NEW YORK CITY HEALTH PROFESSIONALS FOR SUPERVISED INJECTION FACILITIES
To Whom It May Concern:
We are concerned medical professionals who care for people who struggle with opioid addiction.
Opioid addiction is a chronic medical condition marked by a physical and psychological dependence on opioids (often prescription drugs or heroin). As the disease progresses, patients often require increasing amounts of opioids to prevent debilitating withdrawal symptoms. As a result, many of our patients resort to intravenous injection of drugs, which is a more efficient and cost-effective way for them to treat their withdrawal.
Unfortunately, it is also far more dangerous.
Intravenous injection of drugs puts our patients at increased risk of fatal overdose. It also increases patients’ risk of bloodstream infections and infection with HIV and Hepatitis C.
And due to stigma around injection drug use, many of our patients must resort to public injecting in abandoned buildings, public parks and bathrooms. Public injection increases the risk of injection drug use even further as these spaces are often 1) unsupervised, putting patients at increased risk of overdose death, and 2) unsanitary, putting patients at increased risk of infection.
While our goal is to link patients who inject drugs to long-term comprehensive treatment for addiction, many are not ready for a variety of reasons. It is these patients who are at the highest risk of harm from their drug use. And it is these patients who are failed by our current healthcare system.
Supervised injection facilities (SIFs) are part of a comprehensive public health approach to reducing the harms of drug use. A SIF is a controlled healthcare setting where people struggling with addiction are able to self-inject pre-obtained drugs in a hygienic environment under the supervision of trained medical staff. SIFs bring a vulnerable and high-risk population out of the shadows — where overdose and injury are more common — and provide a safe, clean space for those who inject drugs but who are not yet ready to engage in drug treatment.
Decades of research on SIFs is strong and compelling. They have been shown to reduce public injecting, overdose deaths and infection with HIV and Hepatitis C. They also increase access to drug treatment for a population that is less likely to seek treatment on their own due to mistrust of the healthcare system.
Moreover, SIFs have been proven to be cost-saving by reducing the need for emergency medical services and by reducing incidence of expensive chronic conditions such as HIV and Hepatitis C.
And despite skepticism by those unfamiliar with the data, SIFs do not increase drug use in the surrounding community. SIFs do not increase initiation of injection drug use. And SIFs do not increase drug related crime.
There are 99 SIFs operating in 66 cities in 10 countries around the world. Yet despite evidence of their success, there is not a single SIF in the United States. We are long overdue. And New York City, which has experienced a steady increase in overdose deaths in the past several years, is in particular need of such a public health intervention.
SIFs cannot prevent all risky drug use or related harms. But evidence demonstrates that they can be remarkably effective and cost-saving, while improving the lives of people who inject drugs and the safety and health of our communities.
NYC Health Professionals Who Have Signed On
|43.||Norma||Hannigan||DNP, MPH, FNP-BC|
|82.||Luis||Rivera||Community Health Workers|
|89.||Richard||Silvera||MD, MPH, CPH|