Imagine that you have a brain disease. The disease causes you to inject a substance into your body. The injection might be occasional, or it could be daily, or even several times a day. Your brain is commanding you to do it. You wish you didn’t do this, but your volition has been hijacked.
You are embarrassed about this task, so you try to do it in private. You try to find a hiding place where you can be alone and where no-one will see you.
You know that there’s a chance that you’ll die from this task. The substance you purchased may be impure and deadly, causing you to overdose, stop breathing, and not be rescued. You know that you probably eventually will die at some point if you can’t stop. You know that your death would shatter the lives of your parents, siblings, partner, and any other loved ones. It would also horrify your friends, employer, co-workers, and neighbors. You know that if you don’t die from overdose, you might get another disease, like HIV or Hepatitis.
You’re aware that even though you tried to find a hiding spot – this time, the restroom at Starbucks – there’s a chance that someone will see you. In fact, a child might see you. Exposing a child to such a disgusting task would sicken you. His or her parent would certainly let you know what a lowlife you are for doing what you’re doing. You think that the parent would be right.
This is the scenario faced by more than 500,000 people in America every day. Your neighbors, co-workers, perhaps your friends, perhaps even your family members are facing this situation. (My novel, Granville Street, describes the struggles faced by people with Opioid Use Disorder (OUD) more fully.)
It would be nice if our nation didn’t have this problem, but we do. It would be nice if 2.5 billion opioid prescriptions hadn’t been written between 2006 and 2016, addicting a generation, but they were. It would be nice if most of the people who got addicted to opioids didn’t end up on heroin, but they did. It would be convenient if the people with OUD would just stop, but most of them can’t.
The opioid epidemic is one of the greatest health care crises this country has ever faced. The question now is, what do we do? How do we keep the problem from getting worse, and how do we treat the people now addicted? Not just treatment in the medical sense, but how do we treat our fellow citizens? Do we want to maximize the harm – putting them in jail, making them felons, preventing them from having jobs? Do we want to ignore them, and let the problem solve itself by letting them die, as Middletown, Ohio, city councilman Dan Picard recently suggested? Or do we want to minimize the harm and try to keep them alive until they might get better, and become productive members of society.
One way of reducing the harm is supervised injection centers – places where people with OUD can go to safely inject. They can get a clean needle and be watched by a clinician after they inject. If they overdose, they can be revived with Narcan. Most people who survive years of heroin addiction eventually get better. The challenge is keeping them alive until they get there.
There are about one hundred safe injection centers in Canada, Australia, and Europe. These centers prevent the spread of additional diseases like HIV and Hepatitis, they keep the people with OUD alive, and they reduce city costs since there are fewer street overdoses for paramedics and police to respond to. There are discussions of such centers being established in California, Colorado, and Pennsylvania, but so far, there are none in the USA.
It’s about time we do more to reduce the harm of this epidemic to our fellow citizens. How about we establish the first American safe injection center right here in Chicago and the suburban area?
Louis Lamoureux is the Founder of Recovery Friendly Workplaces Inc, a consulting firm dedicated to helping employers update their policies, practices, and benefits programs to support recovery from Substance Use Disorder. He is the author of the bestselling novel, Granville Street, which explores a fateful week in the lives of four people impacted by the opioid epidemic.