What's The Evidence That Supervised Drug Injection Sites Save Lives?
Critics say supervised injection sites encourage drug use and bring crime to surrounding communities. Proponents argue that they save lives and can help people in addiction reconnect with society and get health services. [...] But what does evidence say? If the policy goal is to save lives and eventually curb opioid addiction, do these sites work? It's a tricky question to answer, although many of these sites have been studied for years.
At least 100 supervised injection sites operate around the world, mainly in Europe, Canada and Australia. Typically, drug users come in with their own drugs and are given clean needles and a clean, safe space to consume them. Staff are on hand with breathing masks and naloxone, the overdose antidote, and to provide safer injection advice and information about drug treatment and other health services.
But most have grown out of community and grassroots efforts, according to Peter Davidson, a researcher specializing in harm reduction at the University of California San Diego who is researching an underground supervised injection site [open, DOI: 10.1016/j.amepre.2017.06.010] [DX] in the United States. They lack big budgets for comprehensive services or for conducting high level evaluations, he says. Still, he says the research – both "the grey" and the robust - point to the benefits, especially in preventing deaths among society's most vulnerable. No death has been reported in an injection site. A 2014 review of 75 studies [DOI: 10.1016/j.drugalcdep.2014.10.012] [DX] concluded such places promote safer injection conditions, reduce overdoses and increase access to health services. Supervised injection sites were associated with less outdoor drug use, and they did not appear to have any negative impacts on crime or drug use.
[...] However, in another review of studies [DOI: 10.1016/j.drugpo.2018.06.018] [DX] published in August in the International Journal of Drug Policy, the researchers, criminologists from the University of South Wales in the United Kingdom, found that the evidence for supervised injection is not as strong as previously thought. Only eight studies met the researchers' standards for high quality design. And of those, the findings on the effectiveness of supervised injection were uncertain, with no effect on overdose mortality or needle sharing. "Nobody should be looking at this literature making confident conclusions in either direction," says Keith Humphreys, an addiction researcher and psychiatry professor at Stanford University who wasn't involved in the study.
Related: Portugal Cut Drug Addiction Rates in Half by Rejecting Criminalization
The Dutch Supply Heroin Addicts With Dope and Get Better Results Than USA
Related Stories
The old rat-with-drug-laced-water "experiment" is a sham. The only choice the rat in the empty cage has is drinking plain water or drinking drugged water. They never show you a CONTROL where there is a rat with a cage full of cool rat toys and rat friends.
Johann Hari reports via Alternet:
The opposite of addiction is not sobriety. It is human connection. [...] just 17.7 percent of cigarette smokers are able to stop [smoking by] using nicotine patches.
[...]Nearly 15 years ago, Portugal had one of the worst drug problems in Europe [...] They decided to do something radically different. They resolved to decriminalize all drugs and transfer all the money they used to spend on arresting and jailing drug addicts and spend it instead on reconnecting them--to their own feelings and to the wider society.
[...]The [sic] most crucial step is to get [addicts] secure housing [as well as] subsidized jobs so they have a purpose in life and something to get out of bed for. I watched as they are helped, in warm and welcoming clinics, to learn how to reconnect with their feelings after years of trauma and stunning them into silence with drugs.
[...]An independent study by the British Journal of Criminology found that, since total decriminalization, addiction has fallen and injecting drug use is down by 50 percent.
[...]The main campaigner against the decriminalization back in 2000 was Joao Figueira, the country's top drug cop. He offered all the dire warnings that we would expect: more crime, more addicts; but when we sat together in Lisbon, he told me that everything he predicted had not come to pass--and he now hopes the whole world will follow Portugal's example.
This Bold Plan to Fight Opioid Overdoses Could Save Lives--But Some Conservatives Think It's "Immoral"
With Ohio beset by a massive public health around opioid use and overdoses--more than 4,000 Ohioans died of opioid overdoses in 2016--the Cleveland Plain Dealer sent travel editor Susan Glaser to Amsterdam in search of innovative approaches to the problem. While there, she rediscovered Holland's long-standing, radical, and highly effective response to heroin addiction and properly asked whether it might be applied to good effect here.
The difference in drug-related death rates between the two countries is staggering. In the U.S., the drug overdose death rate is 245 per million, nearly twice the rate of its nearest competitor, Sweden, which came in second with 124 per million. But in Holland, the number is a vanishingly small 11 per million. In other words, Americans are more than 20 times more likely to die of drug overdoses than the Dutch.
For Plain Dealer readers, the figures that really hit home are the number of state overdose deaths compared to Holland. Ohio, with just under 12 million people, saw 4,050 drug overdose deaths in 2016; the Netherlands, with 17 million people, saw only 235.
What's the difference? The Dutch government provides free heroin to several score [where a score=20] hardcore heroin addicts and has been doing so for the past 20 years. Public health experts there say that in addition to lowering crime rates and improving the quality of life for users, the program is one reason overdose death rates there are so low. And the model could be applied here, said Amsterdam heroin clinic operator Ellen van den Hoogen.
[...]"It's not a program that is meant to help you stop," acknowledged van den Hoogen. "It keeps you addicted."
That's not a sentiment sits well with American moralizers, such as George W. Bush's drug czar, John Walters, whom Glaser consulted for the story. He suggested that providing addicts with drugs was immoral and not "real treatment," but he also resorted to lies about what the Dutch are doing.
He claimed the Dutch are "keeping people addicted for the purpose of controlling them" and that the Dutch have created "a colony of state-supported, locked-up addicts."
Your humble Ed (who rechopped the quoting, so head off to the full article(s) to see the full story) adds: of course, this is quite a contentious issue, digging deep into moralistic debate, and where clearly there's little agreed-upon objective truth and plenty of opinions. However, we are a community dotted widely round the globe, and so I'm sure there are plenty of stories of what has or has not worked in different locales.
Previous: Tens or Hundreds of Billions of Dollars Needed to Combat Opioid Crisis?
Portugal Cut Drug Addiction Rates in Half by Rejecting Criminalization
(Score: 2) by JoeMerchant on Saturday September 08 2018, @06:12PM (7 children)
Says it all, but will people really listen, or just overreact?
🌻🌻 [google.com]
(Score: -1, Troll) by Ethanol-fueled on Saturday September 08 2018, @07:02PM (6 children)
Injection sites and needle handouts are an idea so stupid it could have only come from California. I tend not to judge most casual drug users except tweekers and junkies, both of which are scum and should be shot on sight.
(Score: 2) by JoeMerchant on Saturday September 08 2018, @08:30PM
The social reality of what happened around Zurich was pretty compelling.
🌻🌻 [google.com]
(Score: 0) by Anonymous Coward on Saturday September 08 2018, @08:38PM
So, "just overreact", then.
(Score: 5, Insightful) by Runaway1956 on Saturday September 08 2018, @08:40PM (3 children)
Have they moved California to Europe?
And, the idea WORKS. It's been working in Europe for years. Here, the efficacy is cast into doubt because - wait for it now - WE WOULD RATHER NOT SOLVE THE DRUG PROBLEM!! Drugs are big money, for the drugs, for enforcement, for lawmakers, for the medical profession, for rat-trap landlords - just about everyone in the food chain. Let's not forget the coroner and the undertaker, who each get a cut from the drug problem.
(Score: 2) by vux984 on Saturday September 08 2018, @09:49PM (1 child)
"WE WOULD RATHER NOT SOLVE THE DRUG PROBLEM!"
Yeah, at least for a certain definition of "WE"; you are tragically right.
"Let's not forget the coroner and the undertaker, who each get a cut from the drug problem."
Not really, they don't care whether you die at 17 or at 71. Either they get paid today, or they get paid tomorrow.
(Score: 2) by Joe Desertrat on Saturday September 08 2018, @10:55PM
But today is better...
(Score: 0) by Anonymous Coward on Sunday September 09 2018, @03:05AM
If anything, it cuts the "dealer" out of the loop.
When the dealers get funded, its bad news for everyone but the gun merchants.
(Score: 0, Flamebait) by Sulla on Saturday September 08 2018, @08:04PM (5 children)
As I said in a prior article or journal entry, unsure which, I think it is worth giving it a shot as long as it is funded by private charity instead of tax dollars. I might even be persuaded to pay for one locally if it means I run into less people shooting up in my local town, where this is a large problem. As these studies go on, if they find a positive link between these locations and lowered mortality/overall medical costs/lowering of usage it might be an interesting place for insurance to step in and help with costs to lower their costs in other areas. I will need to read more about how this 'undergound' site in the US opiates.
Ceterum censeo Sinae esse delendam
(Score: 5, Insightful) by Anonymous Coward on Saturday September 08 2018, @08:48PM (4 children)
While you're there withholding tax dollars from social programs that "might have a benefit, but we can't be sure either way", can you also pull them out of the DEA and related orgs that definitely cause/perpetuate the majority of the violent crime surrounding the issue.
(Score: 2, Insightful) by Sulla on Sunday September 09 2018, @02:55AM (1 child)
Yes, that is also a good idea. But im not stoppin there, if you act today ill agree to a minimum 50% reduction in military spending
Ceterum censeo Sinae esse delendam
(Score: 0) by Anonymous Coward on Sunday September 09 2018, @03:48AM
Even better, I’ll take it!
(Score: -1, Flamebait) by Anonymous Coward on Sunday September 09 2018, @04:57PM (1 child)
I and many other sane people would prefer not funding these drug dens, round up druggies instead and toss them in a meat grinder, along with the dealers. Results probably should not be fed to pigs, since god knows whatvchemical coctail it contains.
(Score: 0) by Anonymous Coward on Sunday September 09 2018, @08:18PM
We'll kill you and rape your wife or daughter first.
(Score: 4, Insightful) by Anonymous Coward on Saturday September 08 2018, @08:25PM
Make the dope legal and regulated, and less people will die. Stop companies from refusing to sell needles and less people will get sick from reusing and sharing. Supervised injection might help save some people from overdoses, but the reason they're overdosing is because the drugs vary wildly in content and potency. The reason people are getting sick from old needles is because they can't get clean needles at the pharmacy that refuses them service.
(Score: 1, Informative) by Anonymous Coward on Saturday September 08 2018, @08:32PM (7 children)
No, supervised injection sites don't work. What is most effective is fentanyl. Reduces crime, cuts healthcare costs, improves neighbourhoods... win-win-win situation.
(Score: 3, Informative) by Anonymous Coward on Saturday September 08 2018, @08:53PM (2 children)
Maybe, but reducing crime and improving neighbourhoods follows reducing the drug cartels and dealer networks. Fix the legal framework so company's can create easily obtained prescription versions and the overdoses and healthcare costs drops along with the crime. Then you don't have 'black hole' neighbourhoods with a gang turf war erupting every other week.
(Score: -1, Flamebait) by Anonymous Coward on Saturday September 08 2018, @11:55PM (1 child)
The benefits also follow if you eliminate the junkies. Once fentanyl kills them, they're no longer a burden on society (after you dispose of their stinking corpses).
(Score: 2) by c0lo on Sunday September 09 2018, @06:39AM
The drug suppliers will take care to create other junkies, no worries.
They used "bait and switch" long before the corporations.
https://www.youtube.com/watch?v=aoFiw2jMy-0 https://soylentnews.org/~MichaelDavidCrawford
(Score: 2) by Snotnose on Saturday September 08 2018, @10:09PM (3 children)
Years ago I had a diabetic cat (I didn't do it, got her from a shelter, took her to the vet and got the diagnosis. No way she was going back to the shelter). Vet gave me a prescription, not for the insulin, but the needles needed to inject her. Stupidest fucking thing I'd ever heard of.
Turned out the cat did not like getting 2 shots a day, and after a couple weeks I faced facts, quit shooting her up, and about 3 weeks later took her in to be put down.
Of course, now I've got some 50 needles and nothing to do with them. Asked around, as I owned them they weren't considered sterile so nobody would take them. Ended up tossing them in the trash. I'm sure some heroin addict would have loved to have them, but I don't know any heroin addicts.
When the dust settled America realized it was saved by a porn star.
(Score: 0) by Anonymous Coward on Saturday September 08 2018, @10:57PM (2 children)
Hint: if the state makes it hard for you to get something, and you've already jumped through their hoops to obtain it legally, don't throw it in the trash.
Suppose you or a friend wants a needle in the future, for whatever reason, and don't have a doctor or vet handy? It's not like you need to rent a storage unit for one box of needles.
(Score: 2) by Snotnose on Saturday September 08 2018, @11:52PM (1 child)
Actually, it was a bag of 100 needles. I kept them until I got divorced, then they went into the trash.
I'm not stupid. I had something hard to get that I didn't need. I hung onto those suckers long as I could, then the wife tossed them.
When the dust settled America realized it was saved by a porn star.
(Score: 0) by Anonymous Coward on Sunday September 09 2018, @03:22AM
I can't tell you how much stuff I keep around, not because I need it, but because I *might* need it, and find it impossible to get.
Then people call me a "hoarder".
But I feel so stupid throwing away something when I know good and well that once its gone, its gonna take an act of God to get another. Whether it be an obsolete IC, or a banned chemical.
How about those guys who stocked R12 when it was 69 cents a can?
I get the idea that even old computers could instantaneously jump tremendously in value should civil unrest arise and people suddenly realize all the newer computers have backdoors that can't be programmed around, and they still need to communicate. Simple things like a C compiler and books on things like programming TCPIP stacks in C++ or assembler worth more than their weight in gold. As nothing coded in the last 20 years or so can be trusted.
I can probably trust an old 3COM 3C905 board driven under my own C++ program under DOS on a 386SX to do specific custom tunneling protocols, where I pick some random port and fit the message I want to send into ONE packet, do a port knock to let my recipient know its me, then accept the packet and decrypt the payload. Stuff like that I could hide and make it look like a stray packet from a video streaming app.
(Score: 5, Informative) by Anonymous Coward on Saturday September 08 2018, @11:59PM (8 children)
Garbage data.
Let me give you some cold, hard, data from the morgue.
In Vancouver, BC last year, there were over 1,500 overdose deaths. Not overdoses; deaths. The overdose count is at least 10x that but most go unreported.
In Vancouver, BC last year, there were ZERO deaths in Insite, the supervised injection site. There were over 100,000 uses there in 2017.
The cost to run is approximately $500,000/year. The cost for a hospital to handle an incoming opioid overdose is $2,000-$100,000 but for severe cases the mean is probably around $25,000 to the Canadian system.
If 1% of those uses would've overdosed (conservative, given fentanyl prevalence), the 1,000 hospital visits would cost an estimated $25,000,000. Or a paltry $2m if they're the very best case scenario.
So. Human lives are being saved. Quality of life is improved for those persons. Useful data for society is gathered by Insite. The cost to society to provide medical care is net lower. Needle sharing is 0% at Insite.
So when they conclude "no effect on overdose mortality or needle sharing" I can tell you they haven't looked at the cold, hard data behind Insite, and I call big fat bullshit.
(Score: -1, Troll) by Anonymous Coward on Sunday September 09 2018, @12:19AM (1 child)
You forgot to mention that each junkie "saved" means another pile of shit and a gallon of urine dumped onto your property. Oh, and your car broken into. Again. Junkies are shit-stains of society and getting/using drugs should not be made easier for them. Junkies steal from their own families. Junkies destroy communities and wreck entire neighborhoods.
(Score: -1, Flamebait) by Anonymous Coward on Sunday September 09 2018, @12:31AM
Exactly. What Vancouver needs is a site that gives away fentanyl for free to junkies (and junkie-lovers like the OP). In fact, there's a charity that I would gladly donate to. Society for a Scum-Free Vancouver.
(Score: 0) by Anonymous Coward on Sunday September 09 2018, @12:55AM (1 child)
Sorry, your "cold, hard data" do not come from an experiment meeting our standards for high-quality design, so they don't count.
The war on drugs will continue apace.
(Score: 3, Informative) by Anonymous Coward on Sunday September 09 2018, @07:57AM
The Nixon campaign in 1968, and the Nixon White House after that, had two enemies: the antiwar left and black people. You understand what I'm saying? We knew we couldn't make it illegal to be either against the war or black, but by getting the public to associate the hippies with marijuana and blacks with heroin, and then criminalizing both heavily, we could disrupt those communities. We could arrest their leaders, raid their homes, break up their meetings, and vilify them night after night on the evening news. Did we know we were lying about the drugs? Of course we did.
— John Ehrlichman, to Dan Baum[41][42][43] for Harper's Magazine[44] in 1994, about President Richard Nixon's war on drugs, declared in 1971.[45][46]
(Score: 0) by Anonymous Coward on Sunday September 09 2018, @09:59PM (1 child)
Reminds a guy that in Oslo, that is Norway, there was a "hilarious" incident when a second such site was opened.
Where as the first site had been located in the "seedier" parts of the city, this new site were closer to the affluent neighborhoods. End result was that suddenly they had incidents of someone dressed in expensive clothing, driving and expensive car, would stop by briefly to inject a dose of their stimulant of choice before heading off to the office or something.
While the individual identities were withheld, as was part of the policy of these sites, it got reported in the media in general terms. Not long after, all media coverage of these sites went quiet and one would not be surprised if their funding had been withdrawn...
(Score: 0) by Anonymous Coward on Tuesday September 11 2018, @10:03PM
Addicts come in all stripes. Some addicts are high functioning. Some coke addicts shoot up daily before work. So they want to do it safely, and are condemned? It's foolish to say that a car and job means the person is doing well; does such a person not also deserve support through addiction? Should we only care for the homeless, and not for those not yet on the street? A stitch in time saving nine is what this is *all about!*
(Score: 2) by All Your Lawn Are Belong To Us on Monday September 10 2018, @06:54PM (1 child)
And with 0% needle sharing you have greatly reduced (not zero) percent risk of developing needle-transmissible diseases. So you can get savings that you can only measure over time (although one could probably predict what the savings would be).
This sig for rent.
(Score: 0) by Anonymous Coward on Tuesday September 11 2018, @09:58PM
Yeah - the big one is simply getting infected at the site of repeated injections. Good point.
(Score: 3, Funny) by kazzie on Sunday September 09 2018, @08:01PM
Having read the two previous news items, I was expecting this one to be about javascript injection or something of that ilk.