Safer injection sites, the flip side of good intentions
2015. 08. 08. - 18:00
Establishing safe injection facilities is the best example of a well-intentioned idea suddenly turning into a nightmare. Avoiding people dying on the streets from drug overdose or infections seems to be a cause worth fighting for. But it would mean curing the symptoms without tackling the roots themselves.
Supervised injection facilities provide the drug addicts a place with the medical oversight. Yet, can we call those people patients? They bring their own drugs to the injection centre where they can inject them without having a fear of being arrested while the nurses watch them to prevent any harm. But let’s get back to reality: addiction is not a thing you can cure as simple as that. It is a common mistake to think that medicine has an answer to everything and that keeping people alive at any price is indeed beneficial for the common good. Sometimes it is not that simple.
Curing the symptoms without tackling the root causes
Even if about 20% of the safe injection centres are informing and counselling on a voluntary basis, the main task of the staff remains to prevent the death from overdose. They successfully fulfil the historical mission of doctors, which is saving lives... But these facilities avoid the mechanics and consequences of addiction, as well as self-destruction behaviour.
Seeing drugs only as a medical issue is a terrible mistake. Overcoming drug addiction is not simply a question of medical assistance. It is also a question of facing one’s fears, facing who we really are and who we want to be. It is a question of having a strong family and strong friends to help you getting out of it. However, these medical centres cannot provide such type of assistance.
Even worse, this solution is likely to make the drug users to avoid their own responsibilities by making them more childish. Conducting safe injection is not as much about keeping people alive but rather keeping them in a nearly-fatal state. It only permits people to remain enslaved by their own addictions.
A society must not organize depravity
A society needs rules and has to show what is wrong and what is right. It should define points of reference for the coming generations. Morality is not a cuss word and it is normal for a society to say what is moral or not. For example, murder, torture or rape is not moral. As a matter of fact, the state does not have to fund every person who wants to achieve his or hers morbid desires.
The society does not have to be responsible for the choice of using drugs. If the addicts want to stop drug consumption, we can provide aid for them. But if their choice is to go deeper into their addiction, we should not make it easier.
Moreover, safe injection services raise the question of limits. How far can the welfare state go? Should we help everyone who has an addiction? The Canadian Health Minister, Tony Clement, taunted the idea in the "Globe and Mail" newspaper by saying that the next step could be "a doctor holding a cigarette to make sure a smoker doesn't burn his lips, or watching a woman with cardiac problems eat fatty French fries to ensure she swallows them properly."
It will make drugs common
Looking for euphoric experiences is something people always want to do. That is why making the consumption of drugs a commonplace is dangerous, even if people are aware of the risks.
If these centres will be expanded, the most vulnerable people would probably be more inclined to try new drugs if they know that they can be easily treated if necessary. It is something that we can also observe with the sexually transmitted diseases. Since the invention of the tritherapy, people have been less careful. The rate of people infected by these diseases is increasing. Even more worrying is the return of the old-school infections that were not so commonly observed, such as syphilis.
It will waste money we could rather dedicate to police control
Cash is something hard to find during the times of crisis. The treatments used in the facilities are expensive and everything is funded by the taxpayers. For example the safe injection site in Vancouver opened in 2003 and since then it cost 3 million per year to maintain the facilities. We could rather use this money to enhance police work to dismantle drug dealing networks and organized crime chains.
It is a tough reality that most of the users visiting the supervised injection sites may never get off drugs. In Vancouver, some of the users have been using the facilities for twenty years and their only wish is to stay close to the medical assistance. The addicts are still down the line and it does not make them stop. Medical assistance centres only maintain the vicious circle of drug use. The main issue of this debate is that we are losing our energy at the edges of the problem instead of facing it an its roots...
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Getting off the high horse and thinking rationally
2015. 08. 08. - 10:14
The decision to introduce so-called “salles de shoot” – supervised injection sites in English – was not an easy choice to make and most definitely was not done by impulse either.
The first facilities appeared gradually throughout the 70s and 80s, though the concept had to take at least a decade to be fulfilled – a large scale construction of supervised injection sites began in the 90s with Netherlands, Germany and Switzerland. In France, the proposition first came in the middle of 2010 from the Minister of Health at the time – Roselyne Bachelot. However the idea was refused by François Fillon, Prime Minister at the time, essentially freezing it for the duration of the UMP-led government. Yet, it already had entered the public space and was reintroduced for debates, during the election campaign of François Hollande, who claimed he would oversee the creation of such facilities. Less than one year after winning the elections, early in February 2013, the green light was given for the construction of trial supervised injection sites in Paris, in order to study the effects of such facilities in France. Not a lot of substantial progress was made, yet by April 2015, it was already agreed to open more supervised injection sites in Paris as well as in two other towns for a test period of up to 6 years.
A solution that will actually have positive effects
Let us examine the potential positive effects that the construction of supervised injection sites would bring. First of all, there is the most obvious one – fewer number of deaths. The main goal of supervised injection sites is to reduce the harm induced by the drug use. This is accomplished in a few ways: there is medical personnel always present, which means that in the case of an overdose, there will be an immediate and adequate reaction from the personnel, which would greatly reduce the chances of fatal overdose. Furthermore, all drugs consumed would be inspected by the on-site experts in order to make sure that the composition of a drug is safe and coincide with its indicated content. This means that poor quality drugs mixed with other some other detrimental chemicals, which are more dangerous than pure drugs, would be seized in order to prevent from the unsafe usage of drugs.
Furthermore, supervised injection sites would provide sterile tools for drug use, such as syringes, spoons, etc. This would result in a substantial decrease of the diseases which are normally spread by sharing and/or multiple uses of the same tools, usually because of the unavailability of new equipment. A broad range of diseases, most notably HIV and Hepatitis, would become much less widespread. It is important to note that this would not only affect the drug-users. but also the general public due to the effect of containment and thus essentially giving a boost to an overall public health.
Understanding the superficiality of the biggest concerns
One of the main concerns voiced out by the opposition is that even a small compromise by the state towards drug users would be seen as belittling the dangers of drug usage and encouraging it. While one might arrive at such conclusion by instincts, studies, however, show that such a logic can reveal its misconceptions. First of all, by accepting new facilities to prevent the fatality number of drug-users, the state is not recognising drug use as safe activity, rather does the exact opposite – it wants to show how serious the dangers actually are. What is more though, that, usually, the first use of drugs is not a rational decision that includes a consideration of its possible dangers or the legality of it; it most often happens at a young age, at a party or under peer pressure. Lastly, to answer this dilemma, one can simply look at the statistics on the rate of drug users in cities where supervised injection sites have already been opened: the numbers show that there is no increase whatsoever, leaving this argument completely unsupported.
On the other hand, the construction of supervised injection sites has a positive effect on the people seeking for help. A lot of drug users would not voluntarily seek out for information on where they could find help to battle their addiction. Going to supervised injection sites, however, provides them such information. Interviewed drug users have said that they have benefited from the information being available to them and have found the courage to seek support from their families, as suggested by the staff at the supervised injection sites.
Another argument against supervised injection sites comes from the locals living in the regions where such sites are being planned to be built. Their big fear is that supervised injection sites would attract more drug users from other regions of the city, which could lead to an increase in drug-related crime. While the former is true, in reality, this has a positive effect on drug-related crime. The movement of drug users to one specific region leads to a natural decrease of drug-related crimes in all the other regions. Subsequently, the concentration of drug use in one region allows more police officers to be more concentrated, which, in turn, would allow to easier contain the drug-related crimes in that region as well. This logic is supported by police statistics, according to which the construction of supervised injection sites leads to a decrease in drug-related crime.
Lastly, there is the moral argument. Many people opposing the construction of supervised injection sites simply state that the idea of showing some flexibility to more efficiently treat an existing issue is “morally wrong” and therefore should not be implemented. Of course, this argument has no logic and therefore a rational explanation of its fallacy is unlikely to convince those who bring it up. However, as long as the general public agrees that saving human lives is a lot more valuable than letting people die in order to protect imaginary moral values, progress will continue to be made in treating the problem of drug use.
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