[EDITOR’S NOTE: The following is a Letter to the Editor, written by a Reader. It does not necessarily reflect the opinion of The B-Town Blog nor its staff:]
Rebuttal: â€œWhy I do not Support â€˜Safeâ€ Injection Sitesâ€:
I am writing in response to the Letter to the Editor written by Cydney Moore in support of Safe Injectio Sites posted on Sept 15, 2017. I have reviewed a link that she provided in support of her position and conclude that the evidence is cited incorrectly and in an obviously biased manner.
Cydney writes that â€œThere is strong evidence to support harm reduction models, including – and especially – safe injection sites. In fact, the World Health Organization and the American Medical Association have both come out and endorsed the implementation of safe injection sites in communities struggling with drug addiction.â€
Cydney makes it sound as if the AMA is touting SISâ€™s whole-heartedly as its recommendation for communities with drug problems. But, if you click on the link â€œendorseâ€ in the 11th paragraph, you find that the AMA was recommending something totally different and that the World Health Organization included in her quote, was not included in the link at all.
If this link is read thoroughly it includes the following information:
- The AMA agreed to support a PILOT SIF/SIS begun to explore the feasibility of endorsing the use of SIF/SISâ€™s in the future, focusing on the legalities, costs, and benefits knowing they could not extrapolate the results of the Canadian and Australian sites to our country. The following statement is a direct quote from the AMA-â€œPilot facilities will help inform U.S. policymakers on the feasibility, effectiveness and legal aspects of supervised injection facilities in reducing harms and health care costs associated with injection drug use.â€
Also cited within the same link was a comprehensive study of the literature by the Massachusetts Medical SocietyÂ which also felt that the research from Canada and Australia could not be generalized to the US.
Other findings from the Massachusetts Med. Soc.:
- Mixed findings on public nuisances generated by SISâ€™s and that the opinions from local residents, police and business owners were mixed.
- The cost effectiveness needs more research.
- From an ethical point of view, the difficulty of obtaining informed consent when evaluating SISâ€™s was compounded by the fact that subjects were under the influence of a controlled substance.
- From a legal point of view, legislation to allow for health care workers being in the presence of heroin, a prerequisite for SISâ€™s, did not pass in the Massachusetts legislature session of 2015-16, and would need much broader support to become law. Also the legalÂ and liability risk to physicians and health care providers was felt to be too greatÂ to pilot a SIS unless such a law was passed, or a federal exemption was obtained. This federal exemption from drug laws would be very unlikely in the absence of convincing scientific evidence of benefit, and in the current political climate.
- The process should include review of both the societal and individual benefits of SIFâ€™s.
I also note that although this article stated there was no increase in the number of people using drugs intravenously in the localities where such facilities operated, it was also found that police stopped charging drug users and instead escorted them to the SIS once these were available, creating a mirage of decreased drug charges and use.
Finally, and most importantly (I believe), it is noted repeatedly that the support for a pilot program for SISâ€™s has only been in the context of â€œready access to counseling, referral, rehab, and placement-on-demand for the insured and uninsured. In our present local situation, this is problematic.
In summation, the well-written and superficially well-researched letter by Cydney Moore was in fact a biased misstatement of the source she included. Burien is not the right place for an experimental program with no convincing scientific evidence behind it. This experiment would require an enormous amount of research and clinical supporting facilities not available in our community. Implementing this experiment would put our community at risk.
– Karen Boyden
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