Safe Injection Sites for Heroin Addicts: Helpful or Harmful?

Heroin overdose deaths in the U.S. have more than quadrupled since 2010, with overdose deaths increasing by 20.6% between 2014 and 2015. But new evidence shows that safe injection sites can reduce the number of drug-related deaths.

People who inject heroin are often at greater risk for death than those who snort or smoke this illicit opiate since needles can easily spread long-term viral infections that threaten public safety. Heroin injection sites would help reduce the harm of injecting heroin by providing heroin addicts with clean, sterile needles. Sites would also have medical staff who could intervene during an overdose, helping reduce the overdose death rate.

Here’s a closer look at what happens at safe injection sites, along with common beliefs and misconceptions surrounding this controversial new program for heroin addicts.

What are Safe Injection Sites?

Safe injection sites are exactly that — safe places addicts can visit to use drugs and face a lower risk for infection, disease, and overdose. But injection sites offer heroin users far more than just a clean needle and a comfortable place to sit. Heroin addicts who visit injection sites have access to experienced medical staff, educational materials about drug use and addiction, and referrals to drug detox centers that can help them get clean. Heroin injection sites also have naloxone on hand so heroin overdoses can be reversed the moment they happen.

Safe injection sites are a form of harm reduction — which means they reduce the negative impact of behaviors like drug abuse on citizens and communities. Harm reduction programs tend to approach drug use in a more realistic way, such as understanding that some people will choose to stay addicted to heroin without seeking help. Harm reduction programs aim to avoid judging people who struggle with addiction, while reducing the impact of heroin use and overdoses on the economy, since incarceration, hospitalization, and legal fees can cost the U.S. up to billions of dollars every year.

At first glance, heroin injection sites may seem like a counterproductive way to lower rates of heroin use and overdose deaths. But studies show that heroin injection sites can reduce overdoses, keep neighborhoods free of dirty needles, and prevent the spreading of viral, fatal diseases.

Where are Safe Injection Sites Located?

At this time, there are no legal safe injection sites open in the U.S. Safe injection sites remain a hotly debated topic in the U.S., as lawmakers and citizens wrestle with whether this harm reduction method is actively helping Americans. However, safe injection sites can be found in Canada, Australia, and many European countries including Switzerland, Germany, and Denmark.

Philadelphia has announced it wants to be the first state to open a heroin injection site, since the city has the highest opioid death rate among large U.S. cities. Officials say Philadelphia’s opioid crisis is mostly concentrated in one particular neighborhood that has access to some of the cheapest, purest, most potent heroin in the U.S. Seattle has also announced it wants to open a safe injection site and has allocated $1.3 million for the program. Other states with plans to open safe injection sites to battle the opioid epidemic are Denver, San Francisco, Ithaca, and New York.

Addressing Common Beliefs and Misconceptions About Safe Injection Sites

It’s normal for some people to be against safe injection sites out of concern for loved ones who may struggle with heroin addiction, or out of fear their neighborhood may suddenly attract a higher number of heroin addicts. While safe injection sites have both pros and cons, the facts surrounding the efficacy of this harm reduction program can help you decide where you truly stand on this issue.

Here’s the truth behind five common beliefs and misconceptions about heroin injection sites:

Statement #1: Safe Injection Sites Will Increase Drug Abuse in the Area

False — Safe injection sites do not cause an increase in drug use, they simply provide a safer way for addicted individuals to use drugs.

Safe injection sites allow for fewer instances of public injecting, resulting in fewer syringes being discarded on streets and in neighborhoods. A recent analysis shows that heroin injection sites are often highly effective at attracting heroin addicts who inject on the streets in risky, unsanitary conditions. Safe injection sites also allow people to inject heroin in a safe, controlled medical environment away from children and others who may be easily influenced or susceptible to drug abuse and addiction.

Statement #2: Safe Injection Sites Will Increase Crime Rates in Surrounding Communities

False — Research shows that safe injection sites are linked to fewer encounters with law enforcement in nearby communities, along with reduced rates of street disorder and crime.

Since addiction is already linked to higher crime rates in general, many believe that injection sites will increase crime rates in nearby communities by default, since these sites exist to serve heroin addicts and other drug users. Studies conducted on crime rates in communities surrounding Canada’s safe injection site in Vancouver, called Insite, found that there was no increase in robberies, assaults, or drug trafficking following the opening of the site.

Statement #3: Safe Injection Sites Can Reduce Infection and Disease

Providing sterile needles reduces the spread of disease.

True — Safe injection sites provide heroin addicts with clean, sterile needles and other materials that help lower the risk of infection and disease.

Many heroin users will use the same needle repeatedly and fail to fully sanitize the needle after each use. Blood remnants can quickly accumulate bacteria, which can then lead to the development and spreading of viral diseases upon needle reuse. This can cause public health issues that affect not only addicts, by nearby communities. A Lancet study shows that communities surrounding Vancouver’s Insite saw HIV infection rates decline by 5.8% within one year after the center was opened.

Statement #4: Safe Injection Sites Will Lead to A Higher Number of Drug Overdoses

False — Safe injection sites have access to an opioid overdose reversal drug called naloxone, which can instantly revive an overdose victim within seconds.

There are also medical staff available at safe injection sites to oversee drug use, and step in if overdose symptoms start to occur. Some safe injection facilities even offer drug testing strips, so users can check if their substance is cut with anything dangerous, such as fentanyl. Case studies conducted on Vancouver’s Insite show that the number of drug overdoses in nearby communities decreased by 35% within one year, while overdoses throughout the rest of Vancouver only decreased by 9%.

Statement #5: People Who Visit Safe Injection Sites are More Likely to Get Treatment

True — The number of people who sought drug detox treatment in Vancouver increased by 30% after the city opened its heroin injection site.

Safe injection sites are welcoming and open to people who struggle with heroin dependence, and aim to help remove the stigma surrounding addiction. Medical staff are available to educate heroin addicts about the dangers surrounding continued drug use and can provide referrals to nearby drug detox centers that can help them safely get clean with fewer health risks.

Examining the Success of Current Safe Injection Sites

Numerous studies conducted on the impact of Vancouver’s safe injection site show that the pros far outweigh the cons in terms of helping heroin addicts stay alive, and improving the health and safety of people in neighboring communities. Since the site opened in 2003, there have been 6,440 overdose interventions without any deaths.

Of the 6,500 people who visited Vancouver’s safe injection site in 2015, 464 were referred to a nearby drug detox center, and 252 were able to finish treatment and achieve long-term sobriety. An additional 4,000 people received medication-assisted treatment using methadone or buprenorphine — both of which are drugs that relieve cravings and withdrawal symptoms so patients can recover from heroin addiction at a slower, more comfortable and gradual pace.

Another case study conducted on the efficacy of safe injection sites surveyed a number of heroin addicts who visited an illegal safe injection site in the U.S. The survey revealed that prior to visiting the injection site, more than 67% of users had disposed of their syringes unsafely within the last 30 days before they were able to start disposing of them safely at the site. Additionally, the facility prevented over 92% of injections from occurring in public places like streets and restrooms — lowering rates of exposure and police arrests.

The Importance of Harm Reduction Programs in the U.S.

Harm reduction programs like safe injection sites help reduce the stigma surrounding addiction by accepting both the problem and the heroin addict, and by connecting the addict with treatment. Heroin users can visit these sites without being judged for their struggle with addiction, and perform injections knowing they’re surrounded by experienced medical staff who can intervene at any time to prevent an overdose.

Advocates for heroin injection sites say that the only way heroin addicts can turn their lives around is to stay alive long enough to receive medical intervention in the form of addiction treatment. Addicts who visit the sites and who interact with medical staff regularly may indirectly become motivated to get sober and seek treatment, while others may be ready to overcome heroin dependence only after being revived from an overdose.

Harm reduction programs are often highly cost-effective and may help improve the U.S. economy. A study conducted on the cost-effectiveness of Vancouver’s safe injection site revealed that the facility was associated with a net savings of nearly $14 million within a 10-year period that would otherwise have been used toward hospitalization, incarceration, legal fines, and other drug-related costs. The savings on medical treatments for heroin-related diseases like hepatitis C and HIV were also included in this amount.

Safe injection sites in the U.S. could also help reduce the number of fatal overdose deaths being caused by heroin that is mixed or cut with fentanyl — a powerful opioid up to 50 times stronger than heroin. Vancouver’s heroin injection site recently launched a pilot program that allows users to check their drugs for fentanyl to help lower their risk for a deadly overdose since naloxone is sometimes not powerful enough to reverse a fentanyl overdose. Fentanyl was linked to over 20,000 overdose deaths in the U.S. in 2016 and is projected to cause more deaths in upcoming years.

Conclusion – Safe Injection Sites are Helpful

America is suffering from a serious opioid epidemic that includes booming rates of heroin use. Safe injection sites can help lower the risk for fatal opioid overdoses that are killing Americans at a rate of over 115 deaths per day. Heroin injection sites also increase admissions rates to drug detox centers so heroin addicts can improve their health, and learn how to fill their lives with new fun sober activities that completely replace drug use.

While heroin injection sites may still be controversial among the general population, this harm reduction program has been proven to make neighborhoods and communities safer. It has also given many addicts a chance to regain control of their lives, by providing access to detox centers.

Many drug detox centers treat heroin addiction using a combination of detox and therapy. Medical detox and medication-assisted treatments involve the use of FDA-approved medications that fully eliminate heroin withdrawal symptoms, which reduces the risk of relapse. Instead of having to quit cold turkey and worry about surviving withdrawal on their own, heroin patients can receive professional medical care that relieves the worst of their symptoms — including drug cravings.

After overcoming heroin dependence with drug detox, patients can receive therapy to learn how to manage triggers, along with other skills that help them stay sober. Cognitive-behavioral therapy, support group therapy, and motivational enhancement therapy are just some examples of therapies that can treat the underlying causes of heroin addiction, and promote long-term sobriety.

If you’re a heroin user who needs help becoming sober, please understand you’re not alone in your fight, and that help is nearby. Call our confidential helpline at 800-996-6135(Who Answers?) to speak about your treatment options. We’ll guide you toward the nearest drug detox center ready to help you achieve a healthier, addiction-free lifestyle.