Big Picture:

In 1971, President Richard Nixon initiated the “War on Drugs,” starting an era of anti-drug laws, regulations and policy that continues to this day. Despite Nixon’s efforts, drug use in America has worsened since this declaration. Over 100 people die every day in the United States from a drug overdose. There is a drug overdose issue in America, and approaching the issue as a war has not been successful.

Operative Definitions:

1. Safe-Injection Site (SIS): Facilities designed to reduce the public health issue of drug overdose and allow individuals to use pre-obtained illegal drugs under the supervision of trained health staff. Other names used include: Supervised Injection Sites, Supervised Consumption Services and Supervised Injection Facilities.
2. The War on Drugs: A government-led initiative that aims to decrease or stop illegal drug use and distribution  initiated by President Nixon in 1971.
3. Drug Overdose: The ingestion of a lethal amount of any substance including prescription medication, over-the-counter medication and legal or illegal drugs.
4. The Honey Pot Theory: The theory that opening a safe-injection site in a community will attract more drug users and distributors to that community.
5. Naloxone: A medicine that can rapidly reverse an opioid overdose.

Important Facts and Statistics:

1. There are legal, formally sanctioned safe-injection sites in 14 different countries: Australia, Belgium, Canada, Denmark, France, Germany, Luxembourg, Mexico, the Netherlands, Norway, Portugal, Spain, Switzerland and Ukraine.
   Currently, there are no formally authorized SIS in the U.S., but multiple states including Pennsylvania, California and New Jersey have initiated the process.
2. As of Jan. 13, 2021, the Department of Justice has deemed the opening of an SIS a federal crime because these sites would allow individuals to break federal law.
3. There has been a small, invite-only, unsanctioned SIS operating in California since 2014. The SIS shows no significant positive or negative effect on drug-related crimes in the area.
4. Drug-related deaths have steadily increased over the years even after President Nixon declared the War on Drugs.

4-Point Plan:

(1) Reevaluate our country’s approach to the drug crisis. America’s current approach to the drug crisis is the “War on Drugs.” This terminology alone can lead to a harsh interpretation and implementation of drug policy and laws. Attacking the problem “war-style” is not working. It is time to shift to a more accepting and treatment-focused approach. Time has proved that making drugs illegal does not stop people from doing them. We know that people are still using drugs, if not more so now than in the past, despite the illegality of them. With this in mind, we need to stop fighting human nature and understand that if drug use cannot be avoided, it needs to be treated.

(2) Allow for the implementation of safe-injection sites in America that will not break federal law. The biggest barrier to the introduction of SIS in America is the illegal status of the drugs these sites would allow people to use. Allowing for the implementation of these sites would create the opportunity for research and analysis of their effectiveness, and would introduce a new approach to the drug crisis: kindness and support.

(3) Combat the stigma of drug use. Everyone has a different experience with drugs. Some experience them first-hand, others witness a loved one experience them (and the side effects), others study the drugs and others completely exclude drugs from their lives. Whatever the interaction, or lack thereof, there is almost always a negative view of drug use. This negative view is a barrier to innovative solutions to the drug crisis. Removing, or reducing, the negative stigma of drug use can allow for solutions like safe-injection sites to be more easily implemented and can usher in a shift to a more hospitable approach to the drug crisis.

(4) Treat drug addiction rather than punish it. Addiction is not exactly a choice. If it were a choice, it would be much easier for addicts to stop using drugs. Keeping this in mind, it would be much more beneficial to promote rehabilitation methods so that those who are in need of help can seek it without concern for other aspects of their wellbeing, such as their freedom.

Why This Initiative is Important:

The American government’s response to the drug crisis is not working. Drugs are still prevalent in society, increasing numbers of people die annually from drug overdose, prison populations are steadily increasing, partly due to mandatory minimums for drug offenses, and there seems to be no real end in sight. It is time for a shift from a punishment-focused approach to the drug crisis to a treatment-focused approach. Safe-injection sites will usher in an era of kindness for drug users, which will hopefully encourage sobriety. Drug use and overdose also impacts multiple aspects of society including public health, public safety, law enforcement, the workforce, homelessness and much more. Safe-injection sites can help drug users access trained professionals who can prevent overdose deaths by providing easy access to naloxone and can ease the load on law enforcement and prisons.

Acknowledgements:

This proposal was written by Elena Carmona. Elena was a Justice and Public Safety intern at ONC during the Fall 2021 Semester. 

Sources:

“Naloxone Drugfacts.” National Institutes of Health, U.S. Department of Health and Human Services, 4 Jan. 2023, https://nida.nih.gov/publications/drugfacts/naloxone. 

Ellis, Mary Ellen. “Drug Overdose: Definition, Treatment, Prevention, and More.” Healthline, Healthline Media, 25 Feb. 2020, https://www.healthline.com/health/drug-overdose.  

“War on Drugs - Timeline in America, Definition & Facts.” History.com, A&E Television Networks, https://www.history.com/topics/crime/the-war-on-drugs.  

“A History of the Drug War.” Drug Policy Alliance, https://drugpolicy.org/issues/brief-history-drug-war.  

“Overdose Prevention Centers.” Drug Policy Alliance, https://drugpolicy.org/issues/supervised-consumption-services.  

Nursing@USC. “Supervised Injection Sites Are Coming to the United States: Here's What You Should Know.” USC.edu, UNIVERSITY OF SOUTHERN CALIFORNIA, 24 June 2021, https://nursing.usc.edu/blog/supervised-injection-sites/. 

“Appellate Court Agrees with Government That Supervised Injection Sites Are Illegal under Federal Law; Reverses District Court Ruling.” The United States Department of Justice, 13 Jan. 2021, https://www.justice.gov/opa/pr/appellate-court-agrees-government-supervised-injection-sites-are-illegal-under-federal-law.