“Safe” Opioid Injection Sites: Are We Biting Off More Than We Can Chew?

• Crying for a solution, a ground swell advocates for government-sanctioned opioid injection sites.
• Motives behind this initiative appear well intentioned, but mask serious problems.
• The long-term societal impact of such sites is unknown, and genuine concerns should be addressed before moving forward with such a program.

By their very nature, the drugs that were responsible for more than 1,100 North Carolinian deaths in 2015, and thousands more across the nation, are perilous. The use of illegal opioids, such as heroin and some forms of fentanyl, have caused unspeakable heartache to parents, spouses, and children of users. North Carolina has seen an 800 percent increase in opioid related deaths since 1999. Some researchers, such as Raleigh-based RTI International researcher, Dr. Alex Kral, believe supervised injection sites are a beneficial way to address this alarming trend.

A recent article by the Raleigh News & Observer provided insight into the character of this issue, when it broached the idea of supervised injection sites for recreational drug users. Supervised injection sites, primarily found in Switzerland, Germany, and Canada, are purportedly established to prevent opioid overdoses. These sites are one of numerous proposed solutions to the growing drug problem. In the world of drug prevention, they fall under the umbrella of what is called harm reduction.

The city of Seattle is the first community in the United States to push for such a site. However, it is facing resistance from surrounding cities, such as Bellevue and Federal Way, both of which have barred injection sites from taking up residence in their communities.

Advocates for providing a site where drug abusers could “safely” shoot heroin or fentanyl believe it would prevent overdosing. If the individual mistakenly overdoses, a site employee can immediately administer Naloxone, a medication designed to prevent overdose from its natural lethal consequences.

RTI International has released a commentary lauding the success of these supervised drug injection sites. Dr. Alex Kral states, “Supervised injection sites are an important evidence-based harm reduction strategy that should be considered for implementation in the United States.” To the extent that these sites have reduced the risks of HIV and Hepatitis in countries that allow them, we should be grateful.

The rationale behind the increasing push for safe injection sites undoubtedly comes from a place of good intentions. It springs from a desire to prevent needless deaths among those struggling with drug abuse. However, is it the right approach? This is an important question we must grapple with. How we decide will have long-term effects.

Take the historically hot button issue of abortion, as an example. One of the purported aims of Roe v. Wade was to prevent maternal deaths from illegal abortions. However, the legalization of this practice dramatically increased the abortion rate. Instead of abortions becoming rarer, they became more common and socially acceptable. One end was achieved: lower maternal death rates. Yet, a consequence of this court ruling was the endangerment of millions more children, especially those in minority and poor communities.

Governor Roy Cooper spoke to attendees of the Opioid Misuse and Overdose Prevention Summit in June on a plan to battle opioid abuse. The Governor said, “North Carolina is losing lives to opioids….This plan gives us a path to reduce these deaths and turn the tide on this crisis.”

The plan Gov. Cooper was referring to is known as North Carolina’s Opioid Action Plan, and it spans the next four years. This government initiative includes the 2016 Syringe Exchange Program, as well as education on the North Carolina Board of Pharmacy’s standing order on issuing on the overdose preventing medication Naloxone.

Whether or not North Carolina, or any other state, should support supervised injection sites is up for debate. There is no doubt that when lives are saved from potential overdoses, we should celebrate. Nevertheless, the unavoidable truth is that what we tolerate, both in the public and private sectors, teaches young children and teens what we believe about right and wrong. The law is a teacher.

There is a concern that these drug injection sites wouldn’t send the message we want young people to have. In fact, they may simply serve to normalize an extremely harmful lifestyle.

Undoubtedly there is much to be said about helping those battling drug addiction move past the encumbering societal alienation they feel, so that they can receive the substance abuse treatment they need. However, it is equally – if not more – important to send the correct message to young people, which is that recreational drug use is harmful and unacceptable. Can we accomplish both goals? Hopefully. Are injection sites a means to do that? While they may have benefits, such programs fail when we consider the long-term impact they will have on society.

The more our public policies facilitate drug use, even if it stems from the good intention of ending the opioid epidemic, the more likely we are to see a surge in its normalization. If you doubt this claim, look once again to the 1973 Roe v. Wade decision. The Supreme Court’s attempt to minimize illegal abortion procedures only served to standardize the practice, so much so that at its peak in the 80s and 90s, 1 in 4 children were being aborted.

The opioid crisis in North Carolina is a real problem that cries out for a solution. Supervised injection sites may still be years down the road for North Carolinians. However, it would behoove us to begin considering their many short-term and long-term implications now.