When a safe injection facility was first introduced, Rep. Jonathan Singer was on the fence. Before taking public office, he had worked with people struggling with addiction. This experience made him wary of giving heroin users a place where they could safely inject their drugs.
“The last thing I thought I wanted to do was to encourage them to continue using,” he said. “By providing them with a safe space to do that, I thought I might actually be rewarding that behavior that we didn’t want to see.”
But since then Singer has changed his mind.
He is a member of the Opioid and Other Substance Use Disorder Interim Study Committee, a bi-partisan group of lawmakers. Last month, they agreed to support a package of bills in the 2018 session that they hope will reduce the opioid dependence and deaths. One of the six bills plans to create a supervised injection facility pilot program in Denver.
Supervised injection facilities have been around since the mid-1980s and there are about 100 operating in nine countries around the world. Vancouver opened the first one in North America in 2003, Insite, and Canada plans to open a handful more this year.
Mark Townsend, one of the founders of Insite, said no one has ever died at a safe injection facility.
“These were places where people could inject drugs safely and their addiction, if you wanted to call it a health problem, didn’t have to be a death sentence,” he said. “You could live for another day to get into treatment or detox.”
There are currently no safe injection facilities in the U.S., but sites have been proposed in cities across the country. The study committee decided to pilot a facility in Denver because the city council had expressed interest in opening one.
Denver City Council President Albus Brooks recently went to Vancouver to take a tour of Insite. While there, he also met with police, local politicians and public health officials. After his visit, Brooks said he now has a great sense of urgency to get the supervised injection facility bill passed.
“There are proven results, we know they work,” he said. “I believe this is one strategy of many that could help.”
Supervised injection facilities also provide sterile injection equipment, access to health care and treatment referrals. The practice falls under harm reduction, a spectrum of strategies that meet drug users where they are. This could mean enrolling someone in a detox program -- or providing sterile water to safely cook black tar heroin.
Supervised injection facilities also provide sterile injection equipment, access to health care and treatment referrals. The practice falls under harm reduction, a spectrum of strategies that meet drug users where they are. This could mean enrolling someone in a detox program -- or providing sterile water to safely cook black tar heroin.
Supervised injection facilities are controversial in the U.S. and some detractors have said they promote drug use. It’s a similar sentiment to how people feel about another harm reduction strategy: needle exchange programs.
Needle exchange programs, now commonly referred to as syringe access programs, began popping up in a few cities around the country in the early 1990s in response to the AIDs epidemic. Handing out clean syringes was illegal at the time, but it helped reduce the spread of illnesses like HIV and Hepatitis C.
The legality of the practice has gone back and forth but today there are syringe access programs in most states. Federal funds can be used to support them in many ways -- except to buy needles.
Nearly three decades ago Boulder was one of the first cities in the country to hand out clean needles, though its syringe access program didn’t become legal until 2011.
The Boulder County Health Department operates four sites, including one that’s open 24 hours a day. The program, which is anonymous, also provides a lot of other services like HIV and Hepatitis C testing, drug safety education and referrals if clients are ready for treatment.
Due to the current opioid epidemic in Colorado, the number of clients Boulder County serves grew from about 200 in 2010 to more than 1,300 so far this year.
Patti Brezovar is an HIV and Hepatitis C prevention specialist and has worked at the Boulder County Health Department for 17 years. She said the syringe access program provides an important service to drug users.
“I think it allows people that have been really stigmatized for a long time to not hide and not have shame around their use,” she said. “That allows them to access services and resources that they might not have otherwise gotten.”
Even with harm reduction programs like syringe access facilities, 528 people died from opioid and heroin overdoses in Colorado last year.
That’s why Jonathan Singer and other members of the legislature’s study committee believe a supervised injection facility is the next step in combating the problem.
“We decided to go with a very small, one-off pilot program to give it an opportunity to see whether is succeeds or fails or see how it succeeds,” he said. “Then see if this is something we can move on a larger scale.”
The supervised injection facility bill, if passed, would also allow hospitals to add syringe access programs and public schools to provide opioid overdose medication. Lawmakers will begin work on the measure when the legislative session begins in January.
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