Do heroin injection facilities actually work?

Are “safe sites” that facilitate heroin use helping or hurting the opiate epidemic in the U.S.? A review of what’s happening on the ground by Clare Waismann, founder of the Waismann Method®. More here.

minute read
By Clare Waismann

The opiate epidemic in the United States, especially heroin addiction, continues to rage. States and municipal governments are struggling to find a way to cope.

In 2014, more than 28,000 people died from opiate-related overdoses, the deadliest year on record, according to the Centers for Disease Control and Prevention (CDC). Now, some municipalities in the United States are turning to a counterintuitive idea to address the problem of opiate addiction and overdose: providing “safe sites” for those addicted to heroin to shoot up. Unfortunately, this might only exacerbate the problem by enabling heroin abusers to keep using in a safe haven environment, while failing to identify and treat their underlying problems.

Does this idea actually work? We review here. Then, we invite your questions or feedback about heroin injection centers at the end. In fact, we try to respond to all comments personally and promptly.

The Scope: A Focus on Heroin Abuse

More than 21 million Americans have some type of substance use disorder, and an astonishing 586,000 suffer from heroin abuse, reports the American Society of Addiction Medicine (ASAM). Among those who try heroin, nearly 1 in 4 will develop an opioid addiction of some kind. Additionally, some people who begin abusing prescription painkillers go on to use heroin because it is potent and cheaper than buying prescription drugs.

Sadly, this leaves hundreds of thousands of Americans vulnerable to the emotional, psychosocial and medical consequences of heroin abuse. There have been numerous reports of new synthetic opioids — some of which are hundreds of times more potent than morphine — popping up in regions around the country. Heroin is often laced with these synthetic opioids, making it more powerful than users realize. This is just one of the factors that has contributed to the skyrocketing rise of opioid-related overdose deaths in this country.

Creating “Safe Sites” for Heroin Users

A recent task force study in Seattle recommended that the city move forward with a controversial plan to create supervised clinics for heroin injection. Technically known as Community Health Engagement Locations, these so-called “safe sites” allow people addicted to heroin to shoot up in a supervised setting.

The purpose of creating safe sites in Seattle is part of a broader move toward “harm reduction” campaigns in the war on drugs. Why is harm reduction so important? Current drug policy is punitive toward those struggling with substance abuse. Possession or use of drugs such as heroin can lead to:

  • Prison time
  • Fines
  • Custodial changes or loss of parental rights
  • Other harsh penalties that limit a person’s ability to get help

The idea behind supervised heroin injection clinics is to create a safe space in which those struggling with heroin abuse can use the drug without experiencing the risks associated with street use. At the clinic, individuals bring their own heroin but are provided with sterile needles to reduce the risk of hepatitis or HIV transmission. Clinic staff are also on hand with opioid antagonist drugs, which rapidly block the effects of opioids in the brain. These drugs can reverse an opioid overdose while it is occurring, preventing deaths.

Seattle is not the first locale to begin establishing heroin injection sites staffed by public health workers. The city is modeling its initiative after a similar program in Vancouver called InSite. During the 13 years of its operation, InSite claims it has never had a heroin overdose death inside one of its locations.

Evaluating the Evidence: Do Heroin Injection Facilities Actually Work?

Proponents of the harm reduction model of drug abuse believe that heroin injection sites may actually help people get clean over the long run. They argue that the most important thing is to get heroin users in the door to receive basic medical services in a safe, non-punitive environment. Over time, some heroin users at the injection facilities decide to get help. Thus, proponents of the safe sites argue that the facilities can help to combat opioid addiction.

However, the evidence in favor of these sites is limited. Despite having a heroin injection facility that has been in operation for 13 years, it is unclear that Vancouver’s InSite has had a positive impact on the overall heroin abuse in the city. Critics argue that drug dealers have flocked to the area, lured by the prospect of selling to InSite visitors who are allowed to possess heroin. Many argue that the site has led to higher crime, abandoned needles, and other dangers to those who live in the area. Plus, those struggling with heroin addiction are still vulnerable to drug overdose when they are not at a legalized injection facility.

How are we really treating heroin addicts?

At a more fundamental level, the proposal to establish safe sites in Seattle raises questions about how we treat those suffering from substance abuse. There is no question that the “War on Drugs” has failed. Punishing those experiencing drug abuse does not eliminate the source of the problem. Instead, we must think about how to expand treatment resources to the vulnerable people suffering from addiction. In many cases, people addicted to heroin first began using the drug to cope with immense physical or psychological pain.

First, we must expand access to effective opioid detox programs. After that, individualized mental health assessment and obtainable long term treatment is needed to address the underlying source of the addiction cycle. The resources being used for legalized injection sites would be much better spent on expanded access to education, drug detox followed by mental health treatment and social services for those vulnerable to opioid abuse.

Reference Sources: CDC Drug Overdose
ASAM: Opioid addiction facts & figures
The L.A. Times: Giving heroin addicts ‘safe sites’ to shoot up
The Toronto Sun: Experts challenge Vancouver’s safe injection stats
About the Author: Clare Waismann, CATC, (Certified Addiction Treatment Counselor), is the founder of the Waismann Method®. The Waismann Method® has provided the latest medical techniques to treat opioid dependency followed by a specialized and individualized recovery care. Almost two decades later the center has established a superior reputation worldwide for achieving exceptional results.
About the author
The Waismann Method® treatment provides one of the highest success rates of any opiate detoxification procedure available today. Combining the latest forms of Medical Opiate Detox (including Rapid Detox), with our Exclusive Recovery Center, our multidisciplinary team of highly trained staff members creates personalized treatment plans based on each patient’s individual needs. The Waismann Institute® is backed by 18 years of unparalleled experience, dedication, and exceptional care.®

1 Comment

Leave a Reply

Your email address will not be published. Required fields are marked *

I have read and agree to the conditions outlined in the Terms of Use and Privacy Policy.

  1. See the PROVE studies et al. Stop the drug war with objective of shutting down the black market. The drug war has failed. The drug war is driving the problems, not fixing them. Decriminalization/legalization is necessary, it needs to be backed up with public health announcements explaining exactly why it is needed. Its not in any way condoning the abuse of addictors, it is done bc the alternative, the drug war, has made things infinitely worse on almost every level, to include making drugs abundantly available to any & all that wants them.
    We need to pull LE out of the drug biz – that will free up a lot of resources currently chasing their collective tails. When the laws create more harm and cause more damage than they prevent, its time to change the laws. The $1 TRILLION so-called war on drugs is a massive big government failure – on nearly every single level. Its way past time to put the cartels & black market drug dealers out of business. Mass incarceration has failed. We cant even keep drugs out of a contained & controlled environment like prison.
    We need the science of addiction causation to guide prevention, treatment, recovery & public policies. Otherwise, things will inexorably just continue to worsen & no progress will be made. Addiction causation research has continued to show that some people (suffering with addiction) have a “hypo-active endogenous opioid/reward system.” This is the (real) brain disease, making addiction a symptom, not a disease itself. One disease, one pathology. Policy must be made reflecting addiction(s) as a health issue.
    The war on drugs is an apotheosis of the largest & longest war failure in history. It actually exposes our children to more harm & risk and does not protect them whatsoever. In all actuality, the war on drugs is nothing more than an international projection of a domestic psychosis. It is not the “great child protection act,” its actually the complete opposite.
    The lesson is clear: Drug laws do not stop people from harming themselves, but they do cause addicts to commit crimes and harm others. We need a new approach that decriminalizes the disease. We must protect society from the collateral damage of addiction and stop waging war on ourselves. We need common sense harm reduction approaches desperately. MAT (medication assisted treatment) and HAT (heroin assisted treatment) must be available options. Of course, MJ should not be a sched drug at all.
    Every human being is precious, worthy of love and belonging, and deserves opportunities to fulfill his or her potential regardless of past trauma, mental and emotional anguish, addictive behaviors or mistakes made.

I am ready to call
i Who Answers?