

Call my analogy “silly.” In most respects, it is. Still, if your loved one was in grave danger due to opioid addiction, you would try every means available just to keep that person alive. I know this because I have talked with and befriended so many families who have struggled for an answer other than losing a life they deem so precious.

Myrick's idea will cause widespread outrage. I'm sure the vast majority of people in his state will do everything to prevent this bold strategy from happening. And yet … there is no value on the life of a single human being. And, there is no greater act than saving a life. Dear reader, addicts are humans who desperately need our help, even if that means we must do things that stick in our craw and defy conventional logic.

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