"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

The failure to acknowledge the concept of ‘for the greater good'?

For a lot of us, I'm afraid so. America was built on "rugged individualism," y'know, AKA "I got mine, screw you, Jack." Lots of people here are (unfortunately) proud of that. :(

Specializes in Community, OB, Nursery.

From a public health perspective, this is a fantastic concept and I can't believe it's taken the US such a long time to even consider the concept. This has been a thing around the world for a very long time.

No sane medical provider is going to promote illicit drug use as a positive life choice. Neither is alcoholism, but that didn't stop us from giving our alcoholics beer TID with their meals to keep them from going into DTs while hospitalized. If a person has no interest in quitting, the best rehab in the world is going to be a waste of everyone's time and money.

Next best thing? Reduce what risk you can. Make sure people have clean needles. Have sharps boxes in public restrooms (this is already a thing I've seen, so hooray) so they're not left lying about to stick others accidentally, or so other folks can't come along & use it to shoot up. The fewer people walking around with HIV, HepB, and HepC the better. The fewer ED visits for an ODed John Doe, the better. There's no reason a needle exchange depot can't have information about rehab as well for those who are considering quitting. This doesn't have to be an either/or proposition.

Specializes in Critical Care; Cardiac; Professional Development.

Proud American here and I would argue that those addicted to drugs are ALSO victims of it. This "Screw them, they ASKED for this by not stopping doing drugs" mentality has gotten us exactly where we are - a dirty disease in which the primary intervention is public shame, as evidenced by this thread.

I do not think clean/safe houses are the answer, but I sure as heck know that the attitude of "help the victims, screw the addicts" isn't the answer either. Until we start to see this as a disease, research it as a disease and treat it like a disease, it is going to continue to kill, both those affected by the disease and those caught in the line of the disease fire. I find the willingness to throw out the addict completely to be shameful.

It should not be mutually exclusive. We can help victims of the violence drugs brings AND help the addict too. Both can be done with humility and compassion.

Specializes in Geriatrics, Home Health.

My town, which recently banned cigarette smoking in parks, is seriously considering safe injection sites for heroin users.

I used to live near a methadone clinic. Apparently, it was a great place to score drugs. It attracted a lot of drug sellers and thieves. I also lived in a town that somehow thought it was a good idea to put a methadone clinic next to a high school.

In my opinion, if safe injection sites are such a good idea, they need to go in wealthy neighborhoods. Anyone who supports the idea should have to live next door to a safe injection site for a year.

Specializes in Geriatrics, Dialysis.

While I fully agree that addiction is a disease that is poorly manged it's not just the addict that is affected. I have a hard time getting on board with a program that condones and supports illegal drug use rather than treatment. Unfortunately addiction is disease that does as much harm to the addicts families, friends and community as it does to the addict. It's not OK with me to provide a safe house to inject drugs that were purchased with money that was stolen from their families, friends or from strangers when the well of money from family and friends ran dry.

While I fully agree that addiction is a disease that is poorly manged it's not just the addict that is affected. I have a hard time getting on board with a program that condones and supports illegal drug use rather than treatment.

Supervised injection sites are not condoning and supporting drug use rather than treatment, part of the point is to provide a pathway to treatment.

Next let's open a "safe house" for non-compliant diabetics to eat as much junk food and sugary sweets as they want, with absolutely no consequences. They're going to do it anyway and we'll be there to bail them out when they go into DKA!

Specializes in Transitional Nursing.

It's an epidemic. Take it from someone who lives a stones throw from Cape Cod.

These places save resources, provide assistance when the person is ready and make it safer all around.

Addicts are going to use until they choose to get help. Thats all there is to it.

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.

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.

If it was just safe injection sites, I would agree with you. However, the sites (again, basing this off the Vancouver model) promote detoxification and rehabilitation. They have an interdisciplinary team involved in addressing the cause of a patients addiction and trying to work with the patient to address concerns. I recommend reading through the link I attached in the first post. It's a summary of the peer reviewed research published and written in a manner that makes it accessible.

Specializes in PMHNP-BC.
:roflmao: I love that they draw the line at smoking...lolololol....
Where do these hard-core addicts get the money for their daily highs? And how much of that type of crime is drug related? I've been robbed at gunpoint a few times. The thought of the robber hopping over to get high in a safe and supervised situation makes me ill.

How many is a few? You have been quite fortunate.