The opiate epidemic is just that: an epidemic. Every 10 minutes someone in the United States dies from an opioid overdose. People with opiate addiction are 56 times more likely to die than their non-addicted counterparts. It is deadlier than many cancers. Despite the existence of several effective treatments for opioid addiction, the epidemic continues and people continue to die. Unique solutions are needed, which is why I support Assemblyman David Orentlicher’s AB345, a proposed measure creating safer injection facilities (SIFs), places where people who have opioid use disorder can come to more safely use their drugs.
On their face, SIFs seem counterproductive. Providing a place to continue using drugs simply feels wrong. However, we know people with opioid addiction are going to continue using drugs until they are given treatment with medications. About 95 percent of people with opioid use disorder who detox will continue to use opioids if not given medication to treat their addiction. When a person has an opioid use disorder, NOT using is not a real option. Without SIFs, people will continue to use their drugs at home, in restaurant bathrooms, at school, on the street, in public parks. Wherever they happen to be, they will use. By providing a clean and safe place for opioid use, SIFs prevent both individual health and community level problems associated with opioid addiction. They protect both the public and the addicted person.
The oldest SIF in North America, called Insite, opened in 2003 in Vancouver, Canada. Many others exist around the world. Data collected about the benefits of safer injection facilities proves:
Simply bringing people inside offers numerous positives to the community and to people who use drugs. Aside from these benefits, SIFs offer a safe space for people with opioid addiction to access treatment for their addiction. Treating people for opioid use disorder with buprenorphine (suboxone), methadone, or natrexone works. Aside from curbing the use of illicit opioid use, these medications provide a level of stability to people’s lives, allowing them to hold a job, reintegrate with their families and return to school — all things which further promote treatment success, result in less opioid use, and a benefit to the public.
Doctors or nurses based at SIFs provide treatment or give referrals to treatment for people with opioid addiction. In my work as a buprenorphine doctor, many of my patients say before meeting me they were unable to find a place to access medication for their addiction. They continued using drugs not because they wanted to but because they could not find treatment. SIFs offer a way to meet people where they are at and provide them with what they need, directly linking them to life saving care.
SIFs open the door to treatment to everyone no matter their status in the community — they save public money, save lives, do not promote drug use, and provide access to life saving treatment. They protect the community from harm. Nevada is no longer a small state with small problems. With treatment ads on the TV and a growing population throughout all parts of the state, Nevada’s libertarian culture is the perfect place to open the first SIF in the country. Support AB345. We need everything available in our arsenal to fight this epidemic and save lives.
Mat Kladney is a Reno native and a graduate of Galena High School. He is an assistant professor of medicine at New York University, and is currently researching how best to treat opioid use disorder by providing buprenorphine and naltrexone for patients at Bellevue Hospital.