Amid a surge of prescription opioid and heroin overdoses ravaging communities nationwide, one California lawmaker has an unconventional proposal: Create facilities for addicts to take drugs under the supervision of medical professionals.
Assemblywoman Susan Talamantes Eggman’s AB 186 would authorize governments in eight counties to test “safe injection sites” in areas with heavy opioid consumption. Adults could bring drugs they had already obtained and use them with clean needles and emergency care available. Under the bill, pilot programs would be allowed until 2022 in cities or unincorporated areas of Alameda, Fresno, Humboldt, Los Angeles, Mendocino, San Francisco, San Joaquin and Santa Cruz counties.
Though perhaps a counterintuitive solution, the Stockton Democrat acknowledged, research on these facilities in other countries has found they reduce overdoses and steer more people toward treatment by having health care providers on hand who can administer the opioid-blocking medication naloxone and refer visitors to services.
“It’s treating addiction as a public health issue and getting people help rather than criminalizing it,” Eggman said.
Law enforcement groups oppose AB 186, which passed its first committee hearing late last month. Cory Salzillo, legislative director for the California State Sheriffs’ Association, said the bill “sends the wrong message about drug use” being sanctioned by the government and could create liability issues for cities and counties that open sites.
“You may be able to monitor what happens inside of the facility while it’s happening,” he said, but not “what the aftereffects may be when the person leaves the facility.”
Officials in California and across the country are looking for solutions to a deadly epidemic of opioid abuse, in which addiction to prescription drugs like OxyContin and Vicodin has led many users to heroin. About 33,000 Americans died from opioid overdoses in 2015, according to the Centers for Disease Control and Prevention, an increase of nearly 16 percent from the previous year. In 2013, California hospitals treated more than 11,500 patients for opioid overdoses, state figures show.
Eggman, a former social worker, said the “safe injection site” model is beneficial to addicts, who are more likely to be assaulted and get infections if they use on the streets, and to communities, which see a reduction in the number of people injecting publicly and dropping syringes in the surrounding area. Those staffing the facilities also develop relationships with drug users who visit regularly, she added, so when someone is ready to seek treatment for their addiction, they know where to turn for help.
“These are folks who are going in and out of jail systems, who are going in and out of our emergency rooms,” she said. “This is not for everybody. This is not a panacea. This is just one tool in the toolbox of treating opioid addiction.”
Eggman points to success at the first such site in North America, which opened in Vancouver in 2003. A 2007 study concluded that the facility’s opening was associated with a 30 percent increase in the use of detoxification services among visitors, which resulted in fewer subsequent visits to inject as well as elevated rates of addiction treatment. The following year, another study estimated savings of $14 million in the first decade from prevented HIV infections.
Though more than 60 cities in 10 countries, mostly in Europe, have started “safe injection site” programs, a legislative analysis of AB 186 found there are none yet in the United States. Seattle and King County, Wash., in January approved a plan for the country’s first two facilities, and lawmakers in a few other states have introduced proposals similar to Eggman’s.