CommentsDEEGAN ON LA-Neighborhood watch committees, homeowner associations, neighborhood councils and other groups that closely monitor what’s happening in their communities could soon be adding “safe injection sites” to their concerns – concerns that already include what some see as predatory developers, the specter of “bridge housing” for the homeless, the clash between preservation and “transit oriented density,” and electric scooters as community disruptors.
The state government is considering a pilot program described in AB 186 (Eggman) as Controlled Substances: Overdose Prevention Program that may go forward with a limited run in San Francisco before coming to Los Angeles.
“Needles in my backyard” may become the new “NIMBY.”
While some can “just say no” to drug use, many others fall within a spectrum that ranges from being criminalized and incarcerated, to being given alternative sentencing by drug courts, or benefitting from public health initiatives that include addiction prevention and treatment programs. Now, add to that the "harm-reduction" strategies, as described in AB 186 that would be a first for California (and the country), although a successful harm reduction model program in Vancouver, Canada, called Insite, has been producing harm reduction results, saving lives for the past fifteen years.
Dealing with the growing opioid problem, on top of heroin, meth, and fentanyladdictions on every level of society has become a nationwide challenge. Stockton Assembly member Susan Talamantes Eggman, who wrote AB 186 and introduced it in Sacramento, speaking about abstinence from drugs, said,“It doesn’t work to just say, ‘Don’t do it.’”
Eggman also told the Sacramento Bee,“This is not enabling anyone. This is about getting people into treatment.” She has vowed to keep pushing for the bill despite objections made by some fellow legislators this legislative session. Her advocacy for safe injection sites may continue in 2019 when there will be a new Governor in the state capitol. As Scarlett O’Hara said at the end of “Gone with the Wind,”“Tomorrow is another day.”
The problem of injecting drugs can be solved in a couple of ways but sending users to jail is not one of the solutions. For too long, approaches to drug addiction have centered around dirty needles and the blood-borne disease havoc they create, along with the serious risks of overdosing, criminalizing it instead of treating it as a public health issue. But what is needed is a holistic care continuum that includes addiction prevention, treatment programs, and now "harm-reduction" strategies, which is what “safe injection sites” are about.
Finally, some legislators are looking at the drug “injection” problem, a subset of drug abuse, as one that could be managed, and they’re willing to try that in San Francisco. If successful, Los Angeles could follow the same template. Locating where to put safe injection sites promises to be as controversial as deciding where to put homeless “bridge housing,” a debate so vociferous that one San Fernando Valley community a few days ago actually called for the recall of its Councilmember for suggesting that they live near sheltered homeless people.
The Eggman Bill (AB 186) would allow San Francisco to:
Approve entities to establish and operate overdose prevention programs for persons 18 years of age or older...until January 1, 2022.
Provide a hygienic space supervised by health care professionals where people who use drugs can consume pre-obtained drugs.
Provide sterile consumption supplies, collect used hypodermic needles and syringes, and provide secure hypodermic needle and syringe disposal services.
Administer first aid, if needed, monitor participants for potential overdose, and provide treatment as necessary to prevent fatal overdose.
Provide access or referrals to substance use disorder treatment services, medical services, mental health services, and social services.
Educate participants on the risks of contracting HIV and viral hepatitis.
Provide overdose prevention education and access to or referrals to obtain naloxone hydrochloride or another overdose reversal medication approved by the United States Food and Drug Administration.
Educate participants regarding proper disposal of hypodermic needles and syringes.
Train staff members to deliver services offered by the program.
Can this work? A successful version of this concept, a supervised harm reduction site for drug addicts who use needles to inject their drugs, has been operating for the past fifteen years in Vancouver, Canada, at the Insite supervised drug consumption site.
Their services, used by 7,301 individuals in a total of 175,464 visits in 2017, give an indication of the deliverables of the program. According to Insite, there was an average of 537 visits per day to the needle exchange service, resulting in an average of 415 injection room visits per day.
The Insite continuum of care includes nurse-supervised consumption and clean injection equipment such as syringes, cookers, filters, water and tourniquets that are supplied by staff who also intervene immediately when there is an overdose--which happened at Insite 2,151 times in 2017. That’s 41 people per week whocould have fatally overdosed. Our government’s National Institute on Drug Abuse reported more than 72,000 drug overdose deaths in 2017.
Insite also offers a harm reduction model that attempts to connect addicts with recovery programs. Their onsite services for withdrawal management include transitional recovery housing. None of those elements are part of the current CA Assembly Bill 186 but are worth looking at.
Not in my back yard? Don't bet on it, as society begins to understand that drug addiction has a public health component that needs to be addressed and can improve the quality of life for addicts. Scarlett O’Hara never gave up, and Assemblymember Susan Eggman and her legislator-colleagues may be just as persistent.
(Tim Deegan is a civic activist whose DEEGAN ON LA weekly column about city planning, new urbanism, the environment, and the homeless appear in CityWatch. Tim can be reached at [email protected].) Edited for CityWatch by Linda Abrams.
