Policy Challenge: The Need for Overdose Prevention Sites and Harm Reduction in 2020

Overdose Prevention Sites, also known as safe injection facilities, are a basic human right. While this sounds like a wild claim, Article 3 of the Universal Declaration of Human Rights states that “Everyone has the right to life, liberty and security of person.” Security of a person can be seen as a prohibition of cruel and unusual punishment. The right to life is more self explanatory, it means that we all have the right to live and shall not be killed by another entity, including the government. Through this Article, Overdose Prevention Sites for IV drug users, is a basic human right. While some may be weary when thinking about how overdose prevention sites may equate to basic human need, it can be simplified with the thought that without these sites IV drug users will die. We do not get to decide whether or not these people are diseased or struggling morally, it is their right to life and security, and it needs to be met. Overdose is a preventable death, however the United States Government views addiction as a flaw in character and in turn uses cruel and unusual punishments when dealing with drug addicted people, jail or death. 

The policy I am presenting is the use of Overdose Prevention Sites in NJ. At this time, overdose prevention sites, although not illegal, are also not legal. Laws and law enforcement have complicated the implementation and limited the impact of harm reduction programs in the United States. Overdose Prevention Sites would be vulnerable to police interference, clients could be arrested for drug possession, and staff members might fear arrest or discipline by professional licensing authorities. (Beletsky et al. 2008)  

Overdose and drug use in Newark cause more problems besides death, albeit that is the largest one. In NJ, over 7 people died a day due to drug overdose in 2017. This number does not reflect the number of people brought to hospitals due to drug overdose, it does not reflect the number of people living on the streets while there families sit and worry, it does not reflect the people discarding their needles on the sidewalk or in the bathroom stall because they know if they have it on them they could be arrested, it does not reflect the amount of times someone tried treatment and it did not work or they were not ready, it does not reflect the amount of times someone using was arrested for possession or how police officers could be doing many other things that would be more beneficial to the general public, it does not reflect the tax dollars people in New Jersey spend criminalizing the disease of addiction, it does not reflect a lot of things, but it reflects the people dying in New Jersey from a 100% preventable death. 

“A SIF (Overdose Prevention Site also known as Safe Injection Facility) is a place supervised by licensed health personnel where IDUs (Intravenous drug users) inject drugs they obtain elsewhere. Facility staff do not directly assist in injection, but rather provide sterile injection supplies, answer questions on vein care and safer injection methods, administer first aid, and monitor for overdose. SIF staff also offer general medical advice and referrals to drug treatment and other social programs. Some SIFs extend services to drug users who do not inject. In addition to reducing the health risks of drug use and serving as a bridge to other services, SIFs are intended to reduce the externalities of public drug use in the communities they serve. They generally target high-risk, socially marginalized IDUs who would otherwise inject in public spaces or shooting galleries.” (Beletsky et al. 2008) 

Overdose prevention sites will assist in decreasing many of the above mentioned problems that come with substance abuse that are plaguing New Jersey. Overdose prevention sites can also address criminal activity that comes along with substance abuse, such as breaking and entering, petty theft, and burglary. Overdose prevention sites will also address a bigger problem, which is a lack of compassion and connection for IV drug users. Within an overdose prevention site, there would be registered nurses to keep the user safe, along with a peer support worker and social worker, that can offer a safe place to talk, to listen, to offer treatment, or to help with emergency housing. While this solves a problem, it also creates a bigger one which is access to affordable and effective treatment. It would be necessary for this policy to address the need for accessible treatment, when a client walks into a site and decides they want help, this puts “where” into question. The Overdose Prevention Site would need multiple beds available at all levels of care for clients to go when they chose treatment, due to addiction being such a fast paced disease the willingness can come and go, making it imperative that when they say “yes I want help,”- help is there.

From my perspective, the only con is the fact that treatment is not accessible or affordable. Throughout all of the United States clients are thought of as insurance policies, and people are dying because of it. If this policy, the Overdose Prevention Sites, came to fruition, that is something we would have to look at and examine, and I don’t think it’s something people want to do. The pro is that less people will die. When a person dies from overdose, they do not have the chance to recover, they do not have the chance to give it their all, a dead person cannot recover. Outside of their personal life, I think about the family and friends that will not see the light go back into their loved ones eyes and instead will have to attend a funeral. From my perspective, Overdose Prevention Sites are a human right. 

Section 6.01 of the NASW states  that “Social workers should promote the general welfare of society, from local to global  levels, and the development of people, their communities, and their environments.  Social workers should advocate for living conditions conducive to the fulfillment  of basic human needs and should promote social, economic, political, and cultural  values and institutions that are compatible with the realization of social justice.” Social workers must engage in political action that ensures that people have access to the resources required in meeting their basic human needs. Overdose Prevention Sites are political, they are socially just, and they promote welfare of an at risk population. One of the core values of social work is the value and dignity of a person, which is something I believe is overlooked when discussing those suffering with substance use disorder. These are people that need our help. They are vulnerable and oppressed, jailed and stigmatized. It is within the ethics and values of social workers to not only help these people, but to advocate for them.

Throughout this paper, I have outlined the change that needs to be made to the policy. The policy now does not allow for the use of Overdose Prevention Sites as a way to utilize the harm reduction model of treatment, or as a way to help those using drugs find accessible treatment. The policy needs to completely change- we need these sites in order to combat the opioid epidemic and to help a vulnerable population of people fight for their lives and their rights. While some may say this ideology is “crazy,” I cannot imagine an argument outside one based on personal bias.  

References

Beletsky, L., Davis, C. S., Anderson, E., & Burris, S. (2008). The law (and politics) of safe injection facilities in the United States. American journal of public health, 98(2), 231–237. https://doi.org/10.2105/AJPH.2006.103747

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