What if there was a way to get dirty needles off the streets while saving the city of Charleston hundreds of thousands of dollars, reducing infectious diseases such as HIV or hepatitis B and C, and saving dozens of lives in the process? Supervised injection facilities have been tried in other cities with remarkable results and could play a large role in combating the opioid epidemic at home.
A supervised injection facility is a place where people who use drugs — such as heroin — can safely inject previously obtained drugs with medical staff supervision. Some facilities also include wraparound services in addition to addiction counseling, such as social services, employment referrals, health education, warm meals and medical care. Some also include smoking rooms to get more drug use off the streets.
For about 15 years, the city of Vancouver, British Columbia, has had a facility called Insite. Over that time, while over 4,000 people have overdosed, none have died. This is because Insite is a safe place with a medically trained staff, along with clean needles, education materials, plenty of naloxone (an overdose reversal drug) and oxygen, and other specialists engaged in harm reduction strategies. Supervised facilities, like Insite, also reduce public disorder, infectious diseases, and refer people to detoxification and addiction treatment programs. And contrary to what some may believe, they do not increase drug use, crime or bring drug use into communities.
Insite has achieved its goals, according to comprehensive evaluations. It has decreased needle sharing, lowered overdose death rates by 35 percent and reduced syringe and needle litter while increasing referrals for drug treatment. Insite is also cost-effective, saving $6 million per year after accounting for program costs.
Supervised injection sites are being considered in San Francisco, Seattle, Philadelphia, Massachusetts, Denver and New York. Altogether, there are over 100 facilities in over 65 cities across the world.
Evidence from supervised injection facilities demonstrates a full range of benefits to a community’s health, safety and economy. For example, peer-reviewed studies show the facilities reduce the transmission of blood-borne diseases, such as hepatitis B/C and HIV, by stopping people from using contaminated injection equipment.
This is good news for West Virginia, which has the highest rate for hepatitis B and second-highest rate for hepatitis C in the nation. In 2016, a study by the Centers for Disease Control and Prevention showed over half of the counties in West Virginia are considered at a high risk for an HIV or Hepatitis C outbreak from drug injection users — the highest number in the nation.
Supervised injection facilities also reduce overdoses, saving lives. West Virginia leads the nation in overdose deaths, many of which are caused by synthetic opioids, like fentanyl or its more dangerous cousin, carfentanil. Having quick and easy access to naloxone is one of the key advantages of the facilities and why no one has ever died at one. Successfully reducing drug-related overdose rates is essential in West Virginia’s fight to combat this epidemic.
A recent study commissioned by the city of Philadelphia estimated that supervised injection facilities could reduce overdose deaths by 76 people annually, while averting up to 18 HIV and 213 hepatitis C infections. Meanwhile, the study showed sizable reductions in hospitalization and ambulance costs for the city. The total value of overdoses averted in Philadelphia was estimated to be between $12 million and $75 million annually.
It is also important to realize that we already have drug injection sites in Charleston, they are just scattered all over the city in bathrooms, alleys, under bridges and road underpasses and in abandoned buildings. If you had a child using heroin, would you rather they do so in an alley or in a space with medical supervision to keep them safe and with easy access to addiction and other wraparound services.
While supervised injection facilities are not a silver bullet, they can play a meaningful role in making our communities safer while savings lives and money. This will mean meeting people who use drugs where they are, to get them where we they need to be: in recovery. Establishing a facility in Charleston and other cities in West Virginia could be a good step toward cleaning up dirty needles and making our cities a better place to live, work and raise a family.