"Safe Injection Houses"- What's This?

I gotta tell ya'll, this was a tough article to write objectively, I wanna hear what you think! I had strong opinions on this subject at first, and then I did some research. Not saying my thoughts changed, but new questions did pop into my mind. "Safe injection Houses" are here in the USA. What are they and what do you think about them? Nurses General Nursing Article

A "safe house" for drug users to use drugs with clean equipment and trained professional supervision using public funding.....what the what????!!! Am I reading this correctly? This instantly stirred up strong feelings and opinions for this nurse, mom and taxpayer. While this concept was news to me, "safe injection houses", which are currently illegal in the United States, have secretly been in existence in the US for at least 3 years. The idea is to provide drug users with clean needles and equipment as well as medical supervision by professionals in the event of overdose. The staff on hand is also available to guide, educated and provide services to willing participants who wish to get clean. Injection sites are legal in countries such as Australia, Canada, Denmark, France, Germany, Luxembourg, the Netherlands, Norway, Spain and Switzerland. This is different than the clean needle exchange programs that at one time were also illegal in the US and now are legal in 33 states.

I read an article in the New York Post about two researchers who secretly evaluated a "safe injection house" in the United States. This sparked my interest to research more on the subject so that I could form a more educated opinion on the matter. According to a New York Post article, two researchers have been evaluating a "safe injection house" for over two years and recently published their report online in the American Journal of Preventive Medicine. "As a condition of their research, they didn't disclose the location of the facility - which is unsanctioned and potentially illegal - or the social service agency running it", reports The New York Post.

According to the researchers, the underground space consists of two rooms. One "injection room" with stainless steel clean stations with stools and mirrors. Drugs such as heroin, cocaine, methamphetamines, and pain pills are allowed to be used there, however smoking is not. The second room is where participants go afterward to be monitored by trained "non-medically licensed" staff. Not much information was provided through the research. It is presented that over 100 participants utilized the "safe injection house" more than 2,500 times. They released that only 2 overdoses were reported and one death at the site itself, but little to no additional information on population, cost service etc due to the secrecy of the program.

Such sites have been backed by lawmakers in New York and California, along with officials in cities like Seattle, San Francisco, Boston, and Ithaca, New York in an effort to combat overdose rates as well as drug use related transmission of Hepatitis C and HIV. This report may help support lawmakers in their efforts to pass laws allowing "safe injections" to exist in the US. As one would expect, there are many opponents to "safe injection sites", for a number of reasons. According to the New York Post article: "critics have argued these places may undermine prevention and treatment, and seem to fly in the face of laws aimed at stopping use of deadly illicit drugs."

As nurses we have a duty to do no harm. If we know that these drugs are so harmful that they cause death, have long term side effects and addiction, how would we stand a collective group on this subject? It is an interesting topic that I am sure we will hear more about in the coming years. The initial response from those I talked to casually about this subject was that this is the worst idea anyone has ever come up with and how on earth did we get here as a society? After much discussion some interesting questions regarding this and other similar topics arose creating some "grey areas" in the thoughts.

In researching this, I think I am left with more questions than I answered for myself. I would love to hear what you all think. Do such places encourage drug use though ease of access and legal use? Would new users take advantage of "safe injection sites" to try new drugs? Who pays for these places? Does the cost of running them outweigh what is spent yearly in Emergency Room visits and hospitalizations for overdose or addiction treatments? What kind of regulations and research are needed to determine the societal worth of such places? What do you think?

Report reveals 'safe house' where heroin users shoot up under supervision | New York Post

Specializes in Med-Surg/Neuro/Oncology floor nursing..

I haven't read all of the responses yet apologies if I am redundant. I am all for harm reduction. As a nurse anything to help keep a person alive can't be a bad thing. The idea that safe injection sites or needle exchage programs encourage drug use and cause people who don't use to start using is preposterous. Actually most needle exchange and supervised injection sites also provide resources to addicts who are ready to get clean. In Manhattan at one needle exchange program they have a bathroom with an intercom in it and if someone goes in there they are required to check in every 2 minutes or so and if someone stops responding the door is unlocked and someone is standing by with narcan. They have saved 25 plus lives since implementing this. Its not a supervised injection site officially but same concept. Addicts lives are worth saving just as much as anyone else's. Until some better solution comes along people are going to do drugs. No getting around that.

Specializes in Med-Surg/Neuro/Oncology floor nursing..
While I understand and appreciate points made by both sides of this debate, I still have trouble getting on board with this concept. I acknowledge that this drug crisis is a rapidly growing epidemic in this country that looks to be spiraling out of control. It is time for the government and healthcare community to work together to find long lasting solutions. I have not read the studies that show how these safe sites have benefited communities in other parts of the world, but I can't help but wonder if these "benefits" are only short-term. The underlying issue is still not being addressed and I see this as nothing more than enabling and offering a short-term solution, which to me, isn't a solution at all.

Enabling? You think not having a supervised injection site around is going to keep drug use down? They will just use in pubic restrooms or in the park or wherever. Having a place to do drugs is the last thing on an addicts mind. These places just have medical help standing by in case of an overdose. They are handing out Narcan now at Rikers Island to inmates upon discharge. Until better solutions come about the only thing we can do is make sure these addicts don't spread disease and stay alive long enough to make the decision to get clean.

You noticed that too, Fiona59? As an American, I want to state that we seen to like punishing people with certain illnesses. I'm not sure where that comes from, possibly from our Puritan roots.

I think the idea of 'safe houses' is a great idea. At least let's try.

It may not be politically correct to say so, but I think this is a horrible idea. Maybe we should provide "safety escorts" for people while they rob businesses to get their drug money, too.

I agree.

Specializes in Med/surg,orthopedics,emergency room,.

I just don't know. It's almost like drug use is being condoned,you know? Mixed feelings!

Specializes in Phlebotomist, nursing student.

Keep in mind that it's to their benefit not to find any crime. How about users who can't get a chair in the place in time for their next fix? They end up on the doorstep of a nearby business or home.

Now Seattle is talking about providing "clean" drugs for the addicts to use, free of charge. What is wrong with this picture? How about providing free drug treatment instead?

They already get free drug treatment.

Nope, nope, nope, nope. Why are we rewarding dangerous and addictive behaviors with zero consequences? This sounds like such a bad idea.

It isn't being rewarded.... it's being isolated. They aren't buying drugs there they are doing drugs there, supervised, by people trained to respond to emergencies.

I would like to partially retract my previous post. I didn't see the part about them being non-licenced trained volunteers. We aren't dealing with the nursing and medical ethics of promoting drug use. It's an organization preventing harm.

I'll say it again. Addiction is a disease. No one wakes up one day aspiring to be an expendable human being.

Getting every person in who walks through those doors treatment (assuming they are ready and want it) would be much cheaper on our system than the side effects of their disease... But even if we could get the funding we wouldn't have the facilities or practitioners to accomplish this.

If they inserted, maintained, and provided supplies for each addict to get a PICC line in that injection house it would still cost pennies compared to an uninsured indigent young adult being treated for Hep C on Medicaid. Some of my mother's meds costed $10k per pill. A foundation funds the drugs and each person we prevent from contracting it means someone else who needs the med gets it. Don't forget interferon, liver biopsies, blood work, imaging, and life-long monitoring.

Come on, we are a highly intelligent and educated population.... let's not act like an issue this big can have an answer that's right or wrong.

Come on, we are a highly intelligent and educated population....

Frankly, I don't see a lot of evidence for that statement. Unfortunately.

Perhaps you are referencing the posters on AN, rather than our population at large.

Frankly, I don't see a lot of evidence for that statement. Unfortunately.

Perhaps you are referencing the posters on AN, rather than our population at large.

I wouldn't even say it about the general AN population.

I wouldn't even say it about the general AN population.

Well, now that you mention it...

I am a needle exchange nurse, HIV/AIDs certified RN and am a strong supporter of harm reduction for injection drug users. There are nursing organizations in Canada and Europe who have been running needle exchanges and injection sites for many years. Check out Insite in Canada and the documentary Street Nurses about Canadian nurses working with injection drug users. I look forward to seeing more of these sites around the country run by nurses who support harm reduction and understand the utility of needle exchange.