Local Commentary

Guest Commentary | Safe Injection Sites: A Sign of Hope in the Opioid Crisis

By Thomas Blount

In 2019, fatal drug overdose is the highest it has ever been in the state of Virginia and is projected to be the main cause of unnatural deaths in the state’s history. Of the 772 deaths caused by drug overdose between January and June of this year, 639 were due to opioids specifically. And according to the Virginia Department of Health, Fairfax County is tied for the second most opioid overdose deaths in the state with 36 cases as of June 30, 2019.

The gravity of the opioid crisis at the national level is no secret. According to the Centers for Disease Control and Prevention, the age-adjusted rate of overdose deaths increased by nearly 10 percent between 2016 and 2017, from 19.8 to 21.7 cases per 100,000 people. Tangibly, this amounts to over 190 fatal overdoses every day, with opioids accounting for two-thirds of those fatalities. These statistics emphasize that this crisis is not unique to Virginia, or to the municipalities therein. This is to say the effects of opioid use are not limited to the users alone; family, friends, colleagues, and communities as a whole are all at risk of significant pain and loss unless a strong effort is made to prevent further damage.

In January 2018, an Opioid Task Force presented a plan to the Fairfax County Board of Supervisors on how best to tackle this issue. The two key goals of the plan were to:

1) Reduce death from opioids through prevention, treatment, and harm reduction; and

2) Use data to describe the problem, target interventions and evaluate effectiveness.

Since the presentation of this plan, the county has been active in their response. The Fairfax-Falls Church Community Services Board began by increasing funding to the Medication-Assisted Treatment (MAT) program. This reduced residential opioid treatment wait time by over 50 percent. The county also expanded the Revive! program, whereby over 2,500 civilians are now trained in the use of Naloxone to reverse opioid overdoses, reducing the burden on emergency medical personnel. A public education campaign, and pharmacy-based drug take-back programs have also furthered the effort to conquer opioid overdoses in the area. The Task Force Plan even outlines exploring a syringe-exchange program as part of their harm reduction strategy.

All of these policies are critical in the fight to end the opioid epidemic at the local level. However, in order to give our community the greatest chance for success, I propose that as part of the next Opioid Task Force Plan, the Fairfax County Board of Supervisors request and approve a pilot safe injection site in Fairfax County.

A safe injection site is a controlled healthcare delivery space where users may inject illegal substances, while monitored by clinicians. Safe injection sites have become an increasingly popular vehicle for harm reduction. In Canada, there are over 30 of these sites, with additional ones being established. A Mainline Health System and Thomas Jefferson University study highlighted that in one facility in Vancouver, overdose deaths decreased by 35 percent in the immediate surrounding area, within three years of opening; compared to just a 9 percent decrease in other areas during the same time period. In addition to a reduction in mortality, safe injection sites decrease the spread of HIV by offering sterile needles, reduce discarded syringes and drug paraphernalia in the streets, and increase long-term health of users who are more likely to seek social services and other mental health treatment while onsite.

In fact, the very first safe injection site in the U.S., Safehouse, is set to open in Philadelphia after a federal judge ruled just last month that its services did not violate federal drug law. The site is projected to provide huge benefits to one of the most drug overdose-plagued cities in America.

Fairfax County should follow suit in 2021 and test the efficacy of a pilot safe injection site through approved funding by the Board of Supervisors or partnership with an existing non-profit. The county could even simply expand the already successful MAT program, where a wholistic treatment approach combines FDA approved detoxification drugs, psychiatric services, and counseling to users in need. Offering clean needles and supervision over injection of opioids as part of MAT will likely only increase the positive gains seen since the implementation of the Task Force’s 2018-2020 plan.

Addiction is a disease that affects all of us. For our community to thrive in the ways we know it can, we must continue to advocate for those who suffer by it. Supporting policies that focus on harm reduction is a staple in this effort, and safe injection sites are the correct and necessary next step.