Insite, North America’s first legal supervised injection site, in Vancouver. Courtesy: Vancouver Coastal Health

From May 2021 to May 2022, there were 103,357 reported overdose deaths in the United States, the equivalent of filling every seat in Mohegan Sun arena ten times. A total 1,515 of those deaths occurred in Connecticut alone. 

There have been many attempts to combat the opioid epidemic in the United States: zero tolerance drug policies; rehabilitation; and medication-assisted treatment. Given the growing number of overdoses as a result of the Covid-19 pandemic, some American cities have responded to the epidemic in a new, polarizing way.

They are suggesting a method of harm reduction known as supervised injection sites, a place where people affected by substance-use disorder can safely use and inject drugs.

Yes, you read that correctly.

Supervised injection sites have trained medical professionals on duty who distribute materials such as clean needles and fentanyl test strips in order to make the use of drugs as safe as possible. Possibly the most important aspect, they are specially equipped with Narcan, a lifesaving medicine in the case of an overdose.

Supervised injection sites also refer patients to rehabilitation services when they express interest in treatment or other forms of care. 

Due to a clause in the United States Controlled Substance Act, supervised injection sites have not been as common here as in other countries. The statute prohibits opening a facility for the sole purpose of using any controlled substance, but some states have worked around this or just blatantly ignored it. New York City was the first municipality to have sites open and accept patients. Rhode Island was the first state to legalize supervised injection sites; currently, they are accepting applications from organizations interested in establishing supervised injection sites. 

Marilyn Brach

Connecticut already supports some harm reduction policies. The Department of Mental Health and Addiction Services set out to distribute 45,750 Narcan kits throughout Connecticut, distributing 29,000 in 2022 alone. Narcan is most effective when an overdose occurs around other people or if the overdose is caught quickly, but most of the time this is not the case.

Connecticut has also authorized the existence of syringe services programs in selected communities. These community-based programs distribute clean needles in order to prevent the spread of infectious diseases that are associated with substance use. Similar to supervised injection sites, syringe services programs provide education on overdose prevention measures, and also refer individuals to substance abuse treatment. Syringe services programs do an important job in providing harm reduction and education to those with substance-use disorder, but there is still a risk of death by overdose. 

Many people are hesitant when it comes to implementing supervised injection sites because they are unsure how these sites will affect their communities. There are fears of increased crime and drug paraphernalia, but these claims are not supported by the current evidence. A study looking at supervised injection sites in Vancouver found that sites are not associated with an increase in crime.

Since supervised injection sites emphasize the safe disposal of materials, drug paraphernalia is less likely to be left in public spaces. More than 90% of people who participated in an unsanctioned supervised injection site located in an undisclosed urban area in the United States said that without the site they would have instead been using in a public space such as a park, restroom, or parking lot.

Implementing supervised injection sites protects both people affected by substance use disorder and the general public. 

The biggest objection is that these programs might encourage drug use. Many ask, why would we help individuals to continue a practice that physically harms them? But at the end of the day, every person with substance use disorder has a different recovery timeline. Recovery is not linear. According to the National Institute on Drug Abuse, 40-60% of individuals with substance use disorder relapse after treatment. The ultimate goal of supervised injection sites is to keep people alive, so eventually, individuals can receive more intensive care options if they choose.

In an ideal world, addiction care is accessible in all forms including medication, counseling, and harm reduction because every individual’s experience and needs are unique. 

Connecticut has the resources necessary to be a leader in implementing supervised injection sites, yet it is choosing not to be. This needs to change. If we are to combat the growing overdose epidemic, more energy needs to be diverted into public health strategies. Substance use disorder can affect anyone, so it is imperative we take action to help those affected because one day it could be you, your friend, or your family member.  

Marilyn Brach is a junior at Trinity College, majoring in Public Policy & Law and Economics.