Pubdate: Mon, 09 May 2016
Source: New Mexican, The (Santa Fe, NM)
Copyright: 2016 The Associated Press
Author: David Klepper, The Associated Press


Officials Weigh 'Heroin Havens' Where Users Can Inject Under 
Supervision of Doctors WHO Can Administer Antidote If Necessary

Across the United States, heroin users have died in alleys behind 
convenience stores, on city sidewalks and in the bathrooms of 
fast-food joints - because no one was around to save them when they overdosed.

An alarming 47,000 American overdose deaths in 2014 - 60 percent from 
heroin and related painkillers like fentanyl - have pushed elected 
leaders from coast to coast to consider what was once unthinkable: 
government-sanctioned sites where users can shoot up under the 
supervision of a doctor or nurse who can administer an antidote if necessary.

"Things are getting out of control. We have to find things we can do 
for people who are addicted now," said New York state Assemblywoman 
Linda Rosenthal, who is working on legislation to allow supervised 
injection sites that would also include space for treatment services. 
"The idea shouldn't be dismissed out of hand. I don't see anyone else 
coming up with anything new and innovative."

Critics of the war on drugs have long talked about the need for a new 
approach to addiction, but the idea of allowing supervised injection 
sites is now coming from state lawmakers in New York, Maryland and 
California, along with city officials in Seattle, San Francisco and 
Ithaca, N.Y., who note that syringe exchanges were once controversial 
but now operate in 33 states.

While such sites have operated for years in places such as Canada, 
the Netherlands and Australia, they face significant legal and 
political challenges in the U.S., including criticism that they are 
tantamount to waving a white flag at an epidemic that should be 
fought with prevention and treatment.

"It's a dangerous idea," said John Walters, drug czar under President 
George W. Bush. "It's advocated by people who seem to think that the 
way we should help sick people is by keeping them sick, but comfortably sick."

But proponents argue such sites are not so radical outside the U.S., 
pointing to examples where they offer not only a place to shoot up, 
but also health care, counseling and even treatment beds. In many 
cases, the users are there to shoot up heroin or dangerous opioids 
like fentanyl, though some take painkillers in pill form.

Three clinics - in Vancouver, Amsterdam and Sydney-visited by the AP 
initially faced opposition from politicians and members of the public 
but gradually won support, in part because of studies showing 
reductions in overdose deaths.

The deaths of actors Philip Seymour Hoffman and Heath Ledger put 
celebrity faces on the risks of overdosing alone, and it was revealed 
recently that representatives for Prince sought help for his 
addiction to painkillers just a day before the musician was found dead.

In an effort to stay safe, some addicts are taking matters into their 
own hands. In Boston, after Massachusetts General Hospital equipped 
security guards with Narcan, the hospital began seeing an uptick in 
addicts shooting up in bathrooms and parking garages.

Elsewhere in the city, a nonprofit recently set aside a room where 
addicts can go after using drugs. The users can't inject there, but a 
nurse monitors those in the room and will intervene in case of overdose.

U.S. federal law effectively prohibits injection facilities, but 
supporters say that if a state or city were to authorize one, 
Washington could adopt a hands-off approach similar to the federal 
response to state medical marijuana programs.

Kevin Sabet, a former drug policy adviser to the Obama 
administration, put the chances of injection sites getting approval 
anytime soon at zero. He believes supporters want full legalization 
of all drugs and are exploiting the opioid crisis to advance their agenda.

California Assemblyman Tom Lackey, who served on the California 
Highway Patrol for 28 years, said he understands that supporters are 
looking for a new approach. But he has deep reservations about 
legislation in his state that would create clinics where users could 
use heroin, crack or other drugs.

"These facilities send a message that there is a safe use, and I 
don't think there is any safe use of heroin," he said.

In Maryland, state House of Delegates member Dan Morhaim is an 
emergency physician who himself has administered Narcan "many, many 
times." He sees his bill for supervised injection sites as just one 
of many creative approaches that will be needed to solve the heroin problem.

"It's not going to cure everyone," he said. "But moving people from 
more dangerous behavior to less dangerous behavior is progress."

Marianne Jauncey, medical director at Sydney's Medically Supervised 
Injecting Centre, said she would prefer better ways to help hardened addicts.

Her facility will work to keep them alive until that happens.
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MAP posted-by: Jay Bergstrom