Desperate for more effective ways to confront the opioid crisis, cities and states are reining in doctors who prescribe too many opioid painkillers and suing drugmakers for downplaying how addictive their products are. But the epidemic has moved beyond prescription pills to illicit drugs, so it also makes sense to try an approach that's more aggressive – and controversial: giving addicts a safe place to use drugs.
Opponents argue that this policy amounts to government sanction of unlawful and destructive behavior. But such centers, which are supervised by medical personnel, save lives and money and help draw addicts into treatment, a recent cost-benefit analysis shows. Like methadone clinics and needle-exchange programs, they are one way to directly confront a grim reality.
Deaths from fentanyl overdose rose more than 72 percent from 2014 to 2015, and show no signs of slowing down. The drug is 50 to 100 times more powerful than heroin, and its derivative carfentanil is 100 times stronger still. Users, who may believe they are taking heroin, can die within minutes of taking the drugs.
At supervised injection facilities – dozens exist outside the U.S. – nurses and other medical practitioners are on hand to administer naloxone to keep overdosing users alive. They also provide clean needles, advice about safe consumption practices, and referrals for treatment for substance abuse, mental health and other needed services.
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The study examined the experience of such a center in Vancouver and projected the impact of a similar center in Baltimore -- a city with an extraordinarily high, and rapidly rising, overdose fatality rate. In Baltimore, the researchers concluded, a supervised injection facility could prevent six deaths a year, 108 overdose-related ambulance calls, 78 emergency room visits and 27 hospitalizations. That would amount to a savings of $7.8 million a year – much more than the $1.8 million it would cost to run the place.
The city of Seattle plans to open the first safe-injection center in the U.S., though some state legislators oppose it. States and the federal government certainly have an interest in enforcing drug laws and policy. In this case, however, they should stand aside and let cities experiment responsibly. In the still-raging opioid crisis, all reasonable efforts to save lives should be given a chance to work.