Recently, the idea of state-approved injection centers where people addicted to heroin may “shoot up” in a safe environment was proposed for further review in New York City. While heroin use is not in any way a social good, such facilities might help tremendously in the war against opiate addiction and drug cartels, at the very least.
This issue is so important to contemporary American society that we must look beyond our personal politics to band together as a society to explore and fund research into viable solutions to the social health crisis, and the answer may well be a medley of ideas from diverse sources, including drug interdiction, medicalizing the opiate drug crisis, as well as enhancing border patrols.
In 2016, over 50,000 deaths were reported as having been caused by opiate overdose. And now, Naloxone, a nasal spray that can reverse overdoses by blocking the drug’s effects, is certainly lowering the death toll, but also hiding the true cost of the epidemic, in many cases just postponing the inevitable for addicted persons.
Safe Injection Zones Are Already Up and Running in Europe and Canada.
Image Credit: Syringe by ZaldyImg
While my community feigns shock at the idea of safe injection sites, needles line the gutters of most neighborhoods in my town of a half million people. Even the areas with smartly designed custom mega-homes with neatly manicured lawns and shrubbery on quiet tree-lined streets are suffering in this same exact way; it’s an epidemic that crosses socio-economic, ethnic, and racial lines.
Europe, the land many Americans can claim at least some ancestors hail from, (including many Black folks – these days genetic testing is revealing this for so many people) is no stranger to what are referred to on that side of the Atlantic drily as “drug consumption rooms.” There’s no way to get confused about what goes on in there; it’s about as unglamorous a name as could be devised, apparently.
According to the European Monitoring Centre for Drugs and Drug-Addiction, such facilities have been successfully operating in Europe for over three decades. The safe spaces aren’t there to let users consume drugs with abandon; rather, there are many important community-aiding functions, which may be quantified and tracked, in terms of results and success. Harm-reduction policies are tested and the data is there: These systems, when carefully implemented, do work to bring down the death-tolls, at the very least.
Needles by Cat Branchman
Having sanctioned areas for addicts to use their drugs in a medical setting sends “the wrong message” to our youth, claim opponents. With supervised injection centers, society is actually medicalizing a longstanding, festering social ill that presently has no end in sight.
Past criminalization of opiate addicts’ behavior of buying and using drugs by our society decades ago was sensible, but had the additional side-effect of sending this population scurrying further underground. This, compounded with the very real fact that many drug addicts stole and committed other crimes to get cash to buy chemicals, and authorities could do little to help.
Today, I witnessed firsthand as the police raided and shut down a “heroin house” on my block. Sadly, in the last few years, two individuals died in that same house, only five doors down, both succumbing to heroin overdose.
Beyond that, the police and ambulances had been on the block regularly to administer “saves’ with Naloxone. Right now, kids (and people of all ages, if you check the obituaries) are using heroin all over my town. Why do the children living on my block have to see two bodies being brought out in bags? What message is this sending? Surely, kids see that drug use is ultimately fatal, and maybe such scary images are, in fact, a good reinforcement in the long-term, but consider the trauma such scenes could bring to the soul of a ten year old.
Heroin Graffiti by Duncan C
Intravenous opiate drug use, and its associated ills, belong in a medical setting, where addiction and overdose can be addressed by professionals there for this express purpose. There could even be opiate purity testing for drugs that addicts buy elsewhere and bring into the center to have tested. If the ultimate goal is harm reduction and lowering of death tolls, then there may be no other way.
Every time an addict enters a safe “shooting gallery” in a hospital or medical building, they
Protester with NIMBY Sign
have the chance to get help with their addiction. If asked each and every time they got high if this would be the day they wanted to stop the horrible cycle, help would only be an affirmative response away, a simple nod of the head or meek uttering of a faint whisper, a monosyllabic, “Yes!” Communities are up in arms, with the “Not In My Backyard!” chant growing louder by the week. Are we also opposed to methadone clinics? If so, I have bad news for you: Chances are, they’re already in your backyard, have been for years, and you probably haven’t even noticed.
The complaints that legal safe spaces for opiate addicts will bring drug dealers to the area are likely unfounded, as methadone clinics, the best example we an use that exists today, are probably not hot-spots for illicit drug activity in most places, though opponents may have a valid point because we just don’t know yet. However, remain mindful of the fact that the medical professionals at a legal heroin-use zone or methadone clinic would quickly call the authorities if anything illegal happens to be observed outside. If we’re unsure, why not assign police to the area? The “shooting areas” and methadone clinics will be the safest places in town, without a doubt.
Medical professionals are in no way there to foster or encourage drug abuse, only minimize it’s harmful effects on the individual and society. Another key role, besides being a fast route for addicted persons seeking immediate help, would be the dissemination of factual information. Pamphlets, business cards, and a small library pertaining strictly to all aspects of opiates, from law to health issues, would permit users a chance to learn more about the pharmacology of their addiction, as well as the bodily harms that eventually come with continual use of the drug.
Clean needles can also be provided; again, this is not to encourage drug use, but to rather decrease collateral damage to the individual and society, by keeping HIV, hepatitis, and other blood-borne pathogens that love needle-sharing at bay. Large cities across the US have already been doing this for decades, with positive results, in terms of helping keep disease from spreading among the IV-drug-using population.
The police have the tools and training necessary to keep out public spaces safe. Image Credit: Dave Conner
Today on my street, the brave police officers walked into a house that could have been a very unsafe experience for them. There’s always a place for interdiction, of course, but this may not solve the entirety of the problem as easily or quickly as dealing with this as a public health crisis, firstly, and crime scene, secondly.
The police, as our society is now structured, are often the last line an opiate addict crosses before death; carrying the lifesaver Naloxone, law enforcement officers have been saving individuals from death every day in almost every town and city in the US. But those same police resources are stretched thin, and are also needed to fight the War on Heroin and deal with law enforcement issues of all kinds as well.
And, Naloxone is not always going to help; the newer synthetics like Fentanyl and Carfentanyl are so powerful, Naloxone will not always bring back an overdose victim, or the patient will just go right back into an overdose state after only a few minutes of regained consciousness, requiring additional doses of Naloxone.
Our police should be fighting crime, including opiate-dealing, as well as keeping our public spaces safe, like our schools and libraries, as well as our private areas by supplementing private security in spots like malls and movie theatres. Right now, the police are doing noble work, but running around administering Naloxone might be a distraction from other important tasks that affect the safety and security of many more citizens.
There lately has been a debate about how to best keep our schools safe. Arming teachers is not viable in most areas; in some rural communities, where everyone is already armed and carries firearms, this is a great plan, easily put into action. But in cities like New York, Newark, and others, this is never gong to happen. Still, places where people gather must be protected.
Kids learning to throw rocks at attackers. Why not? Image Credit: Rocks by Sandor Weisz
realistically, protection by a firearm and a licensed and trained operator is the best protection to be found. Training kids to throw rocks is a novel and possibly effective way to slow an emotionally disturbed gunner down; an armed police presence at a school will surely do far more in that regard.
There are even more stark and drastic options available, if we seek to end this culture of heroin addiction as quickly as possible, but I must warn that they’re even more controversial than even legal shooting galleries.
Straying further from the known, we can consider research into the benefits of having a “heroin license” that addicted persons can trade for their driver’s/equipment operator’s license, permitting them to possess small amounts of heroin for personal use instead that cannot be traded or resold. If we seek fewer obstacles to success, pure medical-grade heroin powder and opiate pills would also be available to users, sold without profit at a small fee to the individual, supervised by the DEA, via physicians who are also drug-addiction specialists at the IV-drug users’ health centers.
DEA resources could grow to include managing stocks of opiates for hospital supplies for addicts. Image Credit: Brett Neilson
This may seem like a 360 degree turnaround from current policy, but reducing trafficking would be the ultimate goal of such centers focusing on opiate addiction . The way to drive the cartels and gangs away is to destroy the possibility for easy high profits; this worked with alcohol re-legalization, why can’t it work with the drug cartels now? Only the details change; the game remains the same. It’s worth at least a thought.
And, if addicts knew their heroin from the hospital was pure and standardized, there would be far less need for anyone to administer Naloxone, anywhere. Choosing the cheaper and purer substance might be an good alternative for someone who’s already ODed five times and lost ten friends to street heroin of unknown purity, often laced with Fentanyl and other substances many times more dangerous than heroin.
Brickfair 2011 – Southside Gangster with Tommy Gun prototype Image Credit: enigmabadger
In the end, measures such as creating safe shooting spaces are of limited value, to be sure. The issue is, most addicts would not use such facilities, unless such facilities were also cheaply selling or freely sharing the drug. Co-locating on the campuses of mental health centers or hospitals would be most appropriate, in terms of having support systems only a few hundred feet away if there were to be an overdose or complication, as well as keeping the drugs further framed within a medical context for all, and keeping the whole worrisome matter out of the sight of the public.
Most addicts will likely continue to use intravenous opiate drugs in the privacy of their homes, regardless of what else society tries to do to accommodate them. There is simply a mistrust of authority within this sub-culture, and many would likely feel wary of participating.
In time, if such a program proved not to be a “sting” or “set-up”, word would get out and heroin users would know this is the way to both better and cleaner drugs, and the very real path back to society. It’s a means of leading people back to health, back to reality, away from the drug dealers and stigma and shame associated with the heroin drug culture.
FDNY – Ambulance
We need to think about a society that’s a lot safer for police to work in, and the average citizen to live in. A two-pronged approach, targeting both supply and demand, will bring America back from our dark days faster and with greater ease. Addicts have definitely made poor choices, there’s no contesting that; but it’s in all of our best interest that they survive and thrive. Some say that we should let addicts overdoes and be gone; that’s heartless, a really cold way of looking at people and the world.
The nature of physical addiction means it’s easier to want to stop than to actually do so, with heroin and opiate pills. Nicotine is NOT more addictive than heroin, contrary to urban legend and popular memes! If you’re a recovering alcoholic, only then do you know the grip a powerful physically-addictive substance can hold over your life, and many say heroin addiction is worse.
By the time a person is addicted to opiates, their continual use of a drug has temporarily changed the complex chemical profile of the brain, and depleted necessary stores of various neurotransmitters. The body eventually gets used to the poison (not that it’s now less harmful) and strong cravings seek to keep the user motivated to get the drugs once more, as a fresh blast of heroin will artificially raise the output of waning neurotransmitters again briefly, ceasing the otherwise rapid decline to dangerously low levels from past depletion caused by recent opiate use. And thus, the cycle of opiate addiction continues.
Education of the youth is the way to prevent demand. It is truly unbelievable, that with decades of history of its sordid killings and social harm, that heroin is even still abused, anywhere in the US or world, let alone the center of a modern day scourge. Kicking your morning cup of caffeine-laden coffee or your binge watching of old Simpsons episodes on Netflix just isn’t the same.
Sorry. I know you may have strongly believed that this was the case, but facts are facts, and physical addiction and psychological addiction are two different beasts, for sure. Giving up eating, fun habits, and sometimes even not-so-fun habits, can be tough. But imagine if a chemical were driving you, via severe discomfort and pain, to act counter to your choices to stop, motivating you to do the exact opposite and keep going? It would be worlds tougher to give up eating the buttered popcorn with those Nexflix shows, no?
Governor Tom Wolf
Governor Wolf Announces Pennsylvania Capitol Police to Carry Naloxone
Having addicted people engaging with a medical team in a health care setting can only work to lessen their experience of isolation and shame, bringing many out of the shadows where they can far more easily get help, or at least re-assess their lives from a different viewpoint.
And, perspective is always good. Further, many addicts have become addicted because of emotional or mental pain that they found overwhelming; they took the drugs to cope. Perhaps social counseling services at the shooting gallery would do more to help individuals crawl out of their pain than anything else we could ever provide. Sometimes a caring listener is key.
And, still many more ended up on heroin either because their doctor ordered them to take opiate pills because of a work injury or because the pills were cheap and plentiful “kicks” before becoming far less accessible because of New York’s I-stop program, and similar programs in other states.
Again, an integrative approach is the only answer, using both traditional policing, as well as alternative health concepts borrowed from other cultures. Whether we go with legal heroin use zones or not, we must act quickly, and do something differently.
The number of overdoses cannot keep climbing, year after year. A whirlwind of socially disastrous consequences awaits, if we cannot take the helm and steer a clear course away from these known deadly hazards. Whatever we do, we have to act now.
Because our President, as well as governors and mayors are concerned and looking for answers, this problem will have a definite end, hopefully sooner rather than later, regardless of what methods and means we choose to end it.
The most significant issue seems to be the constant push and pull between lawmakers of opposing camps with different underlying social and economic philosophies; again I implore the reader to abandon such notions when considering this extremely urgent topic and just explore solutions that make sense, even if such answers seem counter-intuitive at first.
Authored by D Alban