Safe injection sites in San Francisco could be first in the US

> Until the politicians find courage to acknowledge that it was a mistake to trust organized crime to control the supply of addictive substances, [...]

What would be a better solution in your opinion? Legalizing it, or allowing it with prescription? I see some problems with those alternatives as well; there's probably no magic bullet here.

Not really entirely true. I was an IV drug user before the fentanyl analogs started being pumped out of China and "hot shots" were always a thing.

It might be a hard sell to use Vancouver as a model. It has an area which is perhaps the most public display of social decay I've ever encounted in a first-world city, principally from drug abuse.

> the safe injection sites

Very interesting, I wanted to fix your plural because I only knew of Insite but turns out there are now two, there's Powell Street Getaway since last summer. http://www.vch.ca/public-health/harm-reduction/supervised-in...

"Does not adequately protect people from themselves, what do we do?"

What we do as a society founded upon the principles of natural rights and liberties is stop trying to protect people from themselves. It always was, and always will be, a slippery and dangerous slope to collectivism and totalitarianism. The government has absolutely no right whatsoever to tell me what I can and can't do with my body, whether that is drinking beer, coke, smoking weed, or cigars, or eating lettuce. For by accepting the encroachment, you open the floodgates for arbitrary decisions on what can and can't be done.

It's not even that these thing need to be "legalized". It was never the right of the government either federal or state to determine them one way or the other. All the proper medical care, mentally and physically, and education about substances, would then be free to do its good work without the interference of lawyers attempting to legislate our lives.

This silent acquiescence of increasingly overreaching government must stop. It is anathema to everything America was founded upon.

"...a long habit of not thinking a thing wrong, gives it a superficial appearance of being right, and raises at first a formidable outcry in defense of custom. But tumult soon subsides. Time makes more converts than reason." - Thomas Paine Common Sense

Being someone who benefited from needle exchanges, it’s a step in the right direction. It’s a place where users will be exposed to options for getting clean. Ultimately they are the ones who need to come to that decision but having options positively shown to them will help.

Addiction becomes a cycle of negative reinforcements and being able to put a possible break in that will make a difference. Many have mental health issues that they are self medicating for. Hopefully there are counselors there to help those who want it.

Well of course people want to eliminate it, but how?

Is this not at least a step in the right direction?

> Of course, the ideal solution will be to eliminate heroin and other hard drug use but this is a start.

That's practically impossible. A much more realistic goal is to minimize hard drugs use, and to minimize the negative impact of that use which will stay on both the users and everybody else.

The problem of thinking about the "ideal solution", in this case, is that trying to reach it brings us to adopt policies that do the opposite of minimizing the negative impact of use, especially if you consider enriching and encouraging violent gangs and mobsters, corruptions, and ruined lives a negative impact.

> If it prevents me from stepping on needles and seeing blood from people shooting up on the street, I am all for it.

For that, all the addicts need to be aware that this center exists, be able to get there (while suffering from withdrawal and other maladies accompanying their addiction) and be motivated to get there as opposed to getting the high right here right now (opioid addicts aren't exactly known for their capacity in delaying immediate gratification). With proper information and enforcement it may happen, but given how the streets of SF look now, this also may not happen.

They mention Vancouver as an example. I've been in Vancouver a few years ago, and I must say, if we're talking about people living on the street and doing drugs there, SF has nothing on Vancouver. The site around where Insite is (according to it's Wikipedia article) was occupied by something that looks like a refugee camp in a disaster area, only with a lot of drugs. Maybe not Insite's fault, maybe they are placed there exactly because that's where people who need it are, but certainly it didn't fix it.

I mean, maybe this saves these people's lives and is worth it. Vancouver locals certainly think it's worth it. But if you expect not seeing people doing drugs or stepping on needless and other unappetizing stuff - nah, didn't happen.

That would be ideal, but probably not possible politically (at the moment, anyway). But this is a step in the right direction, and will hopefully lead to this in time.

Because then the organizers of the site would be in jail for drug trafficking, and so would be any doctor who prescribed those. That could happen only if drugs are legalized, and not only on the state but on federal level. You can judge how far we are from there if you notice that DOJ, under Sessions, is still battling the benign marijuana, even for medical use (which makes me seeing red and my blood pressure skyrockets each time I think about it - ffs, we use chemicals in medicine that can are like a nuclear weapon compared to marijuana's zippo lighter, and still these people refuse to see the case for even prescribed medical use!). And you're talking about legally dealing out the real bad stuff, which is dangerous. We are decades from that, at the very best.

We're getting there. There are opiate maintenance programs that utilize diamorphine (obviously not in the USA). They will give you pure heroin and supervise you so you don't fall out.

The citizens of Seattle are fighting back against it pretty hard.

That’s because Bavaria is close to the Czech republic and the bavarian/czech border is a well known import corridor. Google further info on that, if you’re interested. Also, I invite you to compare the NRW numbers to the Berlin ones.

> have consistently shown them to be effective at reducing overdose deaths, preventing transmission of HIV and viral hepatitis, reducing street-based drug use and linking people to drug treatment and other services

There are a lot of people addicted to drugs that don't want to be. In a safe injection site, you have a bunch of health professionals around who are experts at treating addiction.

I'm not an expert on opioid addiction but I'd wager that the ease or difficulty of injecting the drugs isn't a major factor for opioid usage. I think the people who are addicted will get and take the drugs by any means necessary, and people who aren't addicted to opioid's probably aren't going to try them all the sudden because there is a safe injection site.

Sources for this would be very helpful. Always interested in alternative viewpoints!

Don't we already have all of those problems though? Or is this saying this increased those issues? If so I'd love to see the data, maybe it can provide some lessons for SF as it experiments with this.

I don't know much about the site in Paris but I do have experience living nearby Vancouver's first of now two safe injection sites. In my experience what you describe did not happen in Vancouver. Safe injection sights save lives by providing a clean, safe place to minimize harm.

As a counterpoint, the Medically Supervised Injecting Room in Kings Cross (Sydney) has quite radically transformed the area for the better - people who used to live there before it opened tell of sometimes walking over the bodies of addicts who'd OD'd on the streets, and of seeing used syringes everywhere. Now, you'd hardly ever see these things.

(I'd link to the Wikipedia article, but it seems to be the subject of an edit war between a couple of groups with agendas to push, so is best ignored.)

There's a safe site in Geneva (quai 9) near the train station, and none of the effects describe can be seen there.

It's interesting, I never heard about such results before (and I live in Paris). Would you care to share some links for further reading?

I'm also curious to know why and how the political orientation of the mayor is relevant?

This comment shows two things, 1. how projects like this will always be blamed for quality of life problems in the area, and how 2. the problems of street people and drug addicts are often much more complex and rooted in previous political clusterfucks.

In the 1990s and early 2000s, the Gare du Nord was the main place that people smugglers would assist people in travelling from France to the UK. At the time you could walk onto a Eurostar without having your papers checked by a British border police (only French passport control, who tolerated migrants travelling to the UK with false papers).

Lots of desperate and often penniless people pitched up around that area. People smuggling was linked to other forms of criminality, including prostitution and robbery by people trying to get the money to make the trip to the UK.

When the border protocol changed, the main staging points for migrants moved to Calais. But that part of Paris remained a centre for migrants to meet and connect. It also remained a centre of street dealing, robbery, other forms of low-level crime like selling fake bags, scams and snatching. It is notorious for street harassment, mainly of women. As far as I can tell, there isn't a particular overlap between people doing this and hard drug addicts.

In practice, most cities have somewhere you go to buy drugs on the street in the middle of the night. No-one wants to be that area, but trying to get it to be somewhere else doesn't really solve the problem. There are lots of things which can make this type of area less upsetting for people who have to work, live and travel through it, safe injection sites might certainly be a part of this.

Source: have lived in Paris and travelled there extensively over last 20+ years. My friend was an asylum seeker in the UK who got the Eurostar from Paris.

But you realise they can't be on their own, without society and its working businesses to feed themselves, its healthcare facilities to care for them, its giving inhabitants to sustain their addiction... I also really wish I would not have to see the worst humanity and its hopelessness everytime I pass the nearby hospital that has a safe and free injection site, but sadly as a society we can't just give up on those people even though a ridiculous proportion is making it in the end.