US should follow Canada’s lead on heroin treatment

published on March 23, 2016 by Patricia Daly in The New York Times

VANCOUVER, BRITISH COLUMBIA – The crisis that led officials in Ithaca, N.Y., to consider opening a supervised-injection center for heroin users, part of what the United States Centers for Disease Control and Prevention has called a national epidemic of overdose deaths, is sadly familiar to us here.

Overdose deaths and H.I.V. infection among injection drug users were so high nearly 20 years ago that Vancouver declared a public health emergency. With open drug use and needles discarded in the streets of downtown Vancouver, we responded in 2003 by opening North America’s first supervised-injection center for heroin and other injection drugs.

Clients come to the center, called Insite, with drugs they’ve obtained. Using clean equipment, including syringes, that the center provides, they can inject themselves in one of 13 booths under the supervision of nurses. Those nurses can help them immediately if they overdose.

This model has been a demonstrable success, preventing overdose deaths and reducing rates of H.I.V. infection, while helping some of the most marginalized members of our community get addiction treatment and other important health services.

But despite these achievements, no other city in Canada or the United States has followed Vancouver’s lead. Political ideology, the illicit nature of injection drugs and a profound misunderstanding of addiction have resulted in thousands of preventable deaths every year in both countries.

Addiction is a chronic, relapsing medical condition, not a lifestyle choice. Those disproportionately affected by it include people with mental illness, brain injury and histories of physical and sexual abuse. In the United States, inappropriate prescribing of opioid painkillers set many on the path to heroin addiction, a cheaper and more accessible alternative. Despite vast investments, law enforcement has failed to keep heroin and other illicit drugs out of the hands of vulnerable addicts.