Why Safe Injection Sites Are Considered More Effective Than Needle Exchange Programs

New research shows that safe injection sites are an effective option for reducing harm among people who inject drugs.

The study, released by the Institute for Clinical and Economic Review (ICER), found that safe injection sites help prevent deaths from drug overdoses when compared with needle exchange programs.

Dr. David Rind, ICER’s chief medical officer, noted that policymakers are often hesitant to adopt these programs.

“However, the evidence we reviewed over the past year — along with the input we received from community leaders, clinical experts, law enforcement, and people who use drugs — suggests that [safe injection sites] can deliver a clear public health and economic benefit for communities that currently experience high rates of overdose deaths,” he said in a press release. “[Safe injection sites] save lives and save money.”

The study doesn’t come as much surprise to two doctors interviewed by Healthline, who said that safe injection sites are a pragmatic approach to mitigating drug use risks.

A safe space

Dr. Christopher Johnston, the chief medical officer at Pinnacle Treatment Centers, told Healthline that these sites allow people to begin treatment without being forced to do things they’re not ready to do yet, such as going “cold turkey” to quit.

“Coming to a safe injection site, they find a place that has kind people who are willing to assist with things that reduce the suffering of untreated substance use disorders, and it appears to motivate people to take incremental steps toward better health, and sometimes toward participating in conventional substance use disorder treatment,” Johnston said.

“These sites have robust data to support their existence, but I feel their most important role is demonstrating that compassionate care yields spiritual benefits that cannot be scientifically measured,” he added.

Dayn Kent, a community health worker at Moss Park Overdose Prevention Site in Toronto, Canada, told Healthline that safe injection sites provide a middle ground for people who use drugs — one that’s safer than using on the streets but doesn’t overtax healthcare systems.

“Safe injection sites save money by preventing stress on downstream services like emergency rooms and paramedics,” Kent said. “The cost saving lowers tax burden and frees up resources to care for other members of society who need it.”

He also noted that the hands-on approach of safe injection sites offers a few benefits over needle exchange programs, including having staff on hand to prevent overdoses along with keeping drug use out of public spaces.

Why aren’t there more?

Proposals for safe injection sites in the United States often lead to a protracted debate.

Last February, plans for the first safe injection site in Philadelphia were rejected after encountering opposition.

Dr. Emily Kauffman, an osteopathic physician at The Ohio State University’s Wexner Medical Center, told Healthline that these sites are a proven success in other parts of the world.

She added that she hopes lawmakers take the ICER findings seriously.

“Vancouver, Canada, has had safe facilities sites since 2003, [like] Insite, without any reported overdose fatalities, and offers immediate linkage to care if desired — literally right beside the injection site,” Kauffman said.

“Many European countries have also utilized this model with success, leading to decreased hospital utilization, decreased mortality, decreased rate of infectious diseases, decreased use of the criminal justice system, and increased access to treatment,” she said.

Kauffman said the United States has a more moralistic view toward addiction.

“It’s seen as a disease of ‘choice’ rather than the complex and chronic brain condition that completely hijacks reward pathways,” she said. “Unfortunately, addiction negatively impacts the complex reward circuitry in the deep parts of the brain, leading to poor coping skills and extreme risk-taking behavior that is often deadly.”

Recovering from a substance use disorder, including opioid use disorder, is possible, but it takes time and treatment, such as medications like Naltrexone.

Kauffman said that safe injection sites operate on the principle of harm reduction: the idea that it’s more pragmatic to decrease the risk of harm, like death or infection, than to tell people to simply stop using drugs.

“By keeping patients safe and alive, we recognize the chronicity of addiction and provide them with another chance to engage in recovery services,” she said. “Providing clean syringes, Narcan, medication for opioid use disorder, peer support, and infectious disease testing adopt the principles of harm reduction.”

Kent said his experience at a safe injection site in Toronto shows that these facilities provide an inclusive place where people can find support, even if they feel rejected by other members of society.

“They provide a sense of community and inclusiveness that individuals rarely find outside of our walls,” he said. “This community aspect of our site is something that helps people alleviate the loneliness and isolation that they experience because they’re stigmatized as street-based substance users.”

Source: Read Full Article