Safe injection sites, or supervised injection sites, are a harm reduction strategy that’s gaining attention in many US cities. Right now there are at least 100 safe injection sites worldwide. Most of those are in Europe, Canada, and Australia. The idea of safe injection sites and other harm reduction strategies is to minimize the damage caused by IV drug use. Typically, these sites will provide sterile needles and give users a safe place to use them. Then, after injection, the users can stay around while the sites’ staff watches for signs of overdose or other complications. This is meant to not only reduce the rate of fatal overdose from opioid injection, but also to reduce the number of infections, such as hepatitis and HIV, from dirty needles. In addition to monitoring for overdose and administering Narcan and getting medical help if necessary, the staff are also a point of contact for users who want to quit but don’t know how. Critics of safe injection sites and other harm reduction programs claim that these programs validate the choice to use IV drugs and enable users to keep using without consequences. They also worry that allowing safe injection sites in their areas will bring more crime. The important questions are do these sites work and do they cause new problems? There are still relatively few studies on the effectiveness of safe injection sites, but so far it seems that they do work without causing more problems. One large study of more than 1000 people at Insite, a safe injection site in Vancouver, Canada found that in the past 15 years, the site has supervised more than 3.6 million injections. Of those, staff have responded to more than 6000 overdoses, and no one has ever died. The researchers estimate that the site has prevented at least 50 deaths. The study also found that there did not appear to be an increase in crime in the area around the site. Another study found that fatal overdoses sharply decreased in the area around the site. This research seems to validate the larger body of research on needle exchange programs that have found that these programs reduce the spread of infectious diseases such as hepatitis and HIV–at a considerable cost savings to the general public, no less–while getting more IV drug users into treatment. One study of safe injection sites found they resulted in a 67 percent reduction in ambulance calls and a lower rate of HIV infection. Another, subtler benefit of safe injection sites is that they reduce the stigma associated with addiction. While anti-drug harliners typically see this stigma as a deterrent, it more often only prevents people with substance use disorders from seeking help. By allowing IV drug users to come in out of the cold–literally, sometimes–they are far more likely to seek help.
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