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Cardella: Safe-injection sites

By Tom Cardella

The debate over whether Philadelphia should open a safe-injection site should be based on available facts. But, like most issues in this country, it’s about choosing up sides. Conservatives claim the sites will increase drug abuse. Liberals claim they will reduce mortality rates from drug overdose. The latest study shows neither side is correct.

Realize there are no safe-injection sites in America today. Cities such as this one, New York, San Francisco and Seattle are getting set to begin pilot programs. Supervised sites presently exist in Canada and some other countries. But for the U.S., this is uncharted territory.

Both sides in the debate agree that the opioid crisis is reaching epidemic proportions in this city and elsewhere around the country. Both sides agree something must be done. And then — like everything else these days — the arguments break down into the familiar syndrome I like to call FOX NEWS versus MSNBC. What makes it worse is that we’ve gotten ourselves into another issue like immigration where the City is pitted against the Department of Justice. The Mayor seems hell-bent on opening a safe-injection site. The DOJ is threatening legal action. Meanwhile, the crisis continues and people are dying.

Supporters of safe-injection sites have pointed to past studies to back their claims that benefits include reduced deaths from overdose. The Mayor has claimed that safe-injection sites could save as many as 25 to 75 lives a year and millions of dollars in hospital costs and public funds. Opponents insistently point to some studies that suggest that the sites would encourage drug abuse and invite abusers into neighborhoods already beset with drug-related problems. Three weeks ago, the results from a supposedly more rigorous study by the International Journal of Drug Policy was published. I suggest we stop choosing sides based on preconceived notions before we actually take a look at the study’s findings.

Summaries of the study were published both by VOX and the Huffington Post. Bottom line? The results suggest both sides ought to take a step back. Supporters of safe-injection sites won’t be thrilled to learn that there was NO evidence that safe-injection sites reduced mortality rates from drug overdose and syringe sharing. That’s important because reducing deaths from drug overdose is the main reason for embarking on safe-injection sites. And the report contradicted the opposition’s claim that safe-injection sites would result in an INCREASE in drug-related crimes. There would actually be a slight DECREASE, according to the study.

Both VOX and the Huffington Post (both of whom were favorably disposed toward supervised sites prior to the published report) agree that this study was more thorough than previous ones. However, a cautionary note — it is generally acknowledged that there is still only a small body of research available. Even this latest report was necessarily based on only eight previous studies. And the report did argue against the opposition that safe-injection sites do NOT result in an increase in drug-related crimes. In fact, the study showed a slight DECREASE.

Which brings us to the current plans in Philadelphia to open a safe-injection site. The usual chorus of Kenney naysayers likes to portray the Mayor as a wild-eyed crazy radical intent on turning our fair city into Haight-Ashbury, San Francisco 1967, if he persists. But they offer no solutions other than those that have already failed and led us to this current crisis. Already upset that — as a sanctuary city — we are lumped in with other liberal bastions, these naysayers must be thinking of fleeing to Canada, now that safe-injection sites may be coming here. (Uh — better get another destination, Canadians are kind of ticked-offed at us right now).

To be fair to the City, which is a novel concept these days, safe-injection sites are just part of its plan to combat the opioid crisis. The program also includes pressuring physicians to write fewer prescriptions for opioids, getting addicts into treatment more quickly, and making naloxone more widely available. Should Philadelphia join San Francisco, Seattle and New York in opening safe-injection sites? A fair question to ask.

In arguing for delegating more power to the states, conservatives have been correct — in my opinion — to suggest that states could be used as laboratories to test new ideas before being federalized. Seems to me that we should also be able to use cities for much the same purpose. Before we know whether safe-injection sites can really work we need a wider sample. The studies themselves suggest as much. The only way we can expand the sample size is to allow cities such as ours to institute pilot programs for a limited, defined number of years, and rigorously do follow-along research while the plan is being implemented.

The latest study shows that, as far as can be determined, safe-injection sites do NOT increase the incidence of drug crimes. And research studies have shown that these programs can help prevent disease. So, where’s the down side? More and better research could result in saving lives.

Why can’t the federal government bless these pilot programs instead of threatening legal action? For all the pompous rhetoric about the war on drugs, we’ve poured untold amounts of money down the drain and the problem has only gotten worse.

Let the cities do their thing. Hope it works.

(You can view or hear Tom Cardella on Monday nights at 6PM on MONDAY NIGHT KICKOFF at wbcb1490.com. You can also follow him on Facebook.)

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