"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

Yes, because a child with leukemia waiting on a bone marrow transplant's family friends community and social circle are completely unaffected.

And I beg you not to insult your and my intelligence by saying one disease was chosen and the other wasn't.

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 guess I'm being too idealistic for my experience level. I have spent the better part of a decade trying to get educated clinicians to accept the application of research evidence to their practice.

Trying not to give up on our profession in general.

Specializes in Family practice, emergency.

Safe injection houses keep needles off the streets, can intervene in overdose, and is safer for our most vulnerable populations. Resources can be given for those looking for medically assisted therapy, rehab, or treatment for HIV/Hep C. These are diseases also less likely to be transmitted when clean needles are available. People have been chasing highs forever and they will use drugs if there is a safe space or not. So let's have it. It is a harm reduction method.

Specializes in ICU.
Many of them beg, prostitute themselves and use cheap, low-qualty drugs which kill them quicker and more painful. Real hard vore addicts will do pretty much anything to avoid police because being in custody = withdrawal.

Since we as society have no tools to force addicts into treatment (which is, in turn, notoriuosly low effective), everything that remains is to make using safer for everyone. This way, at least, you and me, hopefully, won't have those 3 to 6 months of soul-searching after an accident poke with insulin needle waiting for HIV and hep panel "window" to pass.

Although I too do not support making those "safe houses" pretty much about everywhere, especially near schools and known tourist zones.

This is as good a quote as any to illustrate why I am against the whole idea; forcing people into recovery doesn't work because it is pointless unless the person wants to recover, I speak from personal experience. Making it easier to do your drug of choice with less risk is called enabling, and delays treatment.

Specializes in Hospice.
This is as good a quote as any to illustrate why I am against the whole idea; forcing people into recovery doesn't work because it is pointless unless the person wants to recover, I speak from personal experience. Making it easier to do your drug of choice with less risk is called enabling, and delays treatment.

It also delays death and disability from hiv and hep c infections. Both for the addicts and their frquently non-addicted partners/kids, etc.

When did health care get to be about revenge?

Specializes in Public Health, TB.
This is as good a quote as any to illustrate why I am against the whole idea; forcing people into recovery doesn't work because it is pointless unless the person wants to recover, I speak from personal experience. Making it easier to do your drug of choice with less risk is called enabling, and delays treatment.

So are you also against immunizing users for Hepatitis A and B? Are you against providing clean needles and condoms? Should we refuse to treat illnesses related to drug injection, such as Hep C, HIV, cellutlitis, endocarditis? Isn't this enabling too, by keeping them alive?

Safe injection sites are not about forcing people into recovery, its about harm reduction, as has been noted in previous posts, and keeping the opportunity for recovery easily accessible. There is no research to demonstrate that harm reduction delays treatment.

This is as good a quote as any to illustrate why I am against the whole idea; forcing people into recovery doesn't work because it is pointless unless the person wants to recover, I speak from personal experience. Making it easier to do your drug of choice with less risk is called enabling, and delays treatment.

Person A over doses on the streets, spends weeks in an ICU, then moved down to a floor bed, then discharged, then the cycle is repeated.

Person B over doses at the site, is able to get help then and there. MAYBE spends one night in the hospital. Oh, and also doesn't spread HIV or any other disease because he or she used a clean needle. Visits the site a few times, notices that there are resources and support services....because that is the point of this service.

I am baffled that America is so behind, when usually they are the "leaders?" Hmm...

Person A over doses on the streets, spends weeks in an ICU, then moved down to a floor bed, then discharged, then the cycle is repeated.

Person B over doses at the site, is able to get help then and there. MAYBE spends one night in the hospital. Oh, and also doesn't spread HIV or any other disease because he or she used a clean needle. Visits the site a few times, notices that there are resources and support services....because that is the point of this service.

I am baffled that America is so behind, when usually they are the "leaders?" Hmm...

I am also baffled. If it's about health and numbers, you could justify this type of service for almost any type of crime.

Let me give you keys and directions to my home so you can rob it. I'll let you know when I'll be out so we don't encounter each other, because that could be unsafe for us both. I'll tell you where I keep my valuables, too ...so you don't have to ransack the house and destroy the stuff you're not interested in taking. Oh! And I'll lock up my dog because he might bite you and the wound could get infected. That would be just awful.

I'm so glad I won't have to pay to change my locks, or replace my front door, or replace my broken windows. It's a win-win!

There are some pamphlets about turning your life around set out on the kitchen table. No pressure, though!

I am also baffled. If it's about health and numbers, you could justify this type of service for almost any type of crime.

Let me give you keys and directions to my home so you can rob it. I'll let you know when I'll be out so we don't encounter each other, because that could be unsafe for us both. I'll tell you where I keep my valuables, too ...so you don't have to ransack the house and destroy the stuff you're not interested in taking. Oh! And I'll lock up my dog because he might bite you and the wound could get infected. That would be just awful.

I'm so glad I won't have to pay to change my locks, or replace my front door, or replace my broken windows. It's a win-win!

There are some pamphlets about turning your life around set out on the kitchen table. No pressure, though!

This is another example of the basic conflict between substance abuse as an illness vs. substance abuse as a crime. The official position of the healthcare community around the world, inc. the US, is that it's an illness. Not to mention the fact that we've been treating it as a crime for generations now in the US, and are getting exactly nowhere with that. But keep on feeling superior and outraged about any attempts to mitigate the harm and treat the illness.

This is another example of the basic conflict between substance abuse as an illness vs. substance abuse as a crime. The official position of the healthcare community around the world, inc. the US, is that it's an illness. Not to mention the fact that we've been treating it as a crime for generations now in the US, and are getting exactly nowhere with that. But keep on feeling superior and outraged about any attempts to mitigate the harm and treat the illness.

It is a huge criminal industry from the beginning to the end. There's just no denying that. If drugs could be legalized and people could manufacture/sell/buy them without robbing/burglarizing/assaulting/murdering, I'd have zero problem with their use. As it stands currently, yes, I am outraged ...whether politically correct, or not.

Specializes in Hospice.
It is a huge criminal industry from the beginning to the end. There's just no denying that. If drugs could be legalized and people could manufacture/sell/buy them without robbing/burglarizing/assaulting/murdering, I'd have zero problem with their use. As it stands currently, yes, I am outraged ...whether politically correct, or not.

Calling someone's opinion "politically correct" doesn't invalidate that opinion.

The criminalization of drug addiction was a social choice that, in my opinion, had nothing to do with public health and welfare. When you call someone a criminal, you don't get to be shocked and offended when they act like one.

Unlike murder, fraud, robbery, child abuse, etc., the state of being addicted is an artificial, socially constructed crime. We can choose to deconstruct it and start treating it like any other mental illness, or we can continue to force it outside the boundaries of law abiding society, thereby increasing the profit for the pushers, violent cartels, et. al. I mean, who's really enabling whom, here?

Specializes in NICU.

I agree that America is so behind when it comes to this concept. Canada does a lot of good work in harm reduction, including safe-injection sites and street nursing. It's a big thing here. The research is clear that safe injection sites DO NOT enable drug use, as so many here suggest. Drug users are going to use drugs regardless if you give them a safe space to do it or not. I'm sure mostly everyone knows that HIV/AIDS, Hep C etc. are not curable diseases and cost the health care system millions in treatment. It's true, an addict isn't going to get help unless they choose it...but it's going to be a hell of a lot easier to help them choose it in a place that promotes rehab and wellness (not drug use, as many here seem to think). Many addicts simply don't know where to turn, or need that extra push from someone to get the help that they need. I find the attitude that drug users decide to become addicts and therefore are undeserving of medical treatment quite disgusting frankly.

+ Add a Comment