Safe injection facilities: A lifesaving approach to battle the opioid epidemic | Guest Editorial

Gina Frank

By Gina Frank

Special to the Reporter

On a cold rainy day in June, I walk into a local grocery store in a Seattle Eastside neighborhood. I walk past a petitioner with a sign reading “Ban the Proposed Safe Injection Sites.”

I get chills, don’t sign it, and continue on my way. I get chills because I know that safe injection facilities (SIF) save lives. I get chills because every day we go without them, more and more people die on the streets from drug overdose. I get chills because it reminds me that drug overdoses are now the leading cause of death among Americans under 50, according to preliminary data compiled by The New York Times. We need to support any and all initiatives that save the lives of Americans, regardless of what that “killer” is.

As an addiction specialist and licensed mental health professional who has worked for many years treating cooccurring disorders (people with addiction and other mental illnesses), I am no stranger to these issues. I also grew up in Vancouver, BC. A city that many call “the heroin capital of North America.” It’s also a place that took a different angle at tackling drug addiction. Insite, North American’s first SIF in Vancouver, BC offers clean needles to reduce the transmission of diseases (they do not inject users). Medical staff are there to supervise use to medically manage overdose. Addiction counselors are also on hand to engage people into treatment.

Canada did not invent the wheel, as there are now about 100 SIFs worldwide. The evidence is clear that they reduce disease transmission risks, prevent overdose deaths, reduce public injections and syringes in the streets, and increase the number of people who enter drug treatment. The most striking fact: Since opening their doors in 2003, Insite has had about 270,000 visits per year and not one single overdose death. Let me repeat that, not one single death.

Locally speaking, in 2016, Seattle and King County set a new record for fatal overdoses with 359 deaths, according to the King County Medical Examiner’s office. This marks the seventh consecutive year of increases that our area has seen, the bulk of these deaths resulting from opiate use. These deaths span across all communities in Washington. Those in the grips of addiction come from all walks of life; from your next door neighbor to your child’s teacher. The homeless, the well educated. Nearly all of us know someone who struggles with addiction. It discriminates against no one and we are losing this battle. So where do we go from here? SIF alone will not fix this problem, but it will stop this horrible uptick in death rates.

Often I hear these two arguments in opposition to SIFs:

1) “It will make it easier for people to use drugs.” This is simply not the case. According to research reports, InSite users are 30 percent more likely to engage in addiction treatment than non-InSite users. Also, those using the facility had already been injecting for an average of 16 years (this is not the place that people being their use).

2) “Why should the tax payers pay for this?” In 2008, a cost-benefit analysis of the site, reported in the Canadian Medical Association Journal, observed net-savings of $18 million and an increase of 1175 life-years over 10 years.

After considering all the benefits of these facilities, the only reason I can come up with for its opposition is the sad reality that many still view addiction as an illness of the immoral, or somehow that those with addictions are not worthy of the same care that people with other serious medical illnesses are granted.

The fight against addiction must be one rooted in compassionate multi-faceted levels of care, ranging from SIFs to specialized inpatient cooccurring disorder treatment; a combination of harm reduction approaches like SIFs that can save lives and improve prognosis and methods that engage folks into abstinence based treatments.

Gina Frank is a licensed mental health professional in the state of Washington and the chair of the Human Services Committee with NPAC (North Precinct Advisory Council), assisting the Seattle Police Department in its responses to human and social issues. She currently runs a private practice in Redmond and specializes in treating adolescents with addiction issues.