Could Supervised Consumption Sites Help Fight The Overdose Epidemic?

The fight to support drug users and keep them from dying has earned support from Presidential candidates

By Adryan Corcione 

Young people are dying before they ever have a chance to recover from opioid addiction. A 2018 survey from the Substance Abuse and Mental Health Services Administration shows that approximately 1.9 million young adults aged 18 to 25 misused opioids in 2018. While use is relatively low among teenagers, overdose rates among young people are still concerning: The National Institute on Drug Abuse for Teens says that in 2017, at least 4,400 people aged 15-24 died from opioid overdose-related deaths.

And what would you do if you do want to receive treatment? Traditional recovery methods often don’t work, and if you’re a minor, you could be disqualified from medically-assisted treatment (MAT) altogether — you must be 18 to receive methadone treatment and 16 to receive buprenorphine treatment, in part because testing for young people specifically doesn’t exist yet. All of that assumes you get tapped into a program at all. Stigma, lack of general knowledge about recovery, and overall inaccess all contribute to disenfranchising people from getting professional help.

However, there’s a (not-so-new) strategy to help drug users get access to care that’s gaining political support in the U.S.: In August, presidential hopeful Bernie Sanders advocated for legalizing safe consumption sites in addition to supporting pilot programs and other overdose prevention initiatives. The endorsement was part of his criminal justice plan, which included a pragmatic approach to drug policy that struck a chord with many people concerned with the war on opioids. Shortly after, fellow Democratic candidate Elizabeth Warren also called for legalizing safe consumption sites in her own criminal justice plan.

Safe consumption sites — otherwise known as safe injection sites, supervised injection sites, supervised consumption sites, or overdose prevention sites — provide a space for drug users to take drugs under medical supervision. That way, if an overdose occurs, staff are available to respond. While SCSs do not facilitate or actively encourage drug use, they do offer wound care, referrals to primary care, and other help. A SCS in Vancouver, Canada, for instance, also advocates for Housing First, citing the correlation between drug abuse and homelessness.

Their strategy also involves medical professionals — including recovery specialists and social workers — building compassionate relationships with drug users, so they are more likely to seek out treatment. According to the Drug Policy Alliance, there are 120 SCSs operating in 12 different countries, including Australia, Denmark, France, Germany, Luxembourg, the Netherlands, Norway, Spain, and Switzerland.

The SCS model is rooted in harm reduction, a framework which Harm Reduction International describes as “grounded in justice and human rights” as it focuses on “working with people without judgement, coercion, [or] discrimination,” and doesn’t require anyone to stop using drugs. The HRI argues that if we accept drug use is part of society and not an individual failure, we can eliminate some of the stigma that stops drug users from seeking treatment to begin with.

“The stigma around drug use is a massive issue that is causing harm to real people,” Roo Parkhe, a SOL Collective outreach organizer and student at Temple University, told MTV News. “When you think of drug users as ordinary people, it makes it much more painful to consider the things that they are forced to endure. It also allows people to consider rehabilitation in a much more realistic light.”

Beyond fighting stigma, these community centers have been proven to greatly reduce drug overdoses in the areas they’ve been installed. According to a 2019 academic paper, a facility in Sydney, Australia, reported no deaths among 5,925 overdoses from 965,000 supervised injections from 2001 to 2015. Additionally, in Barcelona, Spain, a facility reported a 50 percent drop in overdose-related deaths between 1991 and 2008 after it introduced SCSs.

Ryan Marino, an emergency physician and medical toxicologist, told MTV News that SCSs would have the same result if implemented in the U.S. “These centers are equipped to give people who use drugs the resources to help them recover when they are ready,” he said. “Nobody can recover if they overdose by themselves, and it's much more difficult to recover without any resources in place.”

And while Americans may not have quite the same public affection for the sites as other nations, that could also be a matter of location, and of how close people are to the overdose epidemic. A 2018 study by Johns Hopkins University showed that only 29 percent of respondents supported legalizing SCSs in their communities and 39 percent supported legalizing syringe services programs in their communities. Meanwhile, 2019 research by Drexel University found that 90 percent of residents in Kensington, a North Philadelphia neighborhood disproportionately impacted by drug use, said they favored a SCS opening in their area.

Another common criticism to SCSs is about public funds being used towards drug use. The reality is that taxpayers are already paying for needle-exchange programs and emergency medicine are also massive public expenses, though some insurances do cover both generic naloxone and Narcan. But these programs are also ultimately worth their cost: Research has shown that needle exchanges have produced an overall more healthful society by significantly reducing the spread of HIV and other blood-transmitted diseases, USA Today reported, and the WHO posits that 20,000 people might be kept alive every year if Narcan and naloxone were more readily available.

And although a legal SCS has yet to open in the U.S., that doesn’t mean folks haven’t tried: The mayor of Somerville, Massachusetts, plans to open a safe injection site next year, Utah lawmakers are planning to file bills to create SCSs, and in 2018, a nonprofit called Safehouse was planning to open an SCS in Philadelphia before facing legal issues including a lawsuit by the federal government.

Medical support may not serve as an immediate recovery fix, but as Marino said, “the alternative to a safe or supervised consumption site is an unsafe and unsupervised site.” While he still recommends that people carry and be trained in administering naloxone, he adds that “a much better solution would be making people safe before they overdose rather than trying to reverse the danger afterwards when it is often already too late.”

While the fight to legalize SCSs is still ongoing, it’s powerful that presidential candidates have taken stances in support of them. Not only does this help increase awareness of sensible drug policy, but it gives those living with opioid addiction a chance to recover.

“Right now, the [government’s] strategy is: make drugs illegal, clear camps out, and hope the drug users magically go away — this is not working,” Parkhe added. According to the Harvard Medical School, only 25 percent of methadone patients eventually abstain from opioid use; statistics like those suggest that perhaps it’s time to invest in alternative treatments, if the old way just isn’t working. “SCSs are a step in the right direction as far as treating addiction like a disease, treating drug users like human beings, and making communities a safer place.”