Harm Reduction Exists for Heroin Addicts

According to Mike Stobbe of the Boston Globe, there is a safe place where heroin addicts can go to shoot up, and it’s been operating underground in the United States for the past three years.

The underground safe place opened in 2014 somewhere in New York. The location has not been revealed because it’s not sanctioned, which means it’s illegal. It’s run by an unnamed social service agency and medical researchers. Unfortunately, they have not as yet had time to research all the factors, such as a potential increase of new users, that supposedly make this type of service dangerous.

There have only been two overdoses since the facility opened, and neither was fatal. Staff members reversed both of them with the overdose medication Naloxone.

More than 52,000 Americans died by overdose in 2015—the highest rate ever—because of the rising use of heroin and prescription painkillers. The rate of overdose deaths continues to rise.

The existence of this safe injection site shows that it is possible to operate a clinic in the United States, said Lindsay Lasalle, an attorney with Drug Policy Alliance, who also helped draft safe haven proposals in six states.

Injection sites are legal in many countries in the world such as Australia, Canada, Denmark, France, Germany, Luxembourg, the Netherlands, Norway, Spain and Switzerland. These clinics are staffed by medical professionals who monitor drug use on site.

Injection sites also provide clean needles to prevent the spread of infectious diseases such as HIV and Hepatitis C. Safe havens also steer IV drug users into drug treatment, health care and other services.

Other good news here in Massachusetts, also revealed in the Globe, is that prison inmates about to be released in Franklin and Hampden counties will be started on a regimen of Suboxone 30 days before their release. Suboxone is a psychiatric drug for heroin addiction. It contains an antagonist, which blocks the effect of an opiate for three days, and it also helps diminish the craving for opiates. It is usually taken daily under the supervision of a specially licensed psychiatrist.

It is sad that only a handful of prisons and jails nationwide dispense Suboxone, which has a good track record as a form of treatment. Statistics from the state health department show that formerly addicted inmates, when released without drug treatment, are 56 times more likely to die of an overdose upon release. When addicts are clean for a period of time, their tolerance for opiates decreases, which means a formerly “typical” amount of the drug can prove fatal to someone who hasn’t used in a while.

I had a friend who was sentenced to two years in the Worcester County House of Correction. When I used to shoot with him, he always dumped two bags of Blue Magic into the cooker and slammed the dose home.

Another friend of mine, who was shooting with him after he was released from prison, told me that after copping the dope in Great Brook Valley, he automatically dumped two bags into the cooker as if he’d been using regularly. My friend warned him, but the guy said, “I’ll be alright.”

He died that day of an overdose because he wasn’t alright.

There is another drug used for drug treatment that blocks the effect of opiates called Vivitrol. The problem with Vivitrol is that while the shot blocks the effect of opiates for one month, it doesn’t do anything for the craving for opiates. Addicts who take Vivitrol are less likely to come back for a second shot and continue treatment than people who take Suboxone.

Another advantage of starting addict inmates on Suboxone 30 days prior to release is that even if they shoot dope the day they’re released, the Narcan in the Suboxone will mute the opiate effect and prevent an overdose.

Correctional officials favor the Vivitrol because it’s not related to the opioid, as is Suboxone. However, the fact is that people who have been using opiates for years have had the pleasure centers of their brains atrophy. Vivitrol does nothing for that.

I was an active heroin addict for over 35 years and have tried many methods to stay abstinent. When I wasn’t taking Suboxone, my longest run of abstinence was a little under four years. Now, on a regular Suboxone regimen, I have been continuously abstinent for almost eleven years.

Just ask my wife, and she’ll tell you that Suboxone treatment is the best thing that ever happened to me—it changed my life and continues to allow me to change my life one day at a time.

I’m glad there is a safe place for addicts to go to shoot up in New York. If things work out, maybe there will be more alternatives in other places around the country, and the United States can learn the lesson they’ve already mastered in Europe. Safe use is the first step to life, whether with or without drugs. Addiction is an illness—not a crime. It’s time to stop treating (and talking about) addicts like criminals. The illness makes a criminal out of an addict, but the first step in stopping an illness is treatment.

Marc D. Goldfinger is a member of the board of directors of the Homeless Empowerment Project, which publishes Spare Change news. Formerly homeless, he serves as the paper’s poetry editor.

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