In an attempt to stem overdose deaths, California could allow drug use at supervised sites

  • By：jobsplane

07

01/2023

Diamond Mendoza rolled up the sleeve of his yellow T-shirt with an exuberant print of the Mona Lisa on the front, to show the scars from the abscesses that had been healed.

She wants to quit heroin, which she first turned to decades ago, after a heartbreak. You want to get certified to prove yourself to employers, maybe become a phlebotomist or nurse. She loves the idea of ​​being able to hand over that piece of paper and say, "Hey, I may be a drug user, but I got a certificate."

But above all, Mendoza said, “I hope to live longer.”

Drug overdose deaths have spiked during the pandemic, claiming more than 90,000 lives last year nationwide, according to federal data. As the numbers have skyrocketed, many experts, advocates, and lawmakers have promoted a still-fresh idea in America: Giving people a safe place to inject drugs under supervision.

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In California, it would mark the most dramatic step yet for health and government officials to pursue the philosophy of harm reduction, which seeks pragmatic ways to mitigate the harmful effects of drug use. The idea was shot down three years ago by Gov. Jerry Brown, who vetoed a bill to test such sites in San Francisco, saying "allowing the use of illegal and destructive drugs will never work."

Now state Sen. Scott Wiener (D-San Francisco) and other lawmakers are pushing to allow San Francisco, Oakland, and the city and county of Los Angeles to approve entities to run such programs. California's latest bill, SB 57, envisions them as "a sanitary space supervised by trained personnel" where people can use "pre-obtained medications," obtain sterile supplies, and be linked to substance use disorder treatment.

When Melvin Latham heard about the idea being made known in Sacramento, it sounded like a pipe dream. A safe and supervised place to consume drugs? A staff member to save someone who overdosed?

“That looks like something out of a movie or something!” Latham exclaimed, leaning back in disbelief.

Dozens of “supervised consumption” or “safe consumption” sites legally exist around the world, including the Netherlands, Germany and Canada. These programs have been credited with preventing deaths, reducing the risk of contracting HIV and other infectious diseases, as well as reducing public nuisances and dangers, such as discarded syringes.

In Switzerland, researchers found that the facilities helped reduce fatal overdoses and cut back on drug use in public places. In the United States, investigators found that an unauthorized site at an undisclosed location had monitored more than 10,000 injections over five years. There were 33 opioid-related overdoses in that time, all reversed with medication by competent personnel.

“There is no increase in crime in the neighborhood where the site is located. There hasn't been a single overdose death in that space," said Peter Davidson, an associate professor in the UC San Diego Department of Medicine who helped evaluate the program. "Overall, it seems to be good for public health and social order outcomes, just as it is in other parts of the world."

The California bill has drawn opposition from groups including the California Narcotics Officers Association, which argued that “instead of a robust effort to get addicts into treatment, SB 57 alarmingly admits the inevitable and unchanging nature of drug addiction and abuse,” according to a controversial report from Alberta, Canada, which raised concerns about police calls, needle remnants and overdose deaths near such sites.

Creating such spaces "only promotes drug use," said Shaun S. Rundle, deputy director of the California Peace Officers' Association, another group that opposes the bill. “We prefer a push to resolve the dependency rather than facilitate it.”

In an attempt to stop deaths from overdose, California could allow drug use in supervised places

Jeannette Zanipatin, California state director of the Drug Policy Alliance, responded that "what's being done right now isn't working." She argued that in addition to preventing overdoses, these sites can build trust to help people when they want to pursue treatment. Health care providers and advocacy groups, such as the California Addiction Medicine, have backed the proposal, along with the local jurisdictions that would host the new spaces.

Researchers at the Rand Corp. Center for Drug Policy Research pored over studies posted on drug use sites and found it to be "nearly unanimous in its support, but limited in nature." The center's director, Beau Kilmer, noted that "there appears to be little reason to worry about adverse effects," but most studies do not have a "credible control group" to assess whether the results are caused by the facilities themselves. .

“It's about time we started testing and learning from supervised consumption sites in the United States,” Kilmer said, including evaluating how they affect those receiving treatment.

Latham, 43, lives in a downtown tunnel near Bunker Hill. He and Mendoza look out for each other, but he explained that for anyone who uses drugs outside, "you're constantly looking over your shoulder," worrying that someone is trying to harass you or injure you.

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Then there's the threat of fentanyl, a powerful opioid that has brought down many people who use drugs, including some who had no idea they were taking it. Los Angeles County officials have linked the synthetic opioid to an increase in overdose deaths among homeless individuals in recent years. Latham and Mendoza said they have tried to stay away from fentanyl because of its potency, but it is often mixed with other drugs.

“A person can be here now, and then you find out they're gone,” Latham said of the deaths in downtown Los Angeles. "It's really scary."

On Skid Row, Darren Willett imagines that, if allowed, the Harm Reduction Center could set up cubicles for people to inject their drugs under supervision, then let them hang out in another room under the watchful eye of staff .

“There would be no such thing as an overdose death,” said Willett, director of the center, which is operated by Homeless Health Care Los Angeles. “The number one reason people die from drug overdoses is consuming alone. And why are they consuming alone? Because that is criminalized and stigmatized”.

Instead of requiring people to stop using drugs, the Center for Harm Reduction tries to help them be safer and healthier. Offer clean syringes to support individuals in avoiding infection from sharing them. He distributes Narcan, a naloxone spray that can bring someone out of an overdose, so people can save lives on the streets.