For anyone who was wondering how the Trump administration might respond to plans for supervised injection facilities (SIFs), which aim to reduce drug-related disease and death by offering a safe, sanitary, and medically monitored environment where people can inject illegal substances, Deputy Attorney General Rod Rosenstein makes it clear in a recent New York Times op-ed piece that the Justice Department is firmly opposed to the idea. What's not clear is why.
Rosenstein complains that local governments plan to "subsidize" SIFs, which he describes as "taxpayer-sponsored haven" for drug users. Given the billions of dollars that the government routinely squanders on anti-drug efforts that are not just ineffective but counterproductive, a strong argument can be made that harm reduction programs like SIFs are a far more efficient use of taxpayer money. But they need not involve any public expenditure. The SIFs under consideration in New York City, for instance, would be funded and run by nonprofit organizations. With that sort of arrangement, government's role is limited to getting out of the way.
Rosenstein says SIFs "are very dangerous and would only make the opioid crisis worse." Yet research has found that SIFs, which operate legally in 66 cities and 11 countries but are prohibited in the United States, help prevent fatal overdoses, control the spread of HIV and hepatitis C, reduce skin and soft tissue infections, and encourage enrollment in drug treatment.
A 2010 study estimated that Insite, a Vancouver SIF that opened in 2003, saves five times as much money as it costs. According to a 2016 cost-benefit analysis, a SIF in San Francisco would save $2.33 for every dollar spent on it. A 2017 summary by the Penn Wharton Public Policy Initiative concluded that "the effectiveness of SIFs is clear," which helps explain why the American Medical Association supports their legalization.
