Feature: Effort to Bring Safe Injection Facility to New York City Getting Underway

Last Friday, more than 150 people gathered at John Jay College of Criminal Justice in New York City for a daylong conference on the science, politics, and law of safe injection facilities (SIFs) as part of a budding movement to bring the effective but controversial harm reduction measure to the Big Apple. Sponsored, among others, by the college, the Harm Reduction Coalition, and an amalgam of 17 different New York City needle exchange and harm reduction programs known as the Injection Drug User Health Alliance (IDUHA), the conference targeted not only harm reductionists but public health advocates and officials, law enforcement, service providers, and the general public.

http://www.stopthedrugwar.org/files/johnjaycollege.jpg
John Jay College, NYC (courtesy wikipedia.org)
The Safe Injection Facilities in New York conference aimed to create public awareness of SIFs, provide evidence that they are cost-effective, and start developing a plan for implementing SIFS in New York. As the conference program indicates, organizers relied heavily on experts from Vancouver, where the Downtown Eastside Insite SIF has been in operation -- and under evaluation -- since 2003, to provide the evidence base.

The first SIFs opened in Switzerland in the mid-1980s. Since then, they have spread slowly and there are now 65 SIFS operating in 27 cities in eight countries: Switzerland, Germany, the Netherlands, Spain, Australia, Norway, Luxembourg, and Canada. Although advocates have been working for the past year-and-a-half to bring an SIF to San Francisco, that effort has yet to bear fruit.

SIFS are credited with saving lives through overdose prevention, reducing the spread of blood-borne disease, reducing public drug use and attendant drug litter, and creating entryways to treatment and other services for hard-core drug users not ready to abstain. The results reported by the Vancouver delegation on Insite were typical:

  • No fatal overdoses at the SIF.
  • No increase in local drug trafficking.
  • No substantial increase in the rate of relapse into injection drug use.
  • Reductions in public drug use, publicly discarded syringes and syringe sharing.
  • SIF users 1.7 times more likely to enter detox programs.
  • More than 2,000 referrals to counseling and other support services since opening.
  • Collaboration with police to meet public health and public order objectives.

But despite such research results, the United States remains without an operating SIF. The obstacles range from the legal, such as the federal crack house law and its counterparts in many states, to the political and the moral. But for harm reduction and public health advocates, it is the failure to embrace such proven life-saving measures that has the stench of the immoral.

"The reality is that we have people shooting up in unsafe injection facilities as we speak," said Joyce Rivera, executive director of St. Ann's Corner of Harm Reduction and chair of the conference. "The reality is they are not shooting up in a safe, hygienic environment with the possibility of a transition into a range of care. That's what's not happening. As public health advocates, we are saying let's recognize that reality and create those safe facilities. Let these people enter through the portal of public health into a safe environment and start to pace their own change," she said.

"We have to acknowledge the social fact that people are shooting up in unsafe venues," Rivera said. "It's not some esoteric or academic argument. The question is what do we do about it? Public health is supposed to protect the community, and SIFs are a necessary evolution in our public health policy."

"The big issue here is that we know we have about 200,000 injection drug users in the city, and the needle exchange programs only serve a few thousand of them," said Robert Childs of Positive Health Project, one of the members of the IDUAH. "Most of them are getting needles from unregulated needle exchanges, shooting galleries, from friends. That is a large part of why New York City has the most HIV and Hepatitis C cases in the US and one of the highest rates of infection in North America," he said.

"The other big issue is that we're giving injectors the tools to inject, but not a safe space to do it," Childs pointed out. "Many shoot up in the public domain, in the bathrooms at Starbucks or McDonalds or White Castle, in libraries, parks, alleys, phone booths. They leave their syringes in locations that aren't evident to a non-injector, and that's a public health issue."

They also overdose. Drug overdose is the fourth leading cause of death in the city. While it is a tragedy for the victim, overdoses both lethal and non-lethal are also a burden to the city. "Taxpayers have to pay these costs," said Childs. "For an ambulance to respond to an overdose costs between $400 and $1,200, and that's going on many times a day every day."

It's not just ambulances. Failing to address injection drug use under prohibition conditions costs real dollars in other ways as well. Each new diagnosis of HIV in the city comes with a $648,000 price tag for life-long medications and medical care, and even that may be on a low end estimate. A case of hepatitis C often requires $280,000 to $380,000 for a liver transplant; for those cases that do not warrant a liver transplant, treatment costs anywhere from $60,000 to $100,000.

And it's not just taxpayers paying. According to Childs, local businesses, including service providers, spend thousands of dollars a year on plumbing repairs -- from needles disposed of in toilets for lack of biohazard containers.

Now, said advocates, it is time to move forward. The conference was but the opening shot in what will likely be a long and frustrating campaign.

"The conference went very well and it will be a bit of a lift," said John Jay Professor Richard Curtis, who addressed the topic of moving forward from here at the conference. "The evidence is piling up from Sydney and Vancouver and Europe, and that is helping us, too. But this isn't something the health departments and the politicians aren't quickly going to jump on the bandwagon for. We have to give them a push, and if we don't start working on it now, it'll never happen. We didn't get where we are today by behaving ourselves," he added, relating how his own needle exchange effort first faced official opposition before being accepted.

The audience included people from the city and state health departments, Curtis said. "The health officials are all very supportive... unofficially," he said. "They didn't want to be on the agenda, but they say they're supportive. But this is an election year, and that makes it hard for them."

There will be an organizing meeting in two weeks to map out strategy, Curtis said. "We'll see who is willing and able, whether there is an existing agency bold enough to forge ahead or whether we will have to create some alternative organizations. We want to put this issue on the table now."

"We're forming an action group to bring this into New Yorkers' consciousness," said Childs. "The people who do know about -- drug users -- are one of the most stigmatized populations in the city. We are going to a campaign similar to Vancouver about how these people are not bogeymen, but our sons and daughters. We're also trying to organize some media events around it. A group of lawyers will help by challenging some codes. And we'll be trying to work with our legislators and city councilors," he said.

But Curtis and others are not willing to wait forever. "I'm not hopeful that federal crack house laws will end any time soon," he said. "But we started needle exchanges by just doing it. If it has to come to that, we'll have to make them arrest us again. We need to back them into a corner at the very least."

Harm Reduction Coalition Western Coordinator Hilary McQuie has been involved in the ongoing SIF effort in San Francisco. Just because something isn't happening officially doesn't mean it isn't happening, she noted.

"I don't know much about shooting galleries in New York," she said, "but out here, it's no big secret that the bathrooms of service providers, drop-in centers, homeless shelters, soup kitchens are used for shooting up. What people are doing to try to make these current injection spaces safer is perhaps having safe injection instructions, syringe disposal devices, soap and water, things like that," she said. "Also, it's sort of semi-supervised. If someone's in the bathroom and doesn't come out, you can open the door and save them from an overdose. That happens every day in San Francisco."

Permission to Reprint: This article is licensed under a modified Creative Commons Attribution license.
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INSITE VANCOUVER STAT'S A LITTLE TAINTED

THE OLYMPIC CITY HAS DRUGS I must say some of the research seems to be skewed re the safe injection site in vancouver’s dtes.First off with out a doubt lives are being saved yes, some people who have od as many as three to ten times, only to continue the self abuse, unaware they have died. Seems weird that you could die more than once only to possibly die again.Next the quote about public drug use must be a few years old, the police here announced that they will no longer charge people for simple possesion so open iv usage is now commonly accepted in this neighbourhood, at the expense of parents having to explain to there children why is that person doing that to themselves.The addiction population in vancouver’s dtes has grown enormously over the last few years to ten thousand in a twelve block square area you would not beleive how high this concentration is, we also have the reputation as the largest per capital in all of north america.On the issue of the availability of detox, this facility has seventy five hundred registered users on file as of 2008 the facility only has ten to twelve beds the whole city only has some 200 or so beds for more than 20.000 addicts it would be awesome if they were able to achieve a thirty percent transition to detox.This i know is wrong most of the people myself included have on average had to wait anywhere from three to seven days to get a bed.Beleive it or not the safe injection site is the only support service available in this neighbourhood from midnight to six in the morning, this to me is a real shame i think that any facility that might be of a benifit to make the transition to recovery should be separate you may have a greater success rate go figure.Just so you know i am currently lobbing for more detox bed’s minimum one hundred ,as well an outreach in this neighbourhood that offers counseling transition to recovery support groups and any thing that might give the junkie hope for a better life.I myself was addicted for over twenty five years today i have seven years clean i have been very active in changing many people’s lives. I started a website to show the world what liberal drug policies can result in and i’m afraid it’s non to pretty the site is http://www.2010homelesschampions.ca Here’s a small sample of out of control as well as a common occurence, you be the judge http://www.youtube.com/watch?v=OuNWCPDrJsM

finally.... someone is getting real in the states...

Everyday that facilities like these do not operate in the United States, crimes are being done to get drug money. Prostitution, armed robbery, theft... all of these could be significantly lowered if we as a society would just use a little common sense. If someone gets addicted to heroin, they are going to be a problem not just for themselves, but everyone around them. As a society, we can lessen their impact on the whole by just giving them drugs. By keeping tabs on someone, and helping them to eventually quit -- when they are ready, we can spare people some of the hellishness of their addictions. This helps them to move toward a lifestyle that does need to be whacked out all the time...

Society is paying for jailing, hospitalizing, treating aids, etc... when for a much smaller investment, we could say that people who are addicted to heroin need to be dealt with from the stand-point of looking for what will really work -- instead of what people wish would happen. We would all like to live in the perfect world without heroin addicts, but we don't. We can however make our world significantly better simply by supplying these people safe drugs.
This would also give society a way to drive the black market out of business with cheap drugs, which would lessen juveniles from being able to obtain the drugs.

Facility to New York City Getting Underway

yes,Facility to New York City Getting Underway.But despite such research results, the United States remains without an operating SIF. The obstacles range from the legal, such as the federal crack house law and its counterparts in many states, to the political and the moral. But for harm reduction and public health advocates, it is the failure to embrace such proven life-saving measures that has the stench of the immoral.

I had never heard of SIF's

I had never heard of SIF's before, what a fascinating concept. It sounds kind of crazy at first, but I guess the results speak for themselves. It's hard to argue with a program that prevents drug overdoses, drastically reduces public drug use, and increases the number of addicts seeking treatment by up to 70%. I say let's do it.

not

hi,

 

 

i read the immoral stop and thought that there was no fur.

 

 

thaks, (thanse)

posted for oers (oa .ers. rew.. s)a

no message in shora ibe.

 

 

 

thanske. 

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