U.S. drug policies are shifting. Slowly, and not enough, but there is progress. Mandatory minimums are being phased out. Treatment is increasingly available to those caught up in the criminal justice system. As the Affordable Care Act begins to take effect, treatment will become more broadly funded, especially for the poor. There is concern among public health professionals, myself included, that the policy shift will fall short of what we need to change conditions for injecting drug users.
Legal pot isn’t enough. For there to be an American version of Insite, Vancouver's celebrated, medically-supervised, legal injecting space, the U.S. would need to decriminalize entirely. If Philip Seymour Hoffman had taken his last bags to a legal injecting space, would he still be alive? Had he overdosed there, medical staff on call might have reversed it with Naloxone. Had he acquired an abscess or other skin infection, he could have sought nonjudgmental medical intervention. Perhaps injection site staff could have directed him back to treatment.
Safe injecting sites are an amazing, life saving, humanity restoring intervention we can’t have because our laws preclude them. Too frequently, heroin addicts instead utilize abandoned buildings and vacant lots to shoot up in order to evade arrest. The risk for assault, particularly sexual assault for women, in off-the-grid, hidden get-high places is incredible. Overdosed bodies are routinely pulled from such spaces in North Philadelphia.
Hoffman and the Terrible Heroin Deaths in the Shadows
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