In 2016, the city of Philadelphia lost 910 men and women to opiate addiction. We are at crisis levels of deaths from heroin and prescription drug abuse. The current methods for handling drug users have not reduced the number of afflicted. We need safe, supervised injection clinics to get needles off our streets, to alleviate the stress on law enforcement and hospitals and, most importantly, to save lives.

This is the "not in my back yard" solution. People are quite literally dying in our streets, in our parks, and in our playgrounds. With a safe injection site comes relief for residents, communities, law enforcement, and victims.

"We cannot police our way out of this. I think many police officers are willing to support new strategies to address the opioid crisis because the methods we are using now are not working."

- Thomas Nestel III, Chief of Transit Police, SEPTA

It is "enabling" to do nothing. It is "enabling" to pretend this is not happening. This problem is getting worse. We need bold action.

 HARD FACTS

• 90% of 911 calls in the 26/25/24th Police Districts are for overdoses

• According to the DEA, 655,000 pounds of opioids were ingested in Philadelphia in 2016

• According to the Centers for Disease Control & Prevention (CDC), 47,055 people died from drug overdoses in the United States in 2014, for a rate more than double that of 2000

• Between 1999 and 2016, the number of prescriptions for pharmaceutical opioid pain relievers in the U.S. more than quadrupled

• People who have misused opioid pain relievers are 19 times more likely than others to start using heroin, even though few people who misuse pharmaceutical opioids become heroin users (4% initiate heroin use
within 5 years)

WHAT IS A SAFE INJECTION CLINIC?

"Supervised injection sites (SIS)[1] (also known as supervised injection facilities,[2] safe injection sites[1] fix rooms,[3] safer injection facilities (SIF), drug consumption facilities (DCF)[4] or medically supervised injection centers (MSIC)[5]) are legally-sanctioned, medically-supervised facilities designed to reduce nuisance from public drug use and provide a hygienic and stress-free environment in which individuals are able to consume illicit recreational drugs intravenously.[4]

They are part of a harm reduction approach towards drug problems. The facilities provide sterile injection equipment, information about drugs and basic health care, treatment referrals, and access to medical staff. Some offer counseling, hygienic and other services of use to itinerant and impoverished individuals."

These facilities are staffed with trained, medical professionals. In the event of an overdose, the staff intervenes to administer life saving treatments such as narcan.

These clinics also provide information about drug rehab facilities offering users a path to recovery, counseling for those who have lost loved ones or struggle with depression, and wound care to heal abscesses and keep users from costly and wasteful visits to the ER. It is counter productive to saddle a penniless drug user with thousands of dollars in hospital bills that are impossible to pay.

WHERE ARE THESE CURRENTLY LOCATED?

In Vancouver, the supervised injection clinic, Insite provides these services and their effect has been astonishing.

INSITE User Statistics
 
To date there are 18,093 registrants with 3,476,722 visits.

There have been 40,245 clinical treatment visits and 4,922 overdose interventions without any deaths.

INSITE 2015 User Statistics

• 263,713 visits to the site by 6,532 unique individuals
• An average of 722 visits per day
• An average of 440 injection room visits per day
• 768 overdose incidents
• 5,359 clinical treatment interventions
• Principle substances reported were heroin (54% of instances) methamphetamine (23% of instances) and cocaine (10% of instances).
• 27% of participants were women
• 5,368 referrals to other social and health services

Insite counselors make thousands of referrals to other social and health service agencies, the vast majority of which are for detox and addiction treatment. The calendar year 2015 saw more than 464 admissions from Insite into Onsite, the adjoining detox treatment facility, which recorded a program completion rate of 54% or 252 clients.

INSITE Budget

Insite and Onsite budget figures for the fiscal year ending March 31, 2016:

Insite's operational budget was $2,938,665.
Onsite's operational budget was $1,454,351.

Most of Vancouver Coastal Health's total expenditures on addictions are used for treatment and prevention. Although harm reduction is an important service to link clients to abstinence programs.

Vancouver Coastal Health spent $231 million in 2015/16 for mental health and substance use community services, of which Insite/Onsite are small programs.

*Overdose interventions include allergic reactions to full cardiac arrests. Insite nurses administer naloxone immediately to reverse the effects of an opioid overdose.

Legislation has also been passed in Seattle to open two supervised injection clinics in King County.

WHY DO WE NEED A SAFE INJECTION SITE?

Not many people know this but Philadelphias is the heroin capital of the world. With a 28.4% poverty rate concentrated largely in the Kensington neighborhoods, hope is little more than another four letter word. A supervised injection clinic offers a way out. It connects users with the resources to get clean and return to society. It gives them safe harbor from forces beyond their control. This is not a permanent solution. This is one facet in a multifaceted effort to end the scourge of the opiate epidemic.

There is a long road ahead. This is a step in the right direction.