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San Francisco opens up safe-injection room

StarOceanHouse

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SAN FRANCISCO - City health officials took steps Thursday toward opening the nation's first legal safe-injection room, where addicts could shoot up heroin, cocaine and other drugs under the supervision of nurses.

Hoping to reduce San Francisco's high rate of fatal drug overdoses, the public health department co-sponsored a symposium on the only such facility in North America, a 4-year-old Vancouver site where an estimated 700 intravenous users a day self-administer narcotics under the supervision of nurses.

"Having the conversation today will help us figure out whether this is a way to reduce the harms and improve the health of our community," said Grant Colfax, director of HIV prevention for the San Francisco Department of Public Health.

Organizers of the daylong forum, which also included a coalition of nonprofit health and social-service groups, acknowledge that it could take years to get an injection facility up and running. Along with legal hurdles at the state and federal level, such an effort would be almost sure to face political opposition.

Bertha Madras, deputy director of demand reduction for the White House Office of National Drug Control Policy, called San Francisco's consideration of such a facility "disconcerting" and "poor public policy."

"The underlying philosophy is, 'We accept drug addiction, we accept the state of affairs as acceptable,'" Madras said. "This is a form of giving up."

Sixty-five similar facilities exist in 27 cities in eight countries, but no other U.S. cities have considered creating one, according to Hilary McQuie, Western director for the Harm Reduction Coalition, a nonprofit that promotes alternative drug treatment methods.

"If it happens anywhere in the U.S., it will most likely start in San Francisco," McQuie said. "It really just depends on if there is a political will here. How long it takes for that political will to develop is the main factor."

Drug overdoses represented about one of every seven emergency calls handled by city paramedics between July 2006 and July 2007, according to San Francisco Fire Department Capt. Niels Tangherlini. At the same time, the number of deaths linked to overdoses has declined from a high of about 160 in 1995 to 40 in 2004, he said.

Colfax estimated that there are between 11,000 and 15,000 intravenous drug users in San Francisco, most of them homeless men. Like many large U.S. cities, the city operates a clean-needle exchange program to reduce HIV and hepatitis C infections.

Advocates plan to work on building community support for a safe-injection center, including backing from Mayor Gavin Newsom and the Board of Supervisors.

In Switzerland, Spain and other European countries with such programs, the sites have been placed in existing public health clinics and created as stand-alone facilities, said Andrew Reynolds, a program coordinator with San Francisco's city-run sexually transmitted diseases clinic.

Possible options for opening one in the city include homeless shelters, AIDS clinics or drug treatment centers, he said.

"They aren't these hedonistic dens of iniquity," Reynolds said. "There is no buying or selling of drugs on the premises. Staff do not assist in injections."

While it's too early to tell what the room in San Francisco would look like, Vancouver's InSite program is located on the upper floor of a low-rise building in a downtown neighborhood where drug users shoot up in the open.

The site, exempt from federal drug laws so users can visit without fear of arrest, has 12 private booths where addicts inject drugs such as heroin, cocaine or crystal. They can use equipment and techniques provided by the staff, and then relax with a cup of coffee or get medical attention in the "chill out" room where they are observed, said program coordinator Sarah Evans.

"It looks kind of like a hair salon," Evans said of the bustling space. "If we were a restaurant, we would be making a profit."

While 800 overdoses have occurred on the premises, none of them resulted in death because of the medical supervision provided at InSite, said Thomas Kerr, a University of British Columbia researcher who has extensively studied the program. His research also has shown an increase in addicts seeking drug treatment and a decrease in abandoned syringes, needle-sharing, drug-related crime and other problems since the clinic opened, he said.

The results indicate the idea is worth replicating, despite the criticism it may attract, Kerr said.

"I prefer the approach of the Vancouver Police Department, which was: 'We don't like the idea of this, but let's look at the evidence and at the end of three years we will tell you either this is something we can support or it's something we can't support,'" he said.

Temple University law professor Scott Burris told the audience at Thursday's forum that a supervised injection room would seem to run afoul of federal drug possession laws and a state statute that makes it illegal to operate a crack house or any place where drugs are used, but only if the police and federal agents enforce them.

He cited as an example California's medical marijuana law, which has allowed pot dispensaries to flourish but at the risk of being raided by federal authorities.

"The law isn't a barrier," Burris said. "The issue of whether it's legal doesn't come up until somebody is arrested."


http://news.yahoo.com/s/ap/20071019/ap_on_re_us/supervised_injections
 
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kush86

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finally, maybe the US will pull it's head out of it's ass and realize that by denying user's programs/services like this, they are exacerbating the crime, OD, HIV/AIDS, Hep C, etc. Hopefully the people behind this succeed and set an example for the rest of the country that having a program like this WILL NOT increase crime, draw drug-users to their community (they are already there....duh).

Although when you consider that some areas of the US do not even allow, or are extremely stringent w/ methadone clinics, which have been around since god knows when, the future of this article seems rather grim, although I do have to give props to the city of San Fran for their liberal views on most things.
 

Mariposa

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I'm actually against this. It IS poor public policy and enables addicts to continue being addicts rather than assist them in getting off the drugs. If one chooses to use drugs intravenously, it is best that they have access to clean equipment. Our needle exchange and other community resources see to that very well.

There is no real comparison between this and medical marijuana dispensaries. Medical use of marijuana is well-established, researched, and I don't recall any recent cases of HIV/hepatitis/whatever transmission from sharing a bowl.

Real estate is at too much of a premium here to use it this way. I can think of much better ways to spend SF's tax dollars - beginning with expanding our bus/light rail system and enforcing fare payment so that ALL citizens of SF can travel throughout the city without getting threatened with our bags being jacked.

The reality of living here is not as utopian as people like to believe.
 

phr

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I'm actually against this. It IS poor public policy and enables addicts to continue being addicts rather than assist them in getting off the drugs. If one chooses to use drugs intravenously, it is best that they have access to clean equipment. Our needle exchange and other community resources see to that very well.
Actually, getting them off drugs is part of the agenda. It allows addicts to come in contact with treatment service personnel. Many do not know what is available. It's the same as with needle exchanges.


Real estate is at too much of a premium here to use it this way. I can think of much better ways to spend SF's tax dollars - beginning with expanding our bus/light rail system and enforcing fare payment so that ALL citizens of SF can travel throughout the city without getting threatened with our bags being jacked.
Fuck the real estate value. It's one location, and it saves lives.


Oh, and they also spread harm reduction.
 

bingalpaws

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"The underlying philosophy is, 'We accept drug addiction, we accept the state of affairs as acceptable,'" Madras said. "This is a form of giving up."
wow, talk about zero grasp on the situation. I'm sorry, but you HAVE to accept drug addiction, history's kind of proved it's been here, is here, and always will be here. Now madras, I want you to think of that real long and hard, and then you'll have an idea about why your drug war will never, and can never, be victorious.
 

SKL

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I wonder if they're taking job applications. I would literally move across country for that, feel like I could really make a difference in that sort of setting and am god damn tired of the east coast.
 

Mariposa

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phrozen, while I am deeply committed to harm reduction, I still feel it's a misallocation of tax dollars.

Someone on another board (www.sfgate.com) made the comment that we in SF are going to give IV drug users a safe place to shoot up, but 25 minutes away in Belmont, a resident cannot even light up a cigarette in his/her own condominium.

Before you buy that airline ticket, realize that SF has the highest (by way of percentage of population) rate of homelessness and drug addiction. I live and work in a relatively high-income neighborhood, and every day when I walk to and from work no fewer than 5 homeless people, some quite aggressively, approach me for money. Although I have compassion for them and their plight, I believe in "teaching a man to fish". I can count the times I have given panhandlers money on one hand. However, I often give homeless (oops, I meant "residentially challenged") persons my leftovers when I take them home from a restaurant. I know my fortune could change in an instant. The point is driven home every day.

It breaks my heart a little bit every time I walk down Market Street. This isn't going to solve anything. I don't agree with Madras, but I'm not about to throw my support behind a solution that is little more than a Band-Aid. I believe there are ways to educate IV drug users that do not involve enabling them. I have never done IV drugs in my life - does this make me unsympathetic?

Get the homeless into programs that are PROVEN to work. "Care, Not Cash" has turned into a fucking joke. Education and assimilating the IV drug using population into the workforce will save more lives than this initiative. THAT, to me is "harm reduction" - not enabling.

I therefore support an initiative in which the needle exchange program was expanded and efforts at education and medical care were given more funding. Hire the registered nurses there. Publicize it more. But don't give a drug user a private booth in which he/she may use. Give them education on "safer" using and give the rest of the funding to our infrastructure and schools. I hear we're pretty much due for an earthquake too...
 

phr

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It's not enabling drug use anymore than needle exchanges. It is providing a safe place to do something very risky that will get done either way. It is saving lives, I don't see how anyone could be against that. Sure, treatment and abstinence will reduce more harm, but not everyone will buy into that. People are going to use IV drugs no matter what, why not help these people out?

Let's say that all drugs would be legal, as they should be, would you be against injection rooms then?
 

chicpoena

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mariposa said:
I'm actually against this. It IS poor public policy and enables addicts to continue being addicts rather than assist them in getting off the drugs. If one chooses to use drugs intravenously, it is best that they have access to clean equipment. Our needle exchange and other community resources see to that very well.
Having medical personnel present when people shoot up saves lives. The article says that they saved 800 lives. Fuck land values. I'm rather surprised that a BL moderator is more concerned with money and the real estate market than saving peoples lives. This is life or death. People aren't less human because they're addicts. These are fucking human beings we're talking about.

Bottom line: people aren't going to stop shooting up. They're going to keep ODing. Having a place where they can safely shoot up increases rates of admission into treatment and cessation of use. It's almost a paradoxical effect. I wrote a paper on this for my community psychology class and in Germany heroin addicts who go to these places often stop using because they find out about methadone and bupe. They find out what the cuts are doing to their body. They receive medical treatment. Crime rates drop. The data is clear: the safe shooting parlors help people quit and reduces deaths from ODs and improves the health of people who are addicted.

Are your tax dollars REALLY worth more going into a railway system instead of a program that will save hundreds of people's lives? How much is a human life worth to you? By labeling someone an addict you can dehumanize them. We're talking about people who are addicted. They have a medical problem and are physically dependent on a drug.

I believe that human life is priceless and that it shouldn't be an issue to spend money on saving people's lives. How much is a human life worth to you Mariposa? How much of your tax dollars would it be ok to spend to save someone from an overdose? None?

I've got to say that I'm quite shocked at your cold and callous view on this issue. Especially for someone volunteering her time at a harm reduction website.

You should read the article by Benedickt Fischer titled Drugs, Communities and "Harm Reduction" in Germany: The New Relevance of "Public Health" Principles in Local Responses. Journal of Public Health Policy, Vol. 16, No. 4. (1995), pp. 389-411.

It will probably change your mind when you see how much money is saved through reduced deaths, ambulance calls, hospital visits, etc. For me, saving lives is enough but maybe seeing how much money is saved will change your mind as well.
 

garuda

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phrozen said:
Let's say that all drugs would be legal, as they should be, would you be against injection rooms then?
Government run yes, private sector or charity supported no.
I just don't see why its the responsibility of government to provide places to use recreational drugs.

This schizophrenic approach troubles me, either drugs are illegal or not. We're getting into drugs are illegal, unless you're an "addict" then they're not. Thats ridiculous, if we've come so far as to provide needles and shooting galleries can we just legalize already?
 

bingalpaws

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chicpoena said:
Having medical personnel present when people shoot up saves lives. The article says that they saved 800 lives. Fuck land values. I'm rather surprised that a BL moderator is more concerned with money and the real estate market than saving peoples lives. This is life or death. People aren't less human because they're addicts. These are fucking human beings we're talking about.
if that's what you took away from those 2 posts you should re-read them because, as much as you seem to want to make this a cash v life issue, that's not what the moderator's point was. Real estate was mentioned but it's quite clear there's another major reason if you go back and re-read.
 

phr

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I just don't see why its the responsibility of government to provide places to use recreational drugs.
I agree with you, it should be up to the private sector. Maybe the city should just pass the law and allow non-profits to run these things.
 

Khadijah

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^^^Dingdingding!!!! I agree w/that completely. everybody knows that the government aint gonna know the best way to handle that shit anyways. Leave it to the peopel with experneice, people get their safetly, the taxes dont go to it, everybodys happy.
 

BlueEclipse

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man i can see cops just sitting around watching people go in and out of that place. amd busting them when there off the property. i would much rather hide in my house and IV than be around a bunch of stange people. but its whatever i dont live in SF i dont know how it is there.
 

jorder1010

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the gov't should just make pure heroin and coke to sell to the addicts. it would be a lot safer 8)

a move like this shows that a) the govt knows its policy of arresting addicts is shitty b) there are things the gov't can do to decrease the problems related to hard drug use (by regulating the usage, giving free syringes).

what better way to regulate the problems of hard drugs than to make them legal and have places for addicts to shoot up?

personally, i hate the idea of hard drugs being legal like that (and i dont think the gov't like it either). sure, it will save lives, but it is also not good for society to have rampant hard drug use. this is one step closer to this and its not good.
 

birdie

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jorder1010 said:
the gov't should just make pure heroin and coke to sell to the addicts. it would be a lot safer 8)

a move like this shows that a) the govt knows its policy of arresting addicts is shitty b) there are things the gov't can do to decrease the problems related to hard drug use (by regulating the usage, giving free syringes).

what better way to regulate the problems of hard drugs than to make them legal and have places for addicts to shoot up?

personally, i hate the idea of hard drugs being legal like that (and i dont think the gov't like it either). sure, it will save lives, but it is also not good for society to have rampant hard drug use. this is one step closer to this and its not good.
Why is "hard" drug use bad for society? Most of the problems related to "hards" drugs are worsened by prohibition, and some are even caused by it. If "hard" drugs were legal, those problems associated with them would start to shrink, some disappearing. Anyway, why are so-called "soft" drugs, like cannabis for example, okay, but not "hard" drug like heroin? Last I checked, heroin wasn't any more physically or mentally damaging than cannabis. Yet many people will fight hard for cannabis legalization, claiming (rightfully so) that the government and the media spread lies and propaganda about it, but when it comes to "hard" drugs like heroin, they believe the same crap their fighting against. You say that the thought that "hard" drugs may one day be legal is not good for society, but what's not good for society is prohibition.

Sorry for going of on a little rant, but I just get tired of saying that one drug is okay to use, usually because they use said drug, and should be legalized, but drugs they don't like are evil and should be illegal. Not saying that's what jorder1010 necessarily said, but I just felt like venting.

As for what this thread is about, I agree with phrozen when he said that the city should allow non-profit organizations to run these safe injection sites. I don't want the government running these sorts of things, but I do think we need them.
 
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