Safe Injection Sites: More Than Just a Place to Shoot Up



By Magnolia Cedeno, Almira Dang, Kenna Hartman, Amy Johnson and Milagros Villarreal

Safe injection sites are a hot topic in California, as San Francisco plans to open sites in July. Safe injection sites have stirred up controversy due to a fear that they will encourage drug use. This rhetoric is often used by the current administration during discussions on drug policy.

On the face of it, this argument seems like a logical conclusion. To some, it may even feel inherently wrong; almost as if it would make us complicit in the use of illegal substances. However, substance use and the process of recovery is far more complex than simply telling a drug user to abstain. Society’s fear of the harmful effects is rightly justified; however, it has also created an inability to critically look at the issue. The lack of provisions for safe drug use does not stop the problem, rather, it creates new ones; drug users share used needles increasing their risk of infections and diseases and unsupervised drug use increases the rates of overdoses and drug-related deaths. Having our heads buried in the sand will not fix this issue. The time has come to look at new, innovative ways to address this public health crisis.

Safe injection sites are based on the concept of harm reduction, a concept which adheres to the principle of minimizing the damage caused by drug use as its primary goal. By reducing harm and engaging in a meaningful dialogue about addiction, it can serve as a first step to starting on the journey of recovery. Countries around the world which have been successful in reducing drug use, and drug-related diseases and deaths have implemented a harm reduction approach, including the implementation of safe injection sites. The goal of a safe injection site is not to provide individuals with harmful substances, but instead to provide a place where people can safely use these substances while in the care of professionals, who can intervene if necessary.

Along with medical staff who can assist in the case of drug-related emergencies, there are also social services staff on site. These staff members provide additional resources such as residential drug treatment, support groups, and services to address basic needs. These safe environments enhance a person’s outlook on the possibility of a sober life. Aside from providing sterile and a safe environment for individuals to self-administer their substance of choice, safe injection sites are a place where people may become educated on drug use and the consequences of the use without shaming the user.

Even though harm reduction has shown to be an effective intervention in preventing unnecessary deaths, it continues to be a controversial and misunderstood topic among the public. It is not about encouraging drug use and it is not about enabling behaviors. It is about taking a realistic approach to a complex public health crisis. It is about addressing the needs of one of the most vulnerable populations, by providing support, resources and understanding. There are thousands of people dying of drug overdoses across the United States, many of whom are marginalized and feel unable to ask for help. The stigma attached to drug use creates a barrier to accessing services and only serves to further marginalize those who are most in need of support. Safe injection sites can serve to break down the wall between drug users and the rest of society. They provide a multitude of effective services, including practical and emotional support. While the practical resources, such as provision of clean needles, meet the goal of reducing harm, it is the emotional and psychological support which provides an equally important role. By facilitating meaningful conversations regarding recovery, free from judgment and stigma, we can embark on a more humane approach to this epidemic of drug abuse.

Clearly, there is a need to address the current opioid crisis affecting the nation. In an ideal world, the ultimate goal would be for drug users to enter treatment and recover from their addiction. However, we must be realistic in how we attain that goal. Abstinence-only and forced drug treatment has proven to be ineffective; so, we must set smaller goals to help drug users reach the point of recovery. By taking the path of harm reduction in the form of safe injection sites, we can reduce drug-related deaths and drug-related disease. Of equal importance is the fact that safe injection sites provide an environment which can facilitate conversations with healthcare workers and provide a starting point for the journey of recovery.

Milagros Villarreal, MSW Candidate 2018, California State University Long Beach can be reached at