Every day in Maine, a life is lost to overdose. Growing up here, I’ve watched the opioid epidemic spread and take hold of classmates and loved ones. Mainers are dying, and a study released earlier this month places Maine ninth in the nation for the rate of fentanyl-related deaths.
Passing judgment and prosecuting and incarcerating people have failed to combat this epidemic. Now is the time to try something new to save lives and heal our community. Now is the time to consider what has been successfully working for others, even if it feels counterintuitive. Harm-reduction methods that work to support, not punish, people who use drugs, have proven to save lives, prevent disease transmission and help people access treatment.
Overdose prevention sites have existed for over 30 years, and not one fatal overdose has occurred at any of these facilities, according to a 2014 review of 75 sites worldwide. These sites allow people who inject drugs to inject already-obtained drugs under supervision of medical professionals. Medical staff save lives by providing test strips to spot fentanyl, as well as oxygen and the overdose-reversing drug naloxone if needed. These sites provide access to addiction treatment and teach safer injection practices and proper syringe disposal. As a result, these facilities not only save lives and improve the health of people in active addiction, but also improve public order by reducing public injecting and syringe litter in our communities.
I know people often react negatively when first exposed to this idea. Even I did, before looking at the data. Over 90 overdose prevention sites exist worldwide, allowing researchers to study their effects, both on people who use them and on their surrounding communities. Recently, my colleagues at the University of Pennsylvania summarized this data. Here are some answers to the most commonly asked questions:
Overdose prevention sites do not increase intravenous drug use in the area. Drug users do not increase their dose or frequency of use. Crime does not increase in the surrounding area.
Overdose prevention sites increase the likelihood that people enter addiction treatment. They save millions of dollars each year by preventing costly ambulance rides and emergency medical care. People who use the sites are less likely to share needles and more likely to dispose of them appropriately. They reduce the spread of diseases like HIV and hepatitis C. Overdose prevention sites save lives.
A close family member of mine is in recovery, and I am grateful that overdose has not taken them from me. Substance use disorder is a relapsing disease, and preventing overdose deaths gives a person in active use or a person who relapses the opportunity to try treatment again. Overdose prevention sites not only provide care for a person in active use, but also provide family members comfort that a safe place exists in the event their loved one relapses.
As a scientist, I train to challenge my intuitions and inherent biases. I train to ask hard questions that challenge the status quo. The status quo is not fixing our community problems, and we need to test new approaches, for our loved ones, for progress.
The data are clear. Overdose prevention sites save money, improve public health and the surrounding area, increase the likelihood that a person in active use seeks treatment and, most importantly, save lives.
If we expect something to change, we must muster our courage and try something new. We ask that our governing body fight for us now, too. I commend Rep. Mike Sylvester, D-Portland, for introducing a bill in April that would allow the Maine Department of Health and Human Services to authorize the opening of two overdose prevention sites. Spokeswoman Lindsay Crete stated, “Gov. Mills will pursue every practical and legal avenue to address the opiate crisis.” On Oct. 2, a federal judge ruled that overdose prevention sites (also called safe injection sites) do not violate federal laws, thereby allowing the overdose prevention site Safehouse to function in Philadelphia. I call upon the rest of our state officials, including Gov. Mills, to come out in support of overdose prevention sites.
If you agree that it’s time to try something better, call your state legislators and ask them to support our fight to care for our loved ones and fellow Mainers.
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