Over the last few years, I have watched with a blend of amazement and grave concern as an odd phenomenon has unfolded against the backdrop of our nation’s opioid crisis: Despite the clear need to battle this ongoing epidemic with all of the tools at our disposal, one evidence-proven option — supervised injection facilities — is being overlooked, and even disparaged.
Back in the spring, the Massachusetts Medical Society began advocating for the establishment of a pilot supervised injection facility in the commonwealth of Massachusetts. It was not an easy decision because physicians don’t want to condone, or to be seen as condoning, the use of illicit drugs. Yet after close review and thorough debate, it was clear that the data supported their use.
A supervised injection facility is a safe, clean space where individuals can inject drugs they already possess under the supervision of trained medical staff. The facilities also offer sterile injection equipment. The advantage is that medical expertise is immediately present in case an emergency occurs. At the same time, these on-site clinicians can facilitate pathways to treatment and rehabilitation from the chronic disease of opioid abuse disorder.
Such sites provide an alternative to dangerous injection tactics like syringe sharing, syringe reuse, and improper disposal of soiled injection materials, all of which can lead to infection with HIV and hepatitis C, as well as other painful and hard-to-treat infections that can attack the heart, bones, and other organs.
As a physician and president of the Massachusetts Medical Society, I was initially inclined to oppose the concept of supervised injection facilities. How, I thought, could a health care professional, someone grounded in ethics and an oath to “do no harm,” stand by and watch as individuals inject street drugs into their veins?
Yet the opioid crisis and the frightening rate at which it has accelerated doesn’t allow for the outright dismissal of this idea — or any others — that could have prevented even one of the more than 60,000 deaths caused by drug overdoses in the United States last year.
As a health care professional, I can’t stand idly by with the knowledge that a better way exists for reaching and caring for those suffering from the disease of addiction. We can’t allow individuals to die cruel deaths alone in alleyways or under the cover of darkness in public parks.
The concept of supervised injection facilities fits well with the overarching and proven public health philosophy of harm reduction: meeting patients where they are in their disease to eliminate existing barriers to rehabilitation.
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