Heroin usage has been on the rise in the United States for years, constituting what some now call an epidemic. Treatment is expensive, and while some users may want it, they are not able to obtain it.
In Colorado, some are fighting for those fighting addiction. Organizations such as the Harm Reduction Action Center in Denver are working to combat this issue, with safe needle exchanges and other resources available to those who need them. Rep. Jonathan Singer, a Democrat serving Longmont, introduced into the Colorado General Assembly a controversial bill pertaining to opioid usage in Colorado.
The bill, SB 18-040, was introduced at the beginning of this legislative session and would allow for the opening of supervised injection facilities (SIF), also known as overdose prevention sites.
“Part of what our SIF pilot program would do is allow people who are struggling with addiction to use while being supervised by somebody who is professionally trained,” said Singer. “We called it an overdose prevention site because that’s the goal here: to prevent overdoses.”
Across the country, the number of deaths from drug overdose is steadily increasing. According to the Substance Abuse and Mental Health Services Administration, the number of heroin users in the United States increased by 135% from 2002 to 2016. In 2016, 64,000 people overdosed in the United States, with 912 of those deaths happening in Colorado. There were more deaths from overdoses in the state than those from car accidents.
According to Lisa Raville, the executive director of the Harm Reduction Action Center, the average heroin user injects about three to five times a day. Most times, the user is injecting heroin not in an attempt to get high but in order to feel normal and not experience withdrawal symptoms.
“There’s a greater fear of withdrawal than there is of death. People are going to use whether or not we think it’s okay, but they don’t want to die,” said Singer.
Of the overdose deaths in Colorado in 2016, 20 of these deaths were outside or at businesses, where people inject in bathrooms to avoid using in the streets. In Singer’s opinion, the biggest hub for those looking to get high indoors in Denver is the Denver Public Library.
“You have people who are indigent or homeless, and they don’t want to use on the streets or want to use surreptitiously, so they find a place with shelter,” said Singer.
The library has social workers and naloxone, a medication used to reverse overdoses, on-site.
“That’s not where it should be happening, which is why we had this bill. It doesn’t belong in our parks and libraries. It should be supervised, but not by librarians,” said Singer.
The overdose prevention sites would allow users to bring in their drugs, and the center would provide everything else needed.
“Syringes, aluminum caps and twist ties … cottons, sterile water, tourniquets, sanitizing stuff, ointment, Band-Aids…pretty much the basics,” said Kevin Garcia, member of the Board of Directors of the Students for Sensible Drug Policy.
The user is not only given these supplies but is allowed in a room, allowed to inject the drugs, and is supervised by a trained professional who is equipped with naloxone in case of an overdose. The user is also provided with resources to get over their addiction.
“When you provide them with the opportunity to say, if you’re going to inject, we want you to do it safely, we care about you. And if you want connections to treatment, to help, then show up because we can help you with that too,” said Singer.
These sorts of facilities are not new. Outside of the United States, several countries have implemented these facilities and have seen very positive results.
“In the mid-1990s, in Switzerland, there was a park called Platzspitz Park, and it was notorious for its drug use, and notorious for its IV heroin use. Eventually, folks started doing some underground harm reduction and started mobile units, and they ran supervised injection facilities,” said Garcia.
An improvement was seen, and police and local officials joined in to eventually make these facilities legal. Since the introduction of legal overdose prevention sites, not only have deaths from overdoses fallen, but the usage of heroin has gone down as well.
According to Singer, in Portugal, policy changes led to funneling more resources into harm prevention services, and the country went from having one of the highest overdose and drug use rates in the European Union to now having one of the lowest.
Ten countries have implemented overdose prevention sites, with a. total of 102 facilities. Raville says in all of these facilities, there has not been one death from overdose.
There are currently several syringe exchanges in the area, which helps cut down the number of people reusing or sharing needles, which could lead to skin infections and the transmission of HIV and hepatitis C. But using a sterilized needle cannot stop overdoses from occurring.
At the HRAC, many people benefit from their services but wish there was more. Sarah, a 37-year-old Denver resident who visits the HRAC, has been using crystal meth for eight years. She came to the HRAC after hearing about the center from a random person on the street to get help with her drug use after beginning to use drugs intravenously. Going to the HRAC has changed her life, even if she is still using.
“It (HRAC) has given me passion and drive again,” she said. “It taught me to love and accept myself.”
Sarah believes these facilities are important and that the overdose injection sites are ‘desperately needed’ in the area.
“(They) will help (users) to not be rushed, thus allowing proper prep…cutting significantly on tissue infections, vein care, etc..,” said Sarah. “(The facilities) are needed for the act of saving lives from overdoses. Beyond that, the potential positive possibilities are truthfully countless.”
The bill to allow for overdose prevention sites was voted down on February 14, even with support from the office of the attorney general. Singer says he will continue to try and help those suffering from addiction and will push for the bill again in the future. There is a stigma attached to drug addiction, which was previously attached to certain economic levels, races or types of people. Now, drug addiction can be found anywhere.
“This is something that is affecting everybody now, and everyone knows somebody that struggles with it. Once it affects you and people you know, you can’t ignore it at that point,” said Singer. “This is a public health issue, and if we can destigmatize it, I think we can actually get to some of those root issues and change the trends, just like they did in Portugal.”
