Drug Policy

Vermont's U.S. Attorney Says Safe Injection Sites Encourage Illegal Drug Use. The Research Says She's Wrong.

Is U.S. Attorney Christina E. Nolan intimidating Vermont legislators who want to keep their constituents alive?

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A nurse at the Insite safe injection clinic in Vancouver, B.C., holds a basket of clean supplies. Credit: Darryl Dyck/ZUMA Press/Newscom

The United States attorney with jurisdiction over Vermont announced this week that a proposal to introduce supervised injection facilities (SIFs) in the state would be illegal under federal law and would "encourage and normalize heroin use."

Vermont legislators are considering supervised injection facilities due to the state's massive increase in opioid overdose deaths. In November, a group of local law enforcement and medical professionals in Chittenden County, Vermont, concluded an eight-month study of SIFs by announcing that the state legislature should legalize them.

Such facilities have operated for years in Canada, Australia, many cities in Europe, and Iran. They allow heroin users a safe place to inject, clean needles, and access to social workers and medical staff.

The list of SIF proponents in Vermont includes Patricia Fisher, a physician at the University of Vermont Medical Center; University of Vermont Police Chief Lianne Tuomey; Chittenden County State's Attorney Sarah George; and Grace Keller, the head of a harm reduction facility called Howard Center.

But others in Vermont's law enforcement community appear unready to lower the death toll. "By permitting SIFs, is Vermont at risk of condoning heroin use and giving illegal drug use the state's stamp of approval?" asked Tom Anderson, the state's commissioner of public safety, in November.

And now a federal prosecutor has waded into what should be a state and local debate. On Wednesday, the office of U.S. Attorney Christina E. Nolan released a statement claiming that SIFs "are counterproductive and dangerous as a matter of policy." Here's more:

[T]he proposed government-sanctioned sites would encourage and normalize heroin use, thereby increasing demand for opiates and, by extension, risk of overdose and overdose deaths. Opiate users, moreover, all-to-often believe they are purchasing heroin when, in fact, they are purchasing its common substitute, fentanyl, ingestion of which gives rise to greatly enhanced dangers of overdose and fatality. Introduction of fentanyl to SIFs would create additional public health risks, not only for the users, but for SIF staff members who might come in contact with that highly potent substance.

What's really interesting about this statement is that not one part of it is true. A 2014 literature review of 75 SIF studies concluded that such facilities are "efficacious in attracting the most marginalized [drug users], promoting safer injection conditions, enhancing access to primary health care, and reducing the overdose frequency." The literature review also found no evidence that SIFs "increase drug injecting, drug trafficking or crime in the surrounding environments."

As to whether it's better to get people off heroin than to let them shoot up safely: That's the wrong question to ask. Of course it's better to not be addicted to heroin. But there's a huge disparity between the availability of evidence-based treatment options and the number of people who want to manage their opioid addiction. Regardless of whether we resolve that asymmetry, basic human decency should compel us to make life less awful for people who risk dying every time they get high.

As Steven Chapman recently put it: "Even the most incorrigible opioid users are not beyond help. But dead ones are, and there are more of those every day."


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  1. Of course they can’t let Vermont try it. What if it worked??

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  2. How can any solution to drug deaths include flouting federal authority? Madness.

  3. Has any place suggested an unsupervised injection site idea? Like, just letting people buy needles, or buy testing kits themselves? Or, hell, just allowing for charity run supervised injection sites.

    Even this is a statist solution. It’s just the solution has a smiley face.

    1. Hamsterdam was supervised too, and we all know how that ended up.

      Smdh.

      1. I mean. I think this is better than we have now, just that a government run clinic isn’t a libertarian solution.

        1. Indeed.

  4. Even Iran is less stupid on drug policy than the US. Sad

  5. How long until the police install hidden cameras to ID every junkie in town? Otherwise, the one in Vancouver seemed to work well enough when I was there on vacation.

  6. Such facilities have operated for years in Canada, Australia, many cities in Europe, and Iran. They allow heroin users a safe place to inject, clean needles, and access to social workers and medical staff.

    Why is this shit being published in an ostensibly libertarian magazine/website?

    1. I can understand your contention with the latter highlight. But I’m pretty sure merely mentioning Europe is not an unlibertarian position.

    2. My first thought reading this one was that it would be an issue that’s pretty good at sorting the libertarians out from the conservatives.

    3. “Why is this shit being published in an ostensibly libertarian magazine/website?”

      Because for the Reason species of libertarian, the sacrament of drug use outranks the principles small government and individual responsibility.

  7. My first thought reading this one was that it would be an issue that’s pretty good at sorting the libertarians out from the conservatives progressives

    fix’d

    There’s nothing even remotely libertarian about this as a policy proposal.

    1. “There’s nothing even remotely libertarian about this as a policy proposal.”

      1. SIV can’t read.
      2. SIV has no idea what ‘libertarian” means.
      3. SIV is an idiot.
      4. All the above.
      I’m going with 4.

  8. Solving the problem of people dying from illegal drugs is simple, legalize them. Nobel Prize please!

    1. Or, shit, just make the benefits of an open injection site available to laymen. Just let them buy it.

      Fuck. This isn’t necessarily a bad thing to do, but having another government financed and managed shelter isn’t libertarian.

  9. “Safe Injection Site” was my nickname in college.

  10. Opiate users, moreover, all-to-often believe they are purchasing heroin

    instead of a well-kneaded dictionary..

  11. This story reminds me of the time that a Drug-Free New Jersey wanted to sponsor a collection and destruction of leftover prescription opioids people had in their medicine cabinets. The organization made arrangements with a local police department to set up a secure dropbox for the drugs to be left in, and for their destruction. All of a sudden, the local DEA told them that collecting prescription drugs for this purpose was not authorized under federal law, and that if the collection took place, Everyone involved, including the local police, would be arrested for drug violations. It took the intervention of the DEA regional administrator to avoid mass arrests.

  12. Think about all of the lives that can be saved if we have publicly funded taxis for drunk drivers? The possibilities are endless once one embraces the welfare state.

    Or we could both not prosecute them AND let them live with the consequences of their decisions. Madness, I know.

    Just announce the merger with Niskanen and Bleeding Heart Libertarians already.

    1. Or just allow anyone to open one of these places. I’m sure some church or something would do this themselves if it was legal.

      Also, allow people to buy needles and the equipment to clean them as a normal thing. Don’t fucking make it illegal except for the powerful few who are deemed worthy to work in a clinic.

  13. What it does do is encourage the migration of junkies. Seattle is a prime example of this.

    1. And for some reason, most people don’t want those fine folks congregating en masse in their neighborhood.

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