What should be done about the millions of people in the United States and around the world who inject heroin and other drugs? For 30-plus years, the U.S. has pushed a "war on drugs" that is more accurately a war on drug users. This war on drugs has not delivered on its promise to keep drugs off our streets or to prevent people from using, but it has filled our prisons beyond capacity and led to far too many cases of HIV/AIDS related to sharing contaminated needles.
Vancouver, Canada adopted a different approach to deal with their city's problems associated with injection drug use. In 2003, the city established clean injection sites where users can take their drugs in a sterile environment, and under the supervision of clinical staff. The rationale is that as much as we don't want people shooting up drugs, some -- often society's most marginalized -- inevitably will.
There are three likely scenarios when it comes to injection drug use: 1) public places like parks and street corners; 2) "shooting galleries" that are often dirty, violent, controlled by drug dealers, and conducive to the sharing of dirty needles; and 3) a safe, clean facility under the supervision of nurses and public health officials. Aside from making sure people are using clean needles and are not overdosing, health professionals can use the opportunity to provide treatment options designed to curb and eventually eliminate the use of drugs.
So what are the results of Vancouver's strategy? A study released on Friday in the esteemed British journal, Addiction, found that not only is the Vancouver injection site accomplishing the goals of reducing public drug use, cutting down on the spread of HIV/AIDS and overdose deaths, but is also a bridge helping people get into treatment. The study found that the city's supervised injection site increased the rate of addicts entering detox by 30 percent. The study confirmed that all of these concrete benefits are happening without increasing drug use. Similar findings were reported in studies of safer injection rooms in Germany, Switzerland and Australia. Despite these encouraging results, the Supervised Injection backers worry that the recently elected Conservative leadership in Canada will terminate the successful program by year's end.
While some may hope and pray for a "drug free society," the reality is that there will always be some who will find their way to drugs. We need to do everything we can to make treatment available to heroin users and everyone trying to quit drugs. But we should also study what Vancouver and other countries are exploring. We need to find ways to reduce the death, disease, crime and suffering of people who are unwilling or unable to stop.
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