Supervised injection facilities may help reduce overdose fatalities, particularly if they provide overdose prevention, counseling, and treatment referral services. While the data are limited, research findings reported in JAMA suggest that these supervised injection facilities may help reduce the likelihood of death and disability in people who inject prescription or illicit drugs.1

More than 70,000 deaths were attributable to drug overdoses in 2017, according to the Centers for Disease Control and Prevention.2 In an effort to combat the rise in overdose-related mortalities, the American Medical Association, along with other national health organizations, support the funding of supervised injection facilities. No drugs are provided at supervised injection facilities, nor do these facilities provide healthcare practitioners that inject drugs into patients. Rather, healthcare personnel at supervised injection facilities supervise individuals’ injections and are available to administer naloxone or other procedures when necessary. Although this is commonly done in the emergency room, it is often too late to save the patient in this setting following an overdose.

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Supervised injection facilities across Australia, Europe, and Canada have reported substantial reductions in mortality in residents who have overdosed at their facility. Public injections in the surrounding communities decreased during varying time periods, while rates of drug trafficking and crime did not increase during the same time points. Critics of supervised injection facilities suggest that governments have no right to incentivize unlawful behaviors in their communities. States may be able to seek research exemptions that specifically permit government-funded public health studies, including studies involving supervised injection facilities.

Current law has been largely unsuccessful in curbing the opioid epidemic and reducing fatal overdoses. “Whether [supervised injection facilities] will succeed in the United States is undetermined, but harm-reduction strategies abroad have prevented overdose deaths and promoted drug dependency treatment for decades,” the investigators wrote. “The opioid crisis remains a national public health emergency that demands therapeutic strategies guided by scientific evidence, and not inappropriate applications of punitive criminal laws.”

References

  1. Gostin LO, Hodge JG Jr, Gulinson CL. Supervised injection facilities: legal and policy reforms [published online February 7, 2019]. JAMA. doi:10.1001/jama.2019.0095
  2. Centers for Disease Control and Prevention. Drug Overdose Deaths. Atlanta, GA: Centers for Disease Control and Prevention. www.cdc.gov/drugoverdose/data/statedeaths.html. Published 2017. Updated December 18, 2018. Accessed February 25, 2019.