War on drugs requires new tactics: Our view

The Editorial Board , USA TODAY Published 4:56 p.m. Updated 6:39 p.m. ET May 16, 2016

Supervised heroin injection sites show promise in Canada, Europe.

With an average 78 Americans dying each day from overdoses of prescription opioid painkillers and heroin, it’s clear that the U.S. is losing the war on drugs. The epidemic has spread to suburbia and rural areas. The death toll from heroin has more than tripled since 2010. And the nation is desperate for answers.

Congress is working on bipartisan measures that would give states, localities and non-profit groups money to finance an array of education, treatment and law enforcement programs. Final passage can’t come a moment too soon. But it’s all rather standard fare.

To deal with people who are already addicted, some unconventional thinking is required, and here’s one idea worth considering: supervised injection facilities, where an addict can bring heroin and inject it in a clean, safe environment under medical supervision, with easy access to counselors and health care referrals.

Yes, we know, this might look crazy at first glance. We thought so, too, but the results where this approach has been tried suggest it just might make sense.

This is not a ploy to legalize heroin, weaken law enforcement or replace treatment. It’s an idea that has been effective in Europe, where about 90 such centers operate, and in Vancouver, where the only center in North America opened in 2003.

According to researchers at the University of British Columbia and the Center for Excellence in HIV/AIDS, the Canadian center has prevented overdose deaths, reduced the risk of HIV and AIDS through the use of clean needles, cut down on public injections and their dangerous debris of used needles, and promoted detox and treatment.

The facility, called Insite, has saved lives after on-site overdoses, and in the 27 months after it opened, overdose deaths dropped 35% in the blocks around the facility — four times the decrease in the rest of Vancouver. The facility, which receives funding from the British Columbia government, has saved taxpayers money by reducing expensive-to-treat HIV and AIDS cases.

Critics have tried to debunk findings of Insite’s success, and in the mid–2000s, a new Conservative Party prime minister moved to shut it down. But the battle became the center’s savior. National medical, public health, and nurses associations intervened on its side, and in 2011 the Canadian Supreme Court unanimously rejected closure, finding that “during its eight years of operation, Insite has been proven to save lives with no discernible negative impact on the public safety and health objectives of Canada.” That opened the way for more facilities. Now Toronto, Montreal and Ottawa considering the idea.

In Europe, such injection centers have been around for 30 years. Since the first one opened in Switzerland, the idea has spread to Germany, the Netherlands, Luxembourg, Denmark, Norway and even Sydney, Australia. Like Insite, they’ve made it more likely that addicts will enter treatment, according to the European Monitoring Center for Drugs and Drug Addiction. Not surprising, when you put the hardest-to-reach addicts in a place where counseling is readily available.

Impressed by these results, a handful of city officials and state lawmakers in the USA are interested. The mayor of Ithaca, N.Y., is pushing the idea, and the county prosecutor is on board. In Seattle’s King County, Sheriff John Urquhart, a former narcotics detective, told The Seattle Times he is “still trying to wrap my head around this. But the more I hear, the more open I am to the possibility.”

Critics remain adamant that the idea is preposterous, tantamount to declaring surrender in the war on drugs and turning the government into an enabler of illegal drug use. The same arguments were used against methadone clinics and needle exchanges, which now have widespread acceptance.

Vancouver’s experience can inform U.S. decisions: Start small with modest goals — bringing addicts off the streets, preventing disease and overdoses — and provide rigorous, independent research to see whether similar programs can work here.