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Public Health and the Heroin Epidemic: Seattle Considers the Nation’s First Supervised Injection Facility

Published by USC Bedrosian Center on

by Robyn Burleson

Prescription drug and heroin abuse continues to be one of the major public health crises facing the United States. Drug overdoses are skyrocketing across the nation, largely due to the over-prescription of opioid pain relievers and the widespread availability of cheap heroin. President Obama has announced a series of actions to escalate the fight against heroin abuse, yet drug overdoses keep rising. In Washington State, where overdose deaths have more than tripled since 2010, City Council members in Seattle are considering a different method to battle the epidemic: the nation’s first safe injection site.

A safe injection site is a place where drugs can be openly used under the supervision of nurses and medical professionals who monitor for signs of overdose. The idea is to deal with drug addiction like a public health problem, as opposed to a criminal justice issue. By allowing users to consume drugs in a clean, supervised area, the goal is to keep those who suffer from addiction alive long enough to get treatment. Council members also hope to reduce the community consequences like piles of used needles in parks and alleys; last year, Downtown Seattle clean-up patrols picked up 5,993 needles. Access to sanitary needles would also help reduce the spread of infectious diseases caused by dirty needles.

There are approximately 90 safe injection facilities around the world, but only one in North America. Insite is a federally licensed facility in Downtown Eastside Vancouver, Canada that opened in 2003 after a public health emergency was declared in British Columbia due to heroin abuse. The site contains 13 mirrored booths and a free supply of clean syringes, alcohol swabs, and rubber tourniquets. Supervised by nurse attendants, more than 600 injections occur at the site each day. No one has ever died of an overdose in the facility. Research shows that safe injection sites help drop the rate of overdoses and infections, and a cost-benefit analysis by a Canadian firm showed a 5-to-1 return.

Opponents voice concerns that a safe injection facility would boost drug use and enable addiction by providing a space for people to inject. Furthermore, there are possible roadblocks due to existing federal law and conservative opposition. However, studies have shown that safe injection sites actually reduce the rate of overdoses, and a study found that drug users who were supervised by a medical assistant were more likely to seek addiction treatment.

If the proposed legislation allowing the facility to be built passes in Seattle, the way our nation frames and deals with drug addiction may shift drastically. As King County Sheriff John Urquhart explains, “Guess what? The war on drugs hasn’t worked, and we need to try to do something different. We will never make any headway in the war on drugs until we turn the war into a health issue.”

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