When it comes to the conversation about Safe Consumption Spaces (i.e. Supervised Injection Facilities or Comprehensive User Engagement Sites), many people get jammed up by the following questions:
“How does providing a safe space for people to engage in IV drug use encourage them to stop using?”
“Won’t providing a comfortable place for people to come and get high actually get in the way of them ever wanting to stop using?”
“What about the notion that we have to let people “hit rock bottom” in order them to “become willing to get help?”
For those of us who found wellness and recovery for ourselves or our loved ones through some of the more traditional pathways, the whole thing can certainly seem counter-intuitive. The idea of a safe space where people use heroin and other drugs actually leading to the possibility of reduced or ceased use can certainly bump up against what many of us believe about recovery. Some of us may even feel like we ourselves had to “hit rock bottom” in order to experience our own recovery initiation, and in turn we may find it extraordinarily difficult to imagine recovery being borne out of any other way. The reality is, however, that those of us who found recovery after “hitting rock bottom” are the lucky ones — and access to recovery should never be about luck. It is long overdue the time that the addiction treatment and recovery communities move beyond this limited and harmful way of thinking about wellness and recovery. With more people dying in this country from preventable drug-related overdose deaths than automobile accidents or gun violence, and with the presence of deadly fetanyl tainting the heroin supply and claiming more and more lives, we must expand our thinking beyond merely personal lived experience and all that we think we know about recovery.
The following are just three of the reasons why we must abandon the idea of letting people “hit rock bottom” and instead support the implementation of Safe Consumption Spaces as one of many strategies for turning the overdose-death tide in this country:
1) Assertive outreach and engagement strategies work.
The idea that we have to wait for people to “become ready” and “come to us” is an old idea in the addiction recovery world that is dying a slow death. Much research exists that demonstrates how assertively reaching out to people and engaging them in whatever stage of change they are in produces positive outcomes. More and more we are seeing that rather than the old “tough love” approaches and shutting of doors, it is through demonstrating concern, caring, empathy, positive regard and frankly, the extension of love to people who are struggling that we see the best results. When it comes to Safe Consumption Spaces, they provide an extraordinary opportunity to engage people, empower them to make healthy choices for themselves, provide hope and offer linkages to mental health, physical health, addiction treatment and other recovery support services. At Insite, a well-studied Safe Consumption Space in Vancouver, there were 2,171 referrals to treatment and recovery support services in just one year. As a matter of fact, people who utilized the Insite Safe Consumption Space were 30% more likely to engage in addiction treatment services than non-Insite users. Safe Consumption Spaces are effective in engaging people.
2) Safe Consumption Spaces prevent fatal overdoses.
In assuming that none of us are okay with people dying if it can be prevented, we should care that the reality is Safe Consumption Spaces prevent death; they prevent fatal overdoses. Since Insite opened, there have been 2,395 overdoses in the facility and ZERO fatal overdoses. Zero. That is 2,395 lives saved from hitting the rock bottom that all too many beautiful human beings are hitting during this current opioid crisis - the rock bottom nobody can bounce back from of death. At a time when we are losing approximately 144 people per day to preventable overdose deaths, zero overdose deaths in these facilities should be enough of a reason to support Safe Consumption Spaces.
3) Dead people can’t recover.
Those four words speak for themselves. Dead people can’t recover. Safe Consumption Spaces provide life-saving services that allow for people to live in order to have the chance to find wellness and recovery. None of us should stand in the way of that, especially those of us who are passionate about recovery. All of us should instead be actively supporting anything that gives more people an opportunity to live to find wellness and recovery. Safe Consumption Spaces have proven effective in doing just that.