Prevention Centers Save Lives, But Only Radical Change Will End Overdose Crisis

A pair of legally sanctioned overdose prevention centers — in which people can use illicit drugs under medical supervision — began taking clients in New York City in late November, potentially opening the door for similar facilities in other cities. The announcement was a rare bright spot in the city. increasingly terrifyingMedia coverage of the overdose crisis. Although the prevention centers are a promising step towards addressing the overdose crisis they are not a panacea. Experts warn that even if there are more centers outside of New York, overdose prevention centers alone will not stop the rising tide of death.

Overdose prevention centers (also known as safe injection sites, safe consumption sites and supervised intake centers) are where people inject drugs, either by smoking or injecting, under the supervision and care of licensed health professionals who have clean syringes. Naloxone is the opioid antidote that reverses overdoses and saves many lives. These facilities offer a variety of harm reduction services in a safe indoor environment, as well as pathways to addiction treatment, health care, and other services. Experts say that the right-wing opposition to the centers has been strong, but it is overblown. People are using drugs both in their homes and on the streets, regardless of whether such centers exist. In some communities, syringe swap and other innovative forms of drug checking have been available for years. Overdose prevention centers give users and their providers a medical office. They also provide a safe space where they can access treatment and other vital resources.

Reams of researchOverdose prevention centers in other countries, and at least one unsanctioned site in the U.S.They save lives. As the rate of fatal overdoses rises, policymakers are beginning to notice. shatter records nationwide.

However, even if more overdose prevention centers are authorized — a crucial step — experts say they must be one component of a larger program. These facilities would have a limited impact on small areas of liberal cities, as well as the number of people who can and will show up.

“I never would have used the safe consumption site, I know that for a fact,” Morgan Godvin, a former heroin user who was incarcerated before becoming an advocate and fellow at Northeastern University’s Health in Justice Lab, told Truthout. “But I tried to get on the methadone twice and couldn’t surmount the red tape.”

Methadone is a prescription treatment for opioid addiction that works well. However, methadone patients and programs are still in need of it. under strict state surveillanceGodvin was unable to access the medication because of this. Godvin and other experts agree that both overdose prevention centres and bolder policies are needed to address the chaotic drug supply that is fueling this overdose crisis. This includes a “safe supply” of drugs, and the “medicalization” of addiction treatment with medications such as methadone, hydromorphoneamphetamines and other powerful synthetic drugs that can be used to replace those found on the streets.

As usual, the law and policy changes required are not keeping pace with activists and drug addicts on the front lines. Federal prosecutors have not yet indicated whether they will target overdose prevention centres for drug violations. President Joe Biden has thus far ignored calls for wider drug decriminalization. can also prevent overdose deaths. The Justice Department stopped a Philadelphia-based overdose prevention center from being built under President Donald Trump’s direction. This created uncertainty for other programs.

“There’s obviously a dire need for these sites across the country, especially in areas with concentrated drug scenes getting hit with overdoses, and it’s a really important move in New York to open these sites,” said Ryan McNeil, director of harm reduction research at the Yale Program in Addiction Medicine, in an interview. “We’ll likely see similar action across the county. Now, I think one thing that’s going to hold that up is the verification about potential legal repercussions, and one would hope that we’ll get that from the Justice Department.”

Advocates for overdose prevention center are reading the Biden administration’s tea leavesIn the hope of establishing similar facilities in other cities, including San Francisco and Seattle, we are hopeful that similar facilities will be legalized quickly. Rhode Island recently passed legislation legalizing “harm reduction centers” as well.

Simply put, people don’t overdose and die when they use drugs at overdose prevention sites. Still, Godvin and McNeil said the facilities are not a “silver bullet.” The overdose crisis in changing rapidly, and it could be years before overdose prevention centers overcome stigma and political opposition to break ground.

Godvin stated that opioid users are shifting from heroin injections to taking fake pain pills. The powerful synthetics in these pills have been linked to high overdose rates. These drug users may see little need for facilities also known as “safe injection sites,” especially if they are not numerous and conveniently located near to where they live.

“So, we’re burning political capital on something that might not be viable in five years when we finally get it off the ground, because drug consumption patterns are changing at a breakneck pace,” Godvin said. “Like we’ve never seen before in history.”

For many who have lost loved ones or friends, the stories of untimely deaths are becoming painfully familiar. Every tool is important. Sometimes, victims quit using drugs recently or are released from prison and start using again with a lower tolerance. Sometimes, their drugs were stronger that they expected. interruptions in the supplypowerful synthetics like fentanyl. Overdose prevention centers allow people to test their drugs for any adulterants and exchange notes with other users or providers.

Overdose victims often die from drug overdoses alone, in the face of severe social stigma and pandemic isolation. There is no one to call 911 or give naloxone. Sometimes they overdose together with others but people around them fear calling 911. draconian laws in a number of statesPermit prosecutors to prosecute fellow drug users for homicide and other crimes in the wake a tragic loss. (Godvin was incarcerated after using heroinHer friend, who overdosed and died accidentally. At overdose prevention centers, nobody uses drugs alone. The police are not involved in the overdose prevention centers. Naloxone is always available.

Researchers, activists, and drug users have worked for decades to develop harm reduction services at overdose preventive centers. This work continues today and will continue for as long as drugs are illegal and stigmatized, and as long as users cannot access proper medical care through the legal system.

For these drug users and allies, the opening of legally sanctioned overdose prevention centers in New York was the result of years of activism in the face of scaremongering politicians, urban “not in my backyard” campaigners and law enforcement. The death toll from overdoses rose to a record 100,000 by the time the centers were operating above ground. As existing policies fail, public health officials in the White House and New York slowly shift to harm reduction.

“The opposition to safe consumption sites is purely ideological, and it’s how they make people feel,” Godvin said. “It is not evidence-based or based in science, but mostly people fear abstract concepts much more than they fear tangible things right before their eyes.”

Although the Biden administration is using harm reduction rhetoric and promoting some harm-reduction policies, it has not yet taken a position regarding overdose prevention centers. Trump officials rejected them. basic principlesGeneral harm reduction. The Biden administration removedOfficials are now reversing a decades-old moratorium to make methadone clinics mobile. doubling down on drug war policing, mass incarceration and “supply reduction,” which makes the drug supply more dangerous. Many barriers remain to effective addiction medication, even though the government is cracking down on the prescribing opioids and other psychoactive medications. This is driving the demand for counterfeit pills laced in the powerful synthetics that are behind the record-breaking death rates.

Advocates like Godvin and McNeil want us to know that a legally sanctioned overdose prevention center going up down the street won’t negatively impact neighborhoods, and they will make a positive difference — but they will not put an end to the overdose crisis alone. Overdose prevention centers in Canada or Europe are located in urban areas where drug abuse is concentrated. They often serve a large population that would otherwise be unable to access stable housing and get high.

“For some people supervised, safe consumption’s going to be fantastic,” McNeil said. “They’ll go regularly. And maybe they’ll primarily inject at the sites. Other people won’t go to them at all. And you know, we’ve done this work for so long evaluating sites in Vancouver, for example, that we just know that is the case.”

There are other possibilities that could be used in tandem with overdose prevention center. McNeil and Godvin pointed to a recent study on hydromorphoneThe opioid painkiller fentanyl was given to people who are high-risk of overdose and would otherwise use heroin or fentanyl. Researchers found that the program decreased street drug use and overdose risk, improved pain management, and was associated with better economic and health well-being.

Hydromorphone must be restricted from being prescribed or distributed at overdose prevention centers. Additionally, advocates say people at risk of overdose should be able to easily access so-called “prescription heroin” and other treatments at the doctor’s office or even special vending machines that are now in use in Canada.

Public policy has shifted in the opposite direction to address the overdose crisis. Opioid prescribing has plummeted over the past decade. The rates of fatal overdoses are now higher than ever. medical experts see the connection.

“Let’s use hydromorphone, a very similar compound and very similar effect [to heroin and fentanyl], and let’s push for broad medicalization of it, and pull it all back into the medical system because the drug supply is so toxic,” Godvin said.

It will require a wide range strategies and a change in how we approach drug use as policy and society to combat the overdose crisis. Advocates say that although the expansion of prevention centers is a positive development, it must be seen as one step towards a larger mission to save lives and protect rights.