A case for safe injection facilities in Chittenden County

Guest Column: A case for safe injection facilities in Chittenden County
By Zach Rhoads
By Observer November 30, 2017

During a press conference Wednesday, State’s Attorney Sarah George announced she will support legislation to legally permit state-run “supervised injection facilities” — where drug users are permitted to consume or inject drugs under medical supervision.
George spoke on behalf of a commission she launched in February, tasked with deciding whether these facilities could curtail harms associated with intravenous drug use in Chittenden County. The group of drug treatment, health care and law enforcement experts made a unanimous decision to support the proposed bills (S.107 and H.108).
“When people first asked me about (supervised injection facilities), I had no idea what they were, and I got a little uncomfortable with it,” she told me. “But after doing some research, I found that they were shown to save lives, which was enough for me to make this a very public conversation.”
Indeed, SIF, as they are called, are widely known to reduce harm and social costs related to injection drug use. One of the key features of these facilities is having medical staff on board to save lives, should anyone overdose. Among the 100 such facilities that already exist within 10 countries worldwide, every public health metric is headed in a positive direction.
But the concept is literally foreign to Americans — no SIFs exist in the U.S. — and many citizens of Chittenden County have serious concerns around the concept. That’s why Sarah George and the commission wrote a detailed, publically-available report.
“The report outlines all the pros and cons the best we can,” George explained, “People want to know, is there a risk of people driving under the influence? Is this going to cost taxpayers a lot of money? Will this increase crime around the facility? Does this enable drug use?’”
The weight of evidence overwhelmingly contradicts those fears. SIFs reduce public injecting, increase voluntary enrollment in treatment, reduce bloodborne diseases, minimize overdose-related deaths, and save money due to reduction in emergency services. George added something crucial regarding the fear that we will enable drug users: “Research has shown that it is not true,” she said. “If anything, the people who will use a safe consumption site are already using. So yes, we are enabling — we are enabling people to make safer choices than they were before.”
These facilities are effective because they are woven into the social fabric. People use drugs in dangerous ways because stigma and fear of legal sanctions deter them from seeking help. Their isolation prevents them from accessing available resources, leading to unsafe use that multiplies their chance of dying. SIFs remove users’ fear of stigma and legal consequences, making it easier for them to access treatment and to further integrate into a non-using lifestyle.
Public fears around SIFs are eerily similar to the fears around Burlington’s syringe exchange program (Safe Recovery) before it opened in 2001. It’s worth mentioning, Safe Recovery has been beneficial for public health since day one. It helped reduced much of the harm associated with intraveinous drug use, including HIV and Hepatitis C. The program still provides clean drug injection equipment, medical assistance, naloxone (an overdose antidote) and on-the-spot referrals to evidence-based treatment. It even provides support with housing, insurance and legal problems, understanding that people must become stable before they can make positive long-term changes.
Perhaps it will ease the minds of concerned citizens to think of a safe injection facility as a logical extension of Safe Recovery. It would likely include all of the tried-and-true health services currently available while also providing a safe and hygienic setting for injection with medical staff aboard should an overdose occur (there has never been a death at any of the 100 SIFs around the world).
Given our current public health crisis, it would be unwise to ignore any serious attempt to reduce harm. With SIFs, there is abundant evidence of effectiveness.
While there is currently no specific plan to open a facility in Chittenden County, the proposed legislation could lay the legal foundation for that process. The state’s attorney’s commission will present its report at a legislative session Jan. 5.
Zach Rhoads is a graduate of Williston Central School and Champlain Valley Union High School. He is an interventionist at South Burlington High School and member of the Chittenden County Opioid Alliance.

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