Is it time to end the stigma of supervised injection sites?
110,236 people died from drug overdoses in 2022. That count is not simply a statistic in a graphical chart. They are all real people whose parents felt the anguish of outliving them, whose partner is left without their love to hold them at night and whose families now have an empty seat at the dinner table. Drug overdose deaths are one of the greatest adversities the United States has contended with in modern times, with the nation consistently scoring one of the highest drug overdose death rates by country.
In previous decades, the U.S. has taken a zero tolerance measure to drug trafficking and usage through the War on Drugs, a measure that has borne no notable achievements bar the mass incarceration of American citizens for drug crimes. Shedding the warlike demeanor against drug usage is no easy task, but a needed remedy to right the wrongs the War on Drugs wrought on the people of the country. Now, many states are looking for more nuanced and effective ways to reduce deaths from drug usage, and Rhode Island is seeking to lead the way.
In July 2021, Gov. Dan McKee signed legislation establishing a pilot program for the opening of supervised injection sites around the state. This measure is often seen as one of the most audacious methods in which states may take a harm reduction approach towards decreasing drug-related deaths. Although many local municipalities have piloted their own versions of this approach and underground supervised injection sites have operated in major cities, Rhode Island has become the first state in the nation to blanket legalize their activity.
Supervised injection sites are, in essence, facilities in which people can use drugs in a safe and sterile environment, with access to on-hand medical personnel, resources connecting patrons to social services and emergency care. Proponents of supervised injection sites claim that they reduce overdose deaths, drug-related 911 calls and public drug usage, while those against the sites allege that they worsen drug addiction and bring prospects of heightened crime.
Such division is expected concerning such a daring effort to curb drug-related deaths. At first glance, supervised injection sites sound foolhardy; preventing drug deaths by allowing people to use illegal drugs in state-approved environments. Observing the statistics borne from areas in which the program has been piloted, however, prove the issue to have more nuance than meets the eye.
One study of a supervised injection site in Vancouver, Canada found that the area saw a 26% reduction in overdose deaths compared to the rest of the city. More studies have concluded that they reduce the rates of needle sharing dramatically, which can prevent the spread of bloodborne diseases such as HIV and hepatitis, and also sharply reduce the rates in which needles are discarded in public. Beyond the public health benefits, research has shown the cost-effectiveness of supervised injection sites as well. One analysis found that the opening of such a site in Baltimore, Maryland would save the city $6 million annually from the reductions of overdoses and need of medical services for said overdoses.
Opponents of the opening of the sites make the increase in crime one of their top concerns. However, no peer-reviewed studies have found any uptick in crime since the launch of any site in a major city.
In regards to public health, those who do not support supervised injection sites claim that they will simply worsen the issue, being a danger to those addicted to drugs by giving them a green light to use illegal drugs whenever they please. This point, again, is not backed by any major research. In fact, the research shows the exact opposite. Areas with supervised injection sites show lower rates of drug use as a whole, due to the life-saving resources provided to those who visit. This is compounded by the reductions in overdose deaths, bloodborne disease, public nuisance and costs related to drug usage and overdoses.
The greatest obstacle standing in the way of widespread adoption of harm reduction measures is simply the way they make people feel on the surface level.
As one first hears of harm reduction methods without a deeper analysis of its effects, they simply chalk it up as state-sanctioned drug addiction. The issue, like all regarding drug addiction, is far more complex than what it may appear. As many have cast the issue as a scorched earth approach to treating addiction, Rhode Island is soon slated to lead the way in progressive approaches to ending the tsunami of overdose deaths washing over the country.
It’s a bold approach, surely, but is it too bold compared to the system widely adopted across the U.S.? That’s a question for the tens of thousands who were incarcerated instead of helped.