Blog Post

Providing a Safe Space to Use Drugs Can Help End the Overdose Crisis

Suchitra Rajagopalan

72,000 lives were lost to accidental overdose in the U.S. in 2017— more than in car accidents or due to gun violence, and more Americans than in the entire Vietnam War. That’s 72,000 lives that often ended alone and without help. But it does not have to be this way.

Supervised consumption sites (SCS) – also called safe injection facilities or drug consumption rooms – invite people into a community of care by providing a space for people to consume pre-obtained drugs in a controlled setting, under the supervision of trained staff, and with access to sterile injecting equipment.

They are safe, monitored facilities where participants are also offered health care, counseling, and referrals to health and social services, including drug treatment. Not a single overdose fatality has occurred at any operating SCS and the research shows they also reduce overall overdose mortality rates. Having supervision also means that an overdose resulting from unknowingly consuming fentanyl—where death can occur in a matter of minutes and long-before emergency help can arrive—can be reversed immediately on site.

Rod J. Rosenstein, Deputy Attorney General of the United States, threatened states that are moving forward with this life saving strategy in an op-ed last month, despite their proven record of saving and improving lives.

This is not a new concept. SCS have been in operation since the 1980s and there are now 120 authorized sites operating in ten countries – but none in the U.S. Canada has made remarkable progress, growing from two authorized sites to more than 30 in just the past two years, largely in response to the current overdose crisis.

The evidence is abundantly clear. Nearly four decades of scientific research across three continents has confirmed that SCS prevent fatal overdose, increase the number of people entering treatment, reduce the risk of infectious disease, minimize neighborhood disorder like public injecting or improperly discarded syringes, and save public resources – all without any increase in drug use or drug-related crime.

The federal government’s threat to thwart these efforts is as old as the drug war itself. Identical threats were used to try to stifle sterile syringe programs and access to medical marijuana – policies that now have widespread support and an abundance of evidence of their effectiveness. Hindsight has proved that the federal government was on the wrong side of both history and science, but we are still paying for their attempted blockages and delays.

HIV and Hepatitis C incidences are surging as a result of increased injection drug use in jurisdictions like Indiana and Kentucky that took their cue from the federal government and refused to offer sterile syringes. Research shows that annual opioid overdose mortality rates are 25% higher in states that do not have access to medical marijuana. Earlier embrace of these critical interventions would have dramatically altered the course of this overdose crisis and saved countless lives.

The DOJ’s aggressive stance follows significant momentum toward the opening of SCS in cities and states across the nation, including California, which became the first state legislature to pass a bill approving such sites – the bill is now on the Governor’s desk.

Thanks to years of persistent advocacy by the Drug Policy Alliance, community-based groups, faith leaders, and public health authorities, numerous cities are on the verge of opening the first SCS in the U.S., including Seattle, Ithaca, Philadelphia, New York City, and San Francisco. Legislation to authorize SCS has also been introduced in Colorado, Maryland, Maine, Massachusetts, Missouri, New York, and Vermont.

By opposing SCS, the DOJ is back on the hamster wheel. But we cannot afford to continue going around and around—not while we have nearly 200 people a day dying wholly preventable deaths. Cities and states must “just say no” to federal attempts to block this critical live-saving intervention.

The overdose crisis did not have to happen—the focus on enforcement and incarceration meant that we did not have the public health infrastructure in place to adequately address increasing rates of drug use and keep people safe. The current crisis is a political one. When we let the DOJ’s ideology trump evidence, and prioritize punishment over preserving life, the result is thousands of preventable deaths. It is time to get off the hamster wheel.

Suchitra Rajagopalan is the research coordinator with the Drug Policy Alliance.


Harm reduction