
Seattle Is Opening First in U.S. “Safe Injection Facility” for Heroin Addicts - danso
https://www.buzzfeed.com/azeenghorayshi/safe-injection-space-heroin
======
booleandilemma
I used to work at a retail pharmacy and we would have addicts come in to buy
needles all the time. On the one hand I felt bad about supplying these people
with what they needed to feed their habit, on the other hand I felt good that
they were coming to us instead of sharing needles with their buddies.

~~~
Slothrop99
I was not good at feeding my good old cat, so I had to give her insulin
injections for a while. Much later, I found the used and unused syringes in a
bottom cabinet where I put them after she died. I used to work in a hospital
and know you need to dispose of this stuff properly. I brought them back to
the neighborhood Walgreens where I'd purchased them. The people in the
pharmacy were just like "yeah right, your cat", and pretty much treated me
like I was a junkie.

Then again, this is San Francisco, and there are a lot of junkies, and
Walgreens people have probably heard it all. But at ground-zero here, I'd
guess not too many people are buying supplies at Walgreens.

~~~
douche
Fuck those people. I had milk jugs full of used needles when I was a kid,
since I had bad allergies and the doctors seemed to think that poking me every
week with allergy antigens was a good idea...

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WheelsAtLarge
Yes, finally people are starting to see drugs addicts as the valuable people
they are and not as disposable felons. Addiction is a sickness that affects
people not a failure of morals that needs a jail sentence.

~~~
jmspring
Living in a community with heroin addicts that see every opportunity to rob
someone for a fix, sorry addicts are criminals first. There is no excuse for
their behavior.

~~~
itsweller
Yes, every heroin addict robs people to feed their heinous, immoral addiction.

I’d love to hear your thoughts on crime in poverty stricken areas or those of
one predominant race or another, I’m sure they’re just as well reasoned,
tolerant, and coherent.

Behavior like yours is why many turn to other avenues of coping rather than
feeling comfortable seeking help. Don’t think for a second I’m condoning what
you perceive, but your definition of “addict” is likely one or two standard
deviations away from reality, and to imply that all “addicts” are criminals or
all criminals you see are addicted to heroin is more than a little amusing.

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pauljaworski
The Midwest/East Coast really need this, since that is where all the powder,
fentanyl-laced heroin goes. People are dropping like flies in those regions of
the country, while I would imagine the West Coast, where black tar heroin is
sold, hasn't seen as much of an increase in overdoses/deaths.

~~~
LargeCompanies
On Facebook here in the middle to upper class suburbs of Baltimore I see
friends of friends OD and dying once a month.

I don't understand why as growing up I dont recall such an epidemic, yet I do
recall a ton of don't do drugs type of education. Has all those type PSAs &
education in schools cease to exist and or not as well funded as back in the
80s and 90s?

~~~
nfbush
Rise in overdoses can be attributed to dealers adding fentanyl (an extrememly
strong synthetic opiate) to their product. If a particular salesman has a
product which people have reportedly overdosed on will flock to them as they
must be selling a stronger product. Another scenario is where the chemical
isn't there in the first place and the dealer is simply mixing fentanyl with a
filler, due to it's extreme potency (a dose being less than a milligram),
making even a small mistake in the mixing can lead to many overdoses
especially with tolerant users used to taking larger amounts.

~~~
pauljaworski
Fentanyl is actually being synthesized by the Mexican cartels now and added to
the heroin before it even makes it to the street dealers. It's getting really
crazy.

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xyzzy4
They should also sell heroin in pharmacies so people can inject an accurate
dosage. This would greatly reduce overdoses and drug trafficking.

~~~
martinald
I literally cannot understand why this is being downvoted. Prescribed heroin
would save thousands of lives and billions of dollars in ER OD cases and the
acquisitive crime that this disorder causes. Shame on you HN.

~~~
jbigelow76

        >Prescribed heroin would save thousands of lives and billions of dollars in ER OD cases and the acquisitive crime that this disorder causes. 
    

If you get a prescription for heroin that would probably lead to addiction
right? Now as an addict you want more, so you go back to the doctor but they
won't prescribe anymore ostensibly to prevent overdose. So now you have an
addict looking for a way to score more outside of a doctor prescription which
would still open them up to every single risk that currently exists today.
Seems like the end result is going to be the same either way unless doctors
continually up the dosages prescribed, no?

~~~
RangerScience
I think you're using the incorrect mental model of addicts popularized by
DARE, etc.

I mean first -

> If you get a prescription for heroin that would probably lead to addiction
> right?

Decently sure OP is suggesting replacing obtaining heroin from the street with
obtaining it through a doctor. As such, only existing (and new) addicts are
effected; you would not create addicts.

Alternatively, this story you have told is already the case with other
prescription opiates.

> Now as an addict you want more

> continually up the dosages prescribed, no?

I mean, do alcoholics do this? Or gamblers? Adrenaline junkies? Yes and no.

Basically, most of what you know about drugs is inaccurate, and addiction (and
escalation of addiction) is complicated. For instance, the rat park
experiments indicate that addiction is a coping mechanism - rats in individual
cages experience addiction; rats in group cages, not so much. Simply by
obtaining the drugs from a sympathetic ear, you can reduce the dependence on
the drugs.

Here's a thing:

[https://mic.com/articles/110344/14-years-after-portugal-
decr...](https://mic.com/articles/110344/14-years-after-portugal-
decriminalized-all-drugs-here-s-what-s-happening#.wSN9OEbNe)

~~~
loeg
You have a great comment, and I agree with much of it. However, Rat Park
doesn't replicate and probably shouldn't be touted as a good example of
addiction behavior.

~~~
RangerScience
Interesting. I sure as shit don't know enough about Rat Park. Do you have some
links to the failure to replicate?

~~~
loeg
[https://www.ncbi.nlm.nih.gov/pubmed/9148292?dopt=Abstract](https://www.ncbi.nlm.nih.gov/pubmed/9148292?dopt=Abstract)

[https://www.ncbi.nlm.nih.gov/pubmed/11072395?dopt=Abstract](https://www.ncbi.nlm.nih.gov/pubmed/11072395?dopt=Abstract)

[https://en.wikipedia.org/wiki/Rat_Park#Reaction_to_the_exper...](https://en.wikipedia.org/wiki/Rat_Park#Reaction_to_the_experiment)

~~~
RangerScience
Interesting. However, those are attempting to replicate the results, and not
the experiment; from my level of education and based on the abstracts, that
sounds more like "significant results" rather than "disproving results".

The first abstract actually describes a theory that cannot be correct given
the Rat Park experiment as described on Wikipedia, due to group PC (no new
rats were supplied to that group). Or, rather, a theory that does not explain
group PC.

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aaronbrethorst
I live in Seattle and regularly see needles on the street, and occasionally
see paramedics tending to OD'ing addicts. This is a great development but
should've happened years ago.

~~~
trome
Definitely, as a Seattlite I'm all for it, less needles in parks, under I-5,
and on the streets are good. Having users all in one place where they can be
monitored, attended to and offered services much more effectively and at a
lower cost to the taxpayer is also a huge win!

~~~
geoka9
Replying to a sibling (dead) comment:

> Go take a stroll up to Vancouver to the safe-injection site they are
> modeling this after and you'll discover destitute conditions in a large
> radius.

The site is located in the Downtown Eastside - aka "the poorest postal code in
Canada" which had been like that long before the site opened.

------
api_or_ipa
See Vancouver's Insite program for proof it works. It's been a huge economic
and social success, allowing timely intervention to help drug users get clean,
reducing the rate of HIV and HepC amongst intravenous drug users and helping
numerous people get a fresh start at life.

~~~
edblarney
"See Vancouver's Insite program for proof it works. It's been a huge economic
and social success"

No - this is not true. OD's are at an all time high in the region [1]

It's a highly politicized issues and the entities behind it are strongly
incented to make it seem as though it's working.

The only evidence of Insite 'working' is provided by them - and the data
points they provide are selective, unscientific and definitely not objective.

There is no objective evidence to indicate that 'it's working'.

If it were a success - we should see number of users down, crime down, cleaner
neighbourhood etc. - but no. None of that.

There has been no effect on the overall drug using population. There are no
external metrics for success at all.

By 'success' Insite points to the 'number of ODs prevented' the number of
'addicts into programs' \- but this assumes that those ODs would have resulted
in death or would not have been dealt with otherwise, and that there are not
other ways to get people into recovery programs.

Given the amount of $$$ being spent on the clinic, I'm very doubtful that we
can claim any degree of success.

It boils down to a cleaner place to shoot up - that's about it.

I think it's worth keeping open as a 'point of experiment' so that we can try
different methods of approach - but it's ripe to call it a 'success'.

When numbers of users is measurably down, crime is down, that area is safe to
walk in during the day (it's not as of now) - then we can start claiming
success.

[1] [http://www.cbc.ca/news/canada/british-columbia/drug-
overdose...](http://www.cbc.ca/news/canada/british-columbia/drug-overdose-bc-
november-1.3903256)

~~~
nikcub
That data has to be normalized for the surge in fentanyl use.

Sydney has had safe injecting for 15 years, initially the rate of overdose
went down ~75% to around 1 per month but now in the past few years it has
spiked back up again to record levels.

There are also other factors to safe injecting rooms - such as opening
pathways to recovery, removing litter from the streets, preventing hepatitis
and other diseases and removing the taboo from drug addiction.

I don't think anybody claims that safe injecting alone can prevent all opioid
deaths, its part of (and usually the first step of) a multi-pronged approach.

~~~
edblarney
"That data has to be normalized for the surge in fentanyl use"

I agree.

"I don't think anybody claims that safe injecting alone can prevent all opioid
deaths,"

'Safe injecting' is not saving _any_ lives and is not doing any 'harm
reduction' is my point.

The only evidence provided that 'it's working' is the sites data where they
say 'we prevented x number of ODs' \- but this is not quite valid - just
because they think they prevented an OD, does not mean they did. Someone who
takes too much on the street can still get an ambulance and emergency
services. Someone on the street who does 'way too much' is gong to die one way
or another.

There's no evidence that the sites actually 'get more people into programs'
than otherwise.

I believe that more directly interventionist programs might work: if you are
caught, high on heroin in public - then you don't go to jail, but you go to a
facility of sorts. This facility is basically a 'dry out hotel'. The only
thing about this facility is you have zero access to heroin - you have to go
through withdrawal and be clean for 30 day.

 _Withdrawal_ is the unavoidable 'first step' to getting off heroin. There is
absolutely no other way, and it must be done.

Then programs to help people stay off of it.

------
rdl
I was at a law enforcement armorer class with some police officers from
various agencies in the Northeast recently.

The most impactful thing I heard "People who get narcanned multiple times
should just be killed" \-- maybe not his literal belief, but the problem seems
to be out of control. He had stories of "frequent customers" who kept coming
to hospitals/police stations/fire departments to shoot up in the bathrooms,
knowing they'd get narcaned if they OD'd.

As a King County resident, though, I want this facility nowhere near me. As
long as it stays in Seattle or near SeaTac, I'm ok with it. Yes, this is
NIMBYism.

~~~
techsupporter
> As a King County resident, though, I want this facility nowhere near me. As
> long as it stays in Seattle or near SeaTac, I'm ok with it. Yes, this is
> NIMBYism.

At the risk of being flagged into oblivion, this is why I f-king hate the
Eastside. I live and own property in Seattle (so I pay King County taxes just
like the rest of you lot) and I'm sick and damn tired of Seattle being the
dumping ground for whatever crappy problems Bellevue, Redmond, Shoreline,
Kirkland, Sammamish, Issaquah, Duvall, and Fall City don't feel like dealing
with.

This is on top of the city then getting a reputation as being "dirty" and
"crime infested" so that those exact same cities in a "regional partnership"
can troll bait in front of the people and businesses of Seattle to induce them
to move out of the city, thus taking away the tax base to deal with those
dumped problems.

I _guarantee_ that there are heroin users near you and those people would
greatly benefit from this kind of service. Oh, and there are also homeless,
unemployed, and special needs people around you, too. Seattle--and SeaTac--
isn't the receptacle for the entire region's problems, especially if we're
going to get looked down by you lot from high atop your long noses for
receiving them.

~~~
forrestthewoods
If Seattle doesn't want so many addicts maybe we should stop paying for them?

Source: Resident of the city of Seattle

~~~
meowface
You're paying one way or another. If not this, you're going to see increased
hospital and law enforcement costs.

~~~
forrestthewoods
I don't think that's true at all. Seattle has a disproportionately large
homeless population when compared to other cities. We have the 3rd highest
homeless population but are only the 18th largest city. And we're far from the
only city experiencing a housing crisis.

So it's a lot more complicated than "you're gonna pay for it one way or
another".

~~~
meowface
Are you suggesting those homeless people will move to a new city if they can't
get safe syringes or injections in Seattle?

~~~
forrestthewoods
I'm suggesting they first moved to Seattle because of the services offered
here.

~~~
meowface
Certainly not impossible, but do you have any evidence to support that?

~~~
forrestthewoods
Hard evidence? Nope. Maybe it's only 1%. Or maybe it's 20%. No one knows!

My #1 frustration with the homeless crisis in Seattle is that we have almost
zero data. In fact almost all of our numbers on how many homeless are in the
area come from the annual January one night count! It's absurd.

How long have the homeless been homeless? When was their last home? Where was
that home? How many times have they bounced into and out of homelessness? When
was their last job? What was their job? Why did they become homeless?

We honestly have no idea. Solving a problem is particularly different when you
don't even know what they underlying source of the problem is!

Now gathering this data is actually pretty difficult. Many homeless don't have
formal id. And many others have a justifiable distrust of the government and
organizations which make them not want to use their real names.

In Seattle it gets even more complicated. Different groups don't like to share
their numbers as to how many homeless they shelter or how many services they
provide. Because if they all start sharing their numbers some of them are
bound to start losing their funding. And we wouldn't dollars to be spent more
efficiently by another organization now would we?

So why is Seattle's homeless population so wildly disproportionate to our city
size? <shrug> No one knows and we're just guessing.

~~~
rdl
Yes -- getting better data and then creating policy based on that data makes a
lot of sense. I think the safe injection site is actually supported by data
from other cities as a way to reduce junkie fatalities, but it has a lot of
other negative externalities.

(Fortunately for me, unincorporated King County is actually a completely
illogical place to put such a center; no transit, no proximity to anything,
etc. It will probably go in Pioneer Square.)

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mhays
The US isn't. The City of Seattle is. This is an important distinction.

~~~
danso
Good point. I just copy-pasted the headline, but it's Seattle and King County
that is responsible for the decision, even if it is the first safe injection
facility in the U.S.

