Safe Injection Sites

Safe injection sites have been popping up around the world since the early 70’s and while the United States has considered the move to be controversial, there are some cities giving the idea a chance.

Heroin use in America

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According to the Centers for Disease Control and Prevention, “Heroin use has been increasing in recent years among men and women, most age groups, and all income levels. . . During 2015, around 828,000 persons in the United States (12 years or older) used heroin in the past year, which is an estimated rate of 0.3 per 100 persons. And in 2014, more than 11,000 hospitalizations occurred for unintentional, heroin-related poisonings.” These statistics account for heroin use, not for other illicit drugs and do not include those persons who were untruthful or who did not participate when the gathering of this information occured.

Spread of disease

With drugs like heroin that are taken via injection comes an increase in disease spread by unsanitary conditions and dirty needles. The CDC estimates that “about 1 in 10 new HIV diagnoses in the United States are attributed to injection drug use or male-to-male sexual contact and injection drug use.” While diseases are spreading rampantly through the drug community, the general public is also at an increased risk in contracting infectious diseases such as HIV and viral hepatitis. Although some inject drugs at home, other use drugs such as heroin in public places including parks, bathrooms, public transportation, homeless camps, or discreet areas near businesses. Any member of the general public, including children, may come across used needles and other drug paraphernalia left out in these areas. Almost 40 states have implemented needle exchange programs in an effort to stop the spread of disease, but this may not be enough if users are too high to transport their dirty needles to these facilities.

Safe injection sites

Safe injection sites, otherwise known as supervised injection sites are areas set aside for users to use illegal drugs such as heroin. These safe injection sites offer access to clean needles and medical supervision as well as educational information regarding drug abuse. Safe injection sites have been gaining in popularity throughout Europe since the 1970’s with countries such as the Netherlands having more than 30 facilities in operation. The United States however has been slow to accept the idea of safe injection sites with authorities worried it will encourage drug use or appear as though state and government officials are endorsing the illegal activity.

Overdose Prevention

Photo by: Todd Huffman

While safe injection sites could help prevent the spread of disease, one of the most beneficial reasons for these facilities is reducing drug overdoses. The CDC has estimated that over the last year, at least 70,000 people have died from drug overdoses. Over just the last month, several cities throughout the country have experienced spikes of drug overdoses from illegal substances such as heroin to even marijuana which is legal in many areas throughout the country. These overdoses as of late have not been caused by users ingesting a greater quantity of the drugs, but from the drug itself being different from what they are used to. Some drug users may think they have an idea as to what their limits are when it comes to how much of a certain drug they can handle safely. Unfortunately, not all drugs are created equal, with some having a higher potency while others are might be cut with other harmful substances that can quickly cause a user to overdose. These other substances may include synthetic drugs such as Fentanyl or chemical fillers with unknown reactions when ingested. With medical staff standing by at safe injection sites, users can rest assured there will be someone there to render aid and overdose reversal drugs if needed.

Protection for users and the public

Fortunately a handful of cities throughout the United States including Seattle, San Francisco, Denver, and Philadelphia that are finally seeing the health benefits safe injections sites can offer to the public as well as drug users. Hopefully more areas of the country will accept these facilities but until then, friends and family of drug users are encouraged to keep drug reversal drugs on hand and to help their loved ones locate safe needle disposal locations in their area.

Rising Overdose Deaths Caused from Counterfeit or Laced Prescription Opioids

Overdose deaths continue to be on the rise and many of those deaths occur from individuals consuming counterfeit or laced prescription opioids.

Prescription pain relief

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Opioid based pain relievers such as Morphine, Oxycodone, and Hydrocodone were created for doctors to help their patients manage severe to chronic pain. Although they can be helpful for pain, they also mimic the euphoric feeling produced by another addictive opioid: heroin. Far too often, patients become addicted to these pharmaceutical opioids and begin obtaining them elsewhere, outside of a doctor’s care.

Opioid crisis

According to the National Institute on Drug Abuse, “prescription and over-the-counter (OTC) drugs are, after marijuana (and alcohol), the most commonly abused substances by Americans 14 and older.“ While heroin is extremely dangerous and has definite negative connotations associated with its use, prescription opioid abuse is more common and sadly, often overlooked. Additionally, misusing prescription pain pills can lead to heroin use as well. The NID notes “about 4 to 6 percent who misuse prescription opioids transition to heroin and “about 80 percent of people who use heroin first misused prescription opioids”.

Rising overdose deaths

Opioid abuse has been declared a crisis throughout Utah and the nation, yet the amount of individuals using and overdosing continues to rise. The Centers for Disease Control and Prevention state: “Drug overdose deaths and opioid-involved deaths continue to increase in the United States. The majority of drug overdose deaths (more than six out of ten) involve an opioid. Since 1999, the number of overdose deaths involving opioids (including prescription opioids and heroin) quadrupled. From 2000 to 2015 more than half a million people died from drug overdoses. 91 Americans die every day from an opioid overdose.”

Fentanyl

While many overdose deaths occur from a person intentionally misusing or overusing a prescription drugs, other deaths are caused by taking counterfeit pills made to look like authentic pain relievers or pills laced with high amounts of other substances. One commonly used ingredient in laced or counterfeit pills is a synthetic opioid known as fentanyl. Fentanyl is similar to other prescription opioids such as OxyContin and morphine, however the effects of fentanyl are “50 to 100 times more potent” according to the NID. That potency increase comes at a price though. The NID affirms “Among more than 64,000 drug overdose deaths estimated in 2016, the sharpest increase occurred among deaths related to fentanyl ( . . . ).”

Laced or phony pills

Sadly, addiction does not allow the danger of fentanyl in prescription drugs to stop individuals from consuming pills bought off the street. Some may think they are doing their due diligence by verifying the pill’s size, color, and imprint on pill checking websites, however many counterfeit prescription drugs on the street look just like original. The only way to know for sure what is contained in a pill is to obtain the medication with a valid prescription. Since that is unlikely to happen for addicts, drug treatment and rehabilitation is encouraged to help those fighting addiction.

Overdose reversal

Loved ones of addicts unable to successfully rehabilitate are encouraged to obtain life saving measures to save their family member or friend should an overdose occur. When a person overdoses on opioids, their respiratory system slows down to a stop which can quickly lead to death. Naloxone, known commercially as Narcan reminds the brain to signal the lungs to breathe. Previously obtainable with a prescription, the nasal spray Narcan is now available over the counter. Walgreens has just announced that nearly 80,000 of their stores across the nation will now be stocked with the lifesaving medication. Until more can be done to prevent mass opioid abuse, at least there are things in place to reduce the lives lost to this dangerous epidemic.

Opioids and Benzos – A Deadly Combination

Opioids and Benzos- two highly addictive drugs that can be obtained illegally or with the help of a physician can be a deadly combination when used together.

Opioids

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Opioids are a type of drug that binds to the opioid receptors in the body, reducing pain while increasing a sense of euphoria. Opioids can come in illegal forms such as heroin or fentanyl or they can be prescribed legally by a doctor. These prescription opioids include the popular:

• OxyContin;
• Morphine;
• Vicodin; and
• Codeine.

Opioids by themselves have caused tens of thousands of overdose deaths last year alone. They are highly addictive, quickly leading to dependency. They who are dependent on opioids commonly misuse them in extreme quantities. Misuse or overuse of opioids can result in respiratory distress and death.

Benzodiazepines (Benzos)

Another “feel good sedative”, Benzodiazepines are “a type of prescription sedative commonly prescribed for anxiety or the help with insomnia“ according to the National Institute on Drug Abuse. The go on to describe common [benzos] as “Valium, Xanax, and Klonopin.” Just like opioids, benzos can sedate a person too much, decreasing their breathing to dangerous levels. Combined, Opioids and Benzos are too often deadly.

A deadly combination

Photo by: Jason Rogers

On their website, NIH also states “More than 30 percent of overdoses involving opioids also involve benzodiazepines”. With both drugs meant to sedate, it is highly likely that the combined effect of both drugs being used simultaneously can suppress breathing to the point of stopping completely. The respiratory system of users is so relaxed, it forgets to intake oxygen.

Help for those with addictions

Those who know individuals struggling with an opioid addiction, inform them of the dangers of mixing benzos with opioids even under a doctor’s care. Those fighting addiction are encouraged to instead look at “effective medications [that] exist to treat opioid use disorders [such as] methadone, buprenorphine, and naltrexone.” Loved ones of addicts should consult with a doctor about obtaining the drug naloxone to reverse an overdose should the unthinkable happen when they are present.