WSANA, President Wu Spar Over Safe Injection Sites

By Seth Daniel

Council President Michelle Wu confirmed that she is in favor of Safe Injection Sites (SIFs), but is not in favor of any particular site – though she stopped short of completely ruling out putting one in the South End.

SIFs are supervised locations where intravenous drug users can legally use illegal drugs under the supervision of clinical staff. They are illegal in the United States, but a movement in the medical community recently has pushed to examine them as part of the solution to the epidemic in Massachusetts.

The discussion came at a meeting of the Worcester Square Area Neighborhood Association (WSANA) on Tuesday, where Wu and Councilor Annissa Essaibi George appeared for a conversation that quickly turned to priority number one in WSANA – the opiate epidemic.

Most in the neighborhood, including WSANA officials and South End Forum Moderator Steve Fox, have been against SIFs and believe that there is an eventual push to locate one in the Mass/Cass area.

That conversation around SIFs quickly surfaced during Wu’s commentary to the Association.

She said she is in favor of the idea of SIFs, but considers the location of such facilities a totally different discussion.

“Am I opposed to it – no,” she said. “That is a philosophical thing and is a separate conversation than the siting of it. The conditions here are not sustainable for residents living here.”

When pushed further, she said again, “Philosophically, do I think we should oppose (them) – no. We’re still a long way off in terms of federal and state law changes. The siting question will be important after that.”

Many WSANA members continue to be concerned about the views of SIFs and the idea to locate one near Boston Medical Center (BMC), in what is unpopularly known as Methadone Mile and more popularly known as Recovery Road. Whatever the name for the area, it has been swamped with addiction and homelessness issues for multiple years, and residents are worried that a SIF could really exacerbate the problem.

“Some of us have panicked on this because we know it eventually is coming to Massachusetts,” said Vice President Bob Minnocci. “We know the people pushing it like Boston Health Care for the Homeless, who are good people and do good work, are going to push to get it near BMC to get it close to the population that they think needs it.”

He and others pushed Wu to commit to not supporting any SIF within one mile of BMC. She said she couldn’t do that, though she could probably reach that position in time.

“No,” she said. “It’s not something I can commit to now. I would be more likely to eventually end up at that position, but not before knowing what it would be like. I feel it would be irresponsible to have that position now. I will commit to continuing to not turn a blind eye to this area. We are making plans to walk the area and that’s because I want to see it firsthand and not just hear about it from others.”

On the other side of the spectrum, Councilor Essaibi George said she is fully against SIFs and against siting anything like it in the South End. As the co-chair of the Committee on Homelessness, Mental Health and Recovery, she said she arrived at that position long ago.

“SIFs have been functioning a long time and have not made a dent in the problem,” she said. “I don’t think we need to regurgitate old ideas and have them not work here. We need to be new and innovative. I am opposed to them and I think they just normalize drug use…Notwithstanding it’s against state and federal law right now.”

There is no doubt that the past summer’s situation on the Mass/Cass Corridor, which was arguably the worst situation for addiction and homelessness there in the last three years. At the WSANA meeting, the problem has become a frequent topic as residents have become quasi-experts on treatment initiatives and have also worn thin on their sympathies as the City and state struggle to keep up with the growing quality-of-life issues.

President George Stergios said he believes SIFs would cause a new community of users to develop and stay in order to use the SIF multiple times in a day.

“They won’t shoot up and go home and shoot up and go home,” he said. “They’re not going to do that. That’s a lot to ask of anyone…I think once you’ve exhausted all options, maybe that’s something you do. I just don’t think we’ve exhausted all the options. Let’s do the proven things first, especially in this area where we can’t stand any more of the experimentation.”

Neighbor Peter Sanborn lives right in the heart of the problem on Harrison Avenue. He said he believes the elected officials are concentrating too much on helping those on the streets, and not enough on the neighborhood.

“I live at the epicenter of this problem and it’s intolerable,” he said. “The elected officials are approaching this from a wrong perspective. Other agencies are going to be the proponents for the people suffering from addiction. It’s your responsibility as an elected official to make the neighborhood and those affected by this the first priority.”

On a separate note, Essaibi George said her committee is ready to flex its muscles at the State House, and Wu said she backs that up as well – saying the Council needs to have more follow up on Beacon Hill for matters affecting the City.

Essaibi George said she is convinced that part of the solution is to dilute the problem, making sure the suburban towns – she often cited Shrewsbury – are paying their fair share. According to statistics at the City’s homeless shelters, more than 50 percent of those coming to the area are from outside of Boston.

She said her Committee is getting ready to receive state data from the methadone clinics in the area that will tell where every client is coming from. With that, she said they have a very strong case for new initiatives.

“Those numbers will really help us back up that message at the State House,” she said. “Maybe what we can do is say to Shrewsbury that they sent 11 people in a calendar year to get services in Boston, and maybe they need to reimburse us for the costs of those 11 people. That’s one idea.”

In the end, those at WSANA on Tuesday night were in need of action. Many said there needs to be a huge response to the issue if it’s going to be solved. There is a continually growing frustration that such a response may not come.

“We need to get everyone together on the same page for something really big,” said Robert George. “When we have wars, we all get together. This is killing more people than some of the wars we’ve been in.”

2 comments for “WSANA, President Wu Spar Over Safe Injection Sites

  1. DonHonda
    December 1, 2017 at 1:26 pm

    Portugal is held up as the gold standard for “decriminalizing” drugs and not “judging” the addict. Their programs has some success due to wrap-around services and is mandatory. Portugal does not have a “Safe” Injection Program. Drug dealing is still illegal and dealt with harshly. Other EU countries tried to emulate the program. With the 2008 recession, their budgets were slashed for the addicts in program and caused overdoses, increased crime, and increased disease transmission, increased homelessness. Can you see us having an Injections Site AND wrap-around services? I don’t believe there will be funding for both. Why not use any proposed funding and increase needed detox/rehab facilities and sober living environments along with all the needed physical/mental health and social services. The way I see it, Injections Sites are prolonging the suffering and misery of the addict with the usual end result of death. Which would be more compassionate?

    “The four pillar approach only works when each pillar is properly funded. Prevention reduces the flow of people into addiction. Treatment reduces the number of addicts including those living in the DTES. Policing keeps a lid on the open drug dealing and the affects of the associated problems on the community. Only after these three pillars are properly funded can we afford to spend money on Harm Reduction initiatives that do not encourage abstinence. Putting HR first is like running up debt on your credit card and never paying more than your minimum payments.”

    A Critical Evaluation of the Effects of Safe Injection Facilities
    Garth Davies, Simon Fraser University

    Conclusion: Taking Causality Seriously
    On the subject of the effects of SIFs, the available research is overwhelmingly positive. Evidence can be found in support of SIFs achieving each of the goals listed at the beginning of the evaluation. In terms of our level of confidence in these studies,the assessment offered here is far less sanguine. In truth,none of the impacts attributed to SIFs can be unambiguously verified. As a result of the methodological and analytical problems identified above, all claims remain open to question.

    Vancouver’s INSITE service and other Supervised injection sites: What has been learned from research?

    Final report of the Expert Advisory Committee

    “At the Vancouver site, the manager said since opening in 2003, the overdose death rate in the area around the clinic has dropped 35 percent. But the clinic also estimates 15 to 20 percent of people using the site come from other parts of the country specifically for it.”
    “Although research appears to bear that out, many of the studies that attest to Insite’s success are small and limited to the years after the center opened. For instance, a 2011 study published in the journal The Lancet found a 35 percent reduction in overdose deaths in the blocks surrounding Insite, versus 9 percent in the rest of Vancouver.

    But that often-cited study looked only at the period two years before and two years after the center opened, not the ensuing decade.”

    “Although Insite is paired with a drug-treatment center, called Onsite, Berner and other critics point out that completion rates are low. Of the 6,500 people who visited Insite last year, 464 were referred to Onsite’s detox center. Of those, 252 finished treatment.”

    The Vancouver Insite was placed in a crime-ridden, drug-ridden, low-income neighborhood. It only got worse.
    “Although the Insite center is a model, the Vancouver neighborhood surrounding it is nothing to emulate, advocates acknowledged.

    “If I came from a city like Seattle and I went to that Insite place, it would scare the hell out of me,” Kral said. “I would think, ‘Are we going to create one of those?’ ””
    Vancouver’s ‘gulag’: Canada’s poorest neighbourhood refuses to get better despite $1M a day in social spending

    What do you think would happen if this was placed in a middle-class neighborhood, or, ANY neighborhood?
    Brian Hutchinson: Finding used drug needles in public spaces has become the new normal for Vancouver

    “Ten years later, despite any lofty claims, for most addicts, InSite’s just another place to get high.”

    The 100% positive studies on Vancouver’s Insite (Safe Injection Facility) was done “Early last decade, Montaner and Kerr lobbied for an injection site. In 2003, the Chretien Liberals acquiesced, gave the greenlight to B.C.’s Ministry of Health, which, through Vancouver Coastal Health, gave nearly $1.5 million to the BC Centre (that’s Montaner and Kerr, you remember them) to evaluate a three-year injection site trial in Vancouver.

    I asked him about the potential conflict of interest (lobbyists conducting research) and he ended the interview with a warning. “If you took that one step further you’d be accusing me of scientific misconduct, which I would take great offense to. And any allegation of that has been generally met with a letter from my lawyer.”

    Was I being unfair? InSite is a radical experiment, new to North America and paid for by taxpayers. Kerr and company are obligated to explain their methods and defend their philosophy without issuing veiled threats of legal action.”

    In the media, Kerr frequently mentions the “peer review” status of his studies, implying that studies published in medical journals are unassailable. Rubbish. Journals often publish controversial studies to attract readers — publication does not necessarily equal endorsement. The InSite study published in the New England Journal of Medicine, a favourite reference of InSite champions, appeared as a “letter to the editor” sandwiched between a letter about “crush injuries” in earthquakes and another on celiac disease.”

    Really? What kind of “science” produces dozens of studies, within the realm of public health, a notoriously volatile research field, with positive outcomes 100 per cent of the time? Those results should raise the eyebrows of any first-year stats student.”

    And who’s more likely to be swayed by personal bias? InSite opponents, questioning government-sanctioned hard drug abuse? Or Montaner, Kerr and their handful of acolytes who’ve staked their careers on InSite’s survival? From 2003 to 2011, the BC Centre received $2,610,000 from B.C. taxpayers to “study” InSite. How much money have InSite critics received?”

    There has never been an independent analysis of InSite, yet, if you base your knowledge on Vancouver media reports, the case is closed. InSite is a success and should be copied nationwide for the benefit of humanity. Tangential links to declining overdose rates are swallowed whole. Kerr’s claims of reduced “public disorder” in the neighbourhood go unchallenged, despite other mitigating factors such as police activity and community initiative. Journalists note Onsite, the so-called “treatment program” above the injection site, ignoring Onsite’s reputation among neighbourhood residents as a spit-shined flophouse of momentary sobriety.”

    Reducing the Transmission of Blood-Borne Viral Infections & Other Injection Related Infections

    “Self-reports from users of the INSITE service and from users of SIS services in other countries indicate that needle sharing decreases with increased use of SISs. Mathematical modeling, based on assumptions about baseline rates of needle sharing, the risks of HIV transmission and other variables, generated very wide ranging estimates for the number of HIV cases that might have been prevented. The EAC were not convinced that these assumptions were entirely valid.
    SISs do not typically have the capacity to accommodate all, or even most injections that might otherwise take place in public. Several limitations to existing research were identified including:
    Caution should be exercised in using mathematical modelling for assessing cost benefit/effectiveness of INSITE, given that:
    There was limited local data available regarding baseline frequency of injection, frequency of needle sharing and other key variables used in the analysis;
    While some longitudinal studies have been conducted, the results have yet to be published and may never be published given the overlapping design of the cohorts;
    No studies have compared INSITE with other methods that might be used to increase referrals to detoxification and treatment services, such as outreach, enhanced needle exchange service, or drug treatment courts.
    Some user characteristics relevant to understanding their needs and monitoring change have not been reported including details of baseline treatment histories, frequency of injection and frequency of needle sharing.
    User characteristics and reported changes in injection practices are based on self-reports and have not been validated in other ways. More objective evidence of sustained changes in risk behaviours and a comparison or control group study would be needed to confidently state that INSITE and SISs have a significant impact on needle sharing and other risk behaviours outside of the site where the vast majority of drug injections still take place.”

    “It has been estimated that injection drug users inject an average six injections a day of cocaine and four injections a day of heroin. The street costs of this use are estimated at around $100 a day or $35,000 a year. Few injection drug users have sufficient income to pay for the habit out through employment. Some, mainly females get this money through prostitution and others through theft, break-ins and auto theft. If the theft is of property rather than cash, it is estimated that they must steal close to $350,000 in property a year to get $35,000 cash. Still others get the money they need by selling drugs.”

    “In addition, the federal government’s Advisory Committee on Drug Injection Sites report only five per cent of drug addicts use the injection site, three per cent were referred for treatment and there was no indication the crime rate has decreased, as well as no indication of a decrease in AIDS and hepatitis C since the injection site was opened.”
    Massive Price Hike for Lifesaving Opioid Overdose Antidote

    Suddenly in demand, naloxone injector goes from $690 to $4,500

    Should we follow the money? Who would be profiting bigly from the increased use of naloxone?

    “Setting up free injection sites to deal with the recent spate of drug overdoses does not address the root of the opioid problem, says Ted Brown, executive director of Brampton’s Regeneration Outreach Community.

    Instead, Queen’s Park and other tiers of governments should consider investing resources and dollars toward rehabilitation programs to help those dealing with addiction and mental health issues, said Brown. ”
    Supervised injection sites—a view from law enforcement

    Jamie Graham, former chief of Vancouver Police has outlined the successful model of dealing with an epidemic: Support, mandatory treatment, abstinence, and counseling as all part of the solution. My recover(ed)(ing) addict friends say they would agree.
    Iceland knows how to stop teen substance abuse but the rest of the world isn’t listening

    In Iceland, teenage smoking, drinking and drug use have been radically cut in the past 20 years. Emma Young finds out how they did it, and why other countries won’t follow suit.

    “The current campaign reports significant reductions in drug overdoses, yet the Government of British Columbia Selected Vital Statistics and Health Status Indicators show that the number of deaths from drug overdose in Vancouver’s Downtown Eastside has increased each year (with one exception) since the site opened in 2003.”

    Pigeon nest of needles highlights Vancouver’s drug problem

    Some graphs about how overdoses in Vancouver, BC have increased:

    One more:

  2. DonHonda
    December 1, 2017 at 1:27 pm

    The “Safe” Injection Movement is sponsored by the Drug Policy Alliance, an advocacy group that works to decriminalize drugs and is funded largely by billionaire George Soros. The group has pushed, thus far unsuccessfully, for similar legislation in New York, Maryland, Massachusetts and Vermont.

    Here’s some examples of their thinking:

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