In 2017, an opioid crisis was declared by the United States Department of Health and Human Services. Opioid overdose deaths have continued to rise since then reaching over 5,000 in 2020. This crisis was sparked by the over prescription of opioids for pain management. Many people start to take them as prescribed but will become dependent due to their high potency and begin taking them more or start to take illicit opioids such as heroin.
California is greatly affected by this and has many addiction treatment centers to manage the crisis. However, opioid overdoses continue to increase each year. The government has proposed a new method in which safe injection sites would be opened. The aim is that people will not die from overdoses as they will be supervised. While it seems likely that a test program will be allowed to pass there is still heavy criticism.
In California, more than 10,000 people died from opioid overdoses in 2021. Opioids are highly addictive drugs which are naturally derived drugs from the poppy plant, synthetic drugs produced to have similar properties, or semi-synthetic. Examples of opioids include morphine, oxycodone, and heroin.
Dependence on opioids can develop quickly and some people who are prescribed them will start to use them in ways which were not prescribed, either taking higher or more frequent doses, or using different methods of taking them such as snorting or injecting. Most people who have a heroin use disorder report that their opioid addiction started with prescription painkillers.
Addiction is a chronic disease but is often treated as a moral failing. Some believe that will power is enough to prevent or treat addiction. However, there are risk factors which increase your chances of developing a substance use disorder and show that one person refraining from abusing drugs does not mean it is the same for everyone. Risk factors include genetics, underlying mental health conditions, traumatic events, and environmental factors such as family or friends using substances around you.
The Proposal for Safe Injection Sites
The proposal to set up legal injection sites in California was passed by a narrow margin by the state Senate over a year ago and recently moved closer to becoming a reality when Assembly Public Safety Committee members voted on it five-to-two. If it passes, test sites will be set up in Los Angeles, Oakland, and San Francisco. The program would run until 2028 and data would be collected to see the effectiveness of the program and its impact on the community. Depending on the results of this the bill would be made into a law.
Test sites will allow people to inject and snort drugs in a safe place under supervision. This will allow members of staff to recognize when someone is having an overdose and prevent them from dying. In the case of overdoses, naloxone is a highly effective drug which rapidly reverses opioid overdose symptoms. It would be available at these sites along with other tools to help deal with overdoses.
The Benefits of Safe Injection Sites
Safe injection sites already exist in Canada, Europe, Australia, and New York. In over thirty-five years there have been no deaths from overdoses at these supervised sites. Those in favor of the bill argue that people will take drugs anyway so it is better for them to do this under supervision where the worst-case scenario of an overdose can be managed.
Safe injection sites will not only reduce the risk of overdosing but also help with other risks associated with injecting drugs. People experiencing withdrawal are likely to share needles. State Senator Scott Wiener has said that safe injection sites will reduce the spread of HIV and hepatitis by giving access to clean needles.
There are also arguments for the general public. Safe injection sites will get people off the street so that people will not see drug use in public. In addition, Wiener states that every dollar spent on safe consumption in San Francisco will save the city $2.33. Resources which are spent on emergency rooms, hospitals, the fire department, and ambulances in relation to drug use and overdoses can be spent on other areas of the city.
Controversy About Safe Injection Sites
While many people agree with setting up safe injection sites, there is almost equal opposition to it. Those in opposition have argued that while there have not been deaths inside injection sites, people are dying around them. Places in which the government supports the use of drugs attract use in the area. The California Narcotics Officers’ Association points out that crime rises in areas where there are high levels of addiction. They worry that safe injection sites will lead to an increase in crime so that while there may be a decrease in drug related deaths, there will be an increase in deaths by different means.
In addition, Michael Shellenberger, the author of San Fransicko: Why Progressives Ruin Cities, has argued that these sites support addiction maintenance rather than addiction recovery. He says that they only deal with the worst-case scenario of people dying from overdoses, whereas the focus should be on getting people off drugs. Marie Schubert, the Sacramento County district attorney agrees with this sentiment. She is shocked that the government would encourage illicit drug use and allow an open drug scene. Schubert has argued that instead there should be more options for court-ordered treatment, this would force people into treatment centers.
Concerns about safe injection sites are valid and should be considered. Dealing only with overdose deaths rather than addiction is not enough. However, those who support safe injection sites speak of them being a place which will encourage treatment by giving access to primary support. Recovery is a life-long process, so forcing someone into treatment is unlikely to work as there is a high chance of relapse even if they complete the treatment process. Giving safe spaces for drug use and access to support may make people more likely to seek treatment themselves and therefore give a better chance of long-term recovery. Time will tell if these injection sites will be a success in California, helping to deal with the opioid crisis.