Councilors want to consider Boston site where addicts could shoot up under medical supervision

City Councilors Annissa Essaibi-George (at large) and Frank Baker (Dorchester) say that with opioid deaths continuing to rise, it's time to look at possibly setting up a place where addicts could inject themselves while under the supervision of healthcare workers who could administer emergency aid.

In a request filed today, the two are asking their fellow councilors to let them hold a hearing on a possible "safe injection site" in Boston. Boston Medical Center already has a room where addicts can go after they've shot up on the street.

In their request, the two admitted to mixed feelings:

A study of the Safe Injection Site in Vancouver, Canada demonstrated a 35% reduction in opioid related overdose deaths and a significant increase in access to drug treatment. However, impacts of Safe Injections Sites on host communities have been mixed. ... Safe Injection Sites are controversial and wrought with medical, ethical and legal
questions for communities. Furthermore, the Boston City Council has a responsibility to promote thoughtful conversation that represents all perspectives while working to promote the safety and wellbeing of all

But with opioid deaths up and Boston having collected 20,000 discarded needles from streets, parks and playgrounds since March, 2015, the city may need to do more than it has so far, they write. They note that the Massachusetts Medical Society recently urged the state to set up at least two pilot safe-injection sites.

The council will consider the request at its Wednesday meeting, which begins at noon in its fifth-floor chambers in City Hall. Typically, councilors make only brief comments before the measure is sent to a council committee, which then holds a public hearing.

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Comments

Smh

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I absolutely agree this is a horrible concept and more so because we want to put all these unorthodox methods in play when this heroin fentanyl addiction opioid crisis is affecting the white community but for years we have enprisoned members cut funding for drug rehabilitation centers and basically shamed the junky oppose to offering assistance mainly the people of other ethnic backgrounds particularly the black community but now we're seeing all this overdosing in "specific communities" now we pretty much want to legalize it and assist and provide drug safe houses like they used that same exact method on the wire season 3: where they referred to the drug sanctuary as hamsterdam smh

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You're right!

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Great contribution! We should let them use on the streets where they will OD and get picked up by EMS which will definitely help your health insurance costs go down

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Consider all options

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Good for the council for leading on this. There are definitely a ton of potential issues but there could be lots of positives (reducing overdoses, if there's some path to recovery for folks, reducing needles in neighborhoods, etc.). Boston has to be a leader on this issue for the region and beyond.

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And when a person dies

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for whatever reason while in this controlled environment or after having shot up in the controlled environment, the City will be sued for millions by the person's family.

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Nope

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They sign a release saying that they take full responsibility before entering the facility.

Nice try, though.

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So someone addicted to heroin

must be of sound mind and body to sign that right? Yeah, no chance of a lawsuit there.

TBH, I don't think this is a terrible idea, just that "they signed a waiver" is somehow going to keep lawsuits from happening. You might as well cast one of these:
Cave inimicum
Disillusionment Charm
Fianto Duri
Muffliato Charm
Muggle-Repelling Charm
Protego horribilis
Protego Maxima
Protego Totalum
Repello Inimicum
Salvio hexia

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Your comment makes no sense.

Your comment makes no sense. They're going to this location to shoot up and get high. That would mean they were sober when arriving. Which means they would be sober at the time they signed the ICF.

Are you suggesting they go in, shoot up, then sign the ICF? Because that makes no sense.

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It could be argued

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that a person high on heroin or whatever is not of sound mind so didn't understand what they were signing. It wouldn't stop a family from suing anyway. It may just lead to a settlement instead of actually going to court.

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Strawman

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Strawman.

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I like it

The War on Drugs is obviously a crock of (expletive). Maybe the More Peaceful on Drugs will work better.

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I disagree

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Particularly as far as drugs this heavy go. It would appear that there is a group of heroin addicts that in fact are chasing the extremely close to death experience. Legalizing and regulating heroin will not help since some people are not looking for safe heroin. Do we just allow people to sell, buy, and inject fentanyl?

I am 100% in favor of good treatment, but by making this "safer," we are essentially giving up on these people. I know this is going to sound harsh, but there comes a time that a final OD might be the only option.

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Not giving up on people

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Giving them an incentive to take their habit off the streets and have daily contact with people who can get them into treatment.

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I mean...

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Do we just allow people to sell, buy, and inject fentanyl?

What's the alternative? If you throw them in prison for drug offenses, you get to spend $40K+ a year per person to keep them away from society, and you have one fewer cell for someone who's actually committed a crime. If you leave them to their own devices, you get needles scattered in public parks, and you get a public health crisis when EMTs have to respond to overdoses caused by bad batches of heroin. If you give them somewhere safe to go, and make it legal to buy their drugs from regulated entities, you at least have some control over the problem.

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So you think we should

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So you think we should structure our treatment programs to apply only to the most far gone users? What about all the addicts that are trying to get clean and need more resources to do so? I don't see why we would deny them this service just because there might be some people that are too far gone to help.

Besides, addiction is a disease. You don't turn your back on sick people and say "maybe they'll die and that'll solve the issue". Let's try to help, first. There's no downside to piloting this program, and at the very least it'll likely get some used needles off our streets.

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Good points, until

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You make good points, but you lose me with the "addiction is a disease" model.

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Addiction is a disease

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And so is lung cancer. But I don't think enabling people to smoke 2 packs a day is a good idea, either. Heroin is a horrible drug, and I've known that from my youth without knowing any junkies (at the time). If you have a propensity for addiction, the best prevention is staying away from that shit.

I think we can all agree that treatment is key, and more resources should go into that. But normalizing heroin, in my view, is the opposite of good.

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Normalizing heroin?

Explain, using factual information. Please try to leave out your own squeamishness and moralizing tendencies.

Compare and contrast with the normalization of oxycontin to the point that there are prime time television ads for meds that combat the associated constipation.

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A couple points

We have ample evidence at this point that the "Just say no" approach to discouraging drug abuse does not work.

With regards to your point about normalizing heroin use, I honestly don't understand that argument. It's not as if there are a bunch of people out there who want to start shooting heroin, but haven't just because there isn't a monitored safe space in which to do so.

There is an opioid epidemic in this country and the traditional methods of combating drug abuse have been ineffective at best and detrimental at worst. I think it behooves everybody to look at alternatives to simply locking up addicts. Supervised injection sites have been successful in other places (e.g. Vancouver, Seattle, Sydney, Germany, etc.) and I don't see any reason that they couldn't be effective here as well.

People who are addicted to heroin are going to do heroin whether these places are there or not. Why not provide a facility that can administer narcan, provide and safely dispose of clean needles, test drug purity to prevent accidental overdoses (I know at least some SIS's do this), and assist those who want to get clean with contacting treatment facilities? To me this sounds like a much better option than forcing people to shoot up with puddle water in Newmarket Square.

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The normalization argument is this

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And it goes back to my "addiction is a disease" retort. There are a few years between the missus and myself, and she grew up ahead of me going to a public school on the west coast while I attended a Catholic school on the east coast. At her high school, there was a place on campus where kids could go and smoke cigarettes. A few years later when I arrived at high school, smoking was banned on campus (aside from the priests' residence, of course, and I'm sure the teachers had a place.) The approach to tobacco over the years has been to actively reduce use through both education and marginalizing use (i.e. you can't smoke in bars or restaurants, and there are government programs to assist landlords in banning smoking in housing.) Now, the two addictions are different, as one could slowly kill you and perhaps people around you while the other can take you very quickly, but imagine if the Boston Public Health Commission decided that there could be smoking bars so that those who want to smoke and drink can do so in public while those who don't want to be exposed could go to nonsmoking bars. That would be a nonstarter.
Same thing with this. How does it make sense to tell people that heroin can kill you, then turn around and say "however, here are some places where you can go and shoot up where your life might be saved if you OD"?
If users aren't going to care about themselves and want to kill themselves on heroin, I think they should be able to do it. There is no saving grace to heroin. I do feel bad for junkies and their families, but the junkies are doing it to themselves.

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Are you opposed to smoking

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Are you opposed to smoking cessation programs as well? Against Alcoholics Anonymous? Do you think that once you've slipped and made the mistake of getting addicted to something, we should say "too bad for you" and wait for you to die (of an OD, liver disease, drunk driving, emphysema)?

I think all these people deserve treatment. The proposed centers have been shown effective in several other cities- there is no reason to not try it in MA, where you can see how ineffective our current programs are by walking by DTX or Methadone Mile anytime of day.

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Then I'm not sure why you're

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Then I'm not sure why you're against these spaces. Sure, research is ongoing in their effectiveness, but this article has a very promising quote,

In Massachusetts, state Sen. William Brownsberger (D) recently introduced legislation to permit safe-injection sites throughout the state. Currently, Boston Health Care for the Homeless offers medical monitoring to people who have injected illegal drugs, but they are not permitted to use drugs onsite.

The program, which started in April, has 10 chairs where addicts can sit while a nurse monitors vital signs and administers Naloxone in case of an overdose. Gaeta said 400 people have used the facility 2,679 times. About 10 percent of them have gone directly from the room into treatment, a number she called “miraculous.”

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Geez

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Perhaps I should have stated my position on the matter somewhere in this thread.

And the other 90%? Do you want 360 heroin addicts by your house every day. Not I.

Frankly, I thought what they did (or hopefully do) in Gloucester is a much better idea.

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Yes, I read your previous

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Yes, I read your previous statements. I agree that Gloucester's program is a good idea, but I also think we don't have to only have 1 method for handling this crazy opioid crisis. Agree to disagree, anyway!

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Very cold comment. I hope you

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Very cold comment. I hope you never have to experience a Son or Daughter addicted to anything. You show no compassion. Read the Bible again.

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"To me this sounds like a

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"To me this sounds like a much better option than forcing people to shoot up with puddle water in Newmarket Square."
Or shoot up and die in restrooms across the city.

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Not exactly

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I think you're assuming a much higher level of awareness/decision-making than is present in heroin addiction. No one is "chasing" some sort of fetishized, higher-stakes experience. I think they're just trying to not be dope sick. The fact that an addict may OD multiple times speaks more to the nature of addiction than to a specific desire for a near-death experience.

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"I know this is going to

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"I know this is going to sound harsh, but there comes a time that a final OD might be the only option." In that case, why not just shoot them like in the Philippines?

That is a dark statement. I wonder if you've ever had anyone close to you in your life addicted to heroin, or to die by overdose? What if it was your child? Your sibling? Would you feel the same way?

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There's a not so subtle difference

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In the Philippines, you are talking homicide, someone taking another's life. When someone injects a drug they know can kill them, that's suicide.

If someone close to me was addicted to heroin or died from an overdose, I would be a wreck. I would ponder how I could have stopped them from using or even getting started. From a public policy perspective, how many people would be looking at treatment if they knew that someone they knew died from the shit they're sticking in their veins? My belief is that the goal of society should be preventing people from using and getting those who are addicted off the smack. Throwing up our hands and just letting people use, again in my opinion, is not a solution.

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This is

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different because white lives are being lost and at stake. We can't have that! All hands on deck because this is the first drug epidemic that matters.

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Your race angst doesn't glom onto this well

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There is no drug epidemic that our culture has ever faced that did not significantly affect the majority 'racial' segment of the population.

Folks are concerned about the opioid epidemic because it is afffecting a large and apparently growing number of people - of all colors. For decades, the demographics of the user/victim/addict population have been a fairly close analog to the more general population. Ie, it's been mostly white folk dying from ODs for a looong time (in fact, whites have been slightly over-represented there since at least the 70s), so the idea that people only care once it affects those who share their skin tone is unsupported by historical data.

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Good Idea

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Get them in the door and in contact with help. Contain the problem to a supervised setting until they are persuaded to change. Reduce barriers to treatment and treatment will happen.

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Seems like it's worth a try

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I know y'all would rather round up every addict in the city and grind them into fertilizer, but since they're actually human beings whose behavioral consequences we have to deal with, why not at least aim for harms-reduction? Clearly the approach we're trying now isn't working, and Methadone Mile is approaching uninhabitable.

Fun story: A friend of mine works at Orchard Gardens, the school over on Melnea Cass near the methadone clinic. After the city closed its largest Long Island last year with no warning and no alternative housing provided, the school had to give some of its teachers and janitorial staff a crash course in hazardous waste disposal procedures, because they have to do two circuits of the playground every day looking for used needles before the 8-year-olds head outside for recess. (One circuit a day quickly proved to be insufficient, which means there are a nontrivial number of folks shooting up on the playground during daylight hours)

But yeah, treating the opiod crisis as a moral hazard and not as a public health emergency is a great plan. Let's just bury our heads in the sand and wait for the problem to go away on its own.

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This proposal isn't a fix, its a bandaid

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And it's a stupid one at that. Education, and keeping people off prescription pills in the first place is a much better use of resources. Otherwise you might as well just make a new combat zone and let the people their do whatever they want.

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Education is great

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But remember abstinence only sex education? Surely that did a great job at preventing teen pregnancies... Not a knock against educating the populace, but it only goes so far. Despite education, people still find themselves in trouble with addiction either by pain meds, or in other cases bad decisions.

I get the impression that you're not exactly very well read on these facilities. Considering that these people would be administered to in the facility, I'd have to imagine that they would be monitored after the injection, as well as the needles properly disposed of. Literally keeping all of the undesirable aspects of addiction off of the street, not turning whatever neighborhood it was in into a "combat zone", or more appropriately, Amsterdam a la The Wire.

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Ahem

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It's Hamsterdam ;-)

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No I'm not well versed on drug facilities

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Thankfully. But this is classic treat the symptom not the problem thinking. What difference does it make if there's a safe place shoot up, but no deterrent to stop new users in the first place? They over prescribe pills and then wonder why people get hooked. In my experience very few people just pick up heroin or fentanyl use with out a reason they were introduced to it in the first place.

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Here's the thing

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You're approaching it from an either/or perspective. Or at least that's how I'm seeing you frame it. We need to, or should do both.

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I was, but you are right

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So I wonder what prevention methods they're coming with, an addition to basically giving it the ok, in a 'safe environment'

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I mean, I don't think there's

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I mean, I don't think there's anyone out there going "wow I'd super love to start doing heroin but there's just not an easy dope den close to my house." It's not a flipping gym membership.

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It will always be an issue

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There will ALWAYS be a subset of people who will get addicted to substances, either legal or illegal, that make them feel better. Regardless of what else you do. And you need a way to deal with these people. Even if you're someone who believes they do not deserve help, it's still a public health issue that needs to be addressed.

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We don't need to condone and reinforce

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Bad behaviors. Everyone who needs help should get it. But I don't think basically encouraging them to continue using drugs is that helpful.

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It's not encouraging them to

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It's not encouraging them to continue using drugs- they were going to use them anyway. It is giving them a safe place to use them, a place to properly dispose of needles, and most importantly it is giving them an opportunity to speak with someone (the nurse) about treatment options if they are trying to overcome their addiction.

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both/and world

This isn't a zero sum game - we need ALL these things right now.

We need to keep people from getting hooked, yes.

We also need to deal with the damage done.

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I haven't heard much about

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I haven't heard much about prevention, but this isn't something I follow generally so please enlighten me if you can. And no sarcasm.

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learn to google

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Every state health department has active programs.

New York included.

You don't hear about it because it it doesn't make the usual reactive chickens go apoplectic.

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If you know anyone working in

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If you know anyone working in the healthcare industry they can tell you about the increasing crackdown on prescriptions of painkillers, for one. My hospital has instituted a bunch of new rules and tracking measures to lower the drugseeking behavior and keep people from being given so much they get hooked.

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this article

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NO!! a lot of these drug addicts don't even live in Boston.. This is a choice not a disease. and stop given Narcam more that once to the same people.. Give diabetics free insulin.. give cancer patients free chemo..

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Care to give us your full name and address?

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That way, if you ever call the paramedics for an emergent medical crisis, we'll be able to tell them whether or not to help you, based on whether your own behaviors are in any way responsible for your crisis. Heart attack? Shouldn't have had that Snickers bar. Diabetic coma? Learn to administer your own insulin properly, lady! Fell off the roof? Shouldn't have been up there on the ladder, idiot.

Which is to say, this is a loathsome proposal and you are a loathsome person for advocating for it.

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bravo

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Legalize drugs with programs like this. Put the nightmare of the cartels out-of-business. Remind me how to hyphenate.

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People live in irrational

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People live in irrational fear of accommodating drug use. We have a new medical weed dispensary downtown. At the neighborhood association meetings one would have surmised the world was coming to an end. It's been open for months and I suspect most people walking by have no idea it's there quietly generating millions in tax revenue.

There will always be Abe Simpsons but we do not have to live in their world.

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You keep saying that it is a terrible idea

But it is not a new idea. This idea has been implemented elsewhere with varying degrees of success. There is data on this idea.

Please support your opinions with some evidence that it is a terrible idea and knock it off with the hyperbole and the overdramatized metaphors.

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What evidence have you supplied?

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Me, over dramatic? Never!

Anyway I think finding a way to get people off drugs, or prevent them from getting hooked in the first place is a much smarter and effective way of going about it. We have to ask why, or more importantly, why, people get hooked on drugs in the first place. We live in an over prescribed country and as along as that remains true there will remain a constant influx of new drug users. So this doesn't solve the problem, it just appeases the people who are tired of seeing druggies laid out on the street. I'd rather support a cause that helps the addicted, and doesn't codify the offended.

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OK.

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Counterpoint: I had surgery last week, and they sent me home with one day's worth of Percocet. Ten years ago, it probably would have been 5 times that. The prescribing physician had to jump through some hoops, as he is not the only doctor to have ever prescribed that same medicine for me, so it trips an automatic flag in a database somewhere. We're stemming the tide! Keeping those would-be-addicts from using. I am, apparently, now at lower risk of heroin abuse once the incision site heals.

So now we've got that vector shored up. And yet I notice that the epidemic of heroin abuse has not receded. It seems especially bad in socioeconomically depressed areas, and tends to correlate with people who have existing mental health problems or have very few economic options available to them. Do we need to implement a full social safety net, before we can open centers that stop addicts from accidentally killing themselves with bad drugs? Or when will we have achieved enough in the "prevention" column that it becomes morally permissible to start up a harms-reduction program?

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Kids have been exposed to

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Kids have been exposed to anti-tobacco propaganda for the past 50 years. Everyone knows it's expensive, hard to quit, and can kill you. Still, 15-20% of kids still smoke. A third of young adults have tried cocaine.

I honestly don't get it.

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That's been done. Just Google

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That's been done. Just Google, "Hamstedam."

. Why not a block for gangsters too?

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Agree with Erik and John Keith

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I agree with @ErikG, it may be worth a try, and probably (?) can't be any worse. Although I'd have a very highly controlled pilot program first, and pull the plug if it's bad for whatever neighborhood it's in. .

Also agree with @johnkeith. These should absolutely be planned for the blocks where the sponsoring city councilors live.

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That makes no sense

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It should be planned for the blocks where the worst impacts are being felt.

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I laugh sometimes

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at people who are terrified and annoyed by the homeless, druggies in Boston. Spend some time in Vancouver BC, where they have safe injection sites.

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Can the healthcare workers

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Can the healthcare workers ask the addict where they bought the heroin and then tell the police? Are there more beds in treatment centers for addicts without health insurance in Vancouver than there are in Massachusetts? Can addicts bring a bag of coke inside the injection site so they can do a speedball? Did you know that the relapse rate is higher for addicts who have had Narcan administered to them?

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What is this world coming too.

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So let me get this straight. We are legalizing HEROINE by giving addicts a safe controlled (monitored) environment to do so. So where in the law and the war on drugs is this legal? Now instead of an addict doing illegal drugs we are supposed to say it's ok for a nurse to be an accomplice. Is this really what my tax dollars ( alot in this state) are paying for. These kind of ideas are ridiculous.

Let me put it another way. There is a park at the end of my street that I can see from my house. I and my neighbors clean this park so our kids can play safe. I see boston public services trucks daily going down the main street in front of the park but never stop to pick up the park. The article says they have gathered 20,000 needles this year. How many parks are there around boston? I would love to see my tax dollars do more than buy nice new company trucks that stay clean and look good driving around.

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Legalizing Heroine

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Hey! It is totally legal to go see Wonder Woman!

IMAGE(<a href="https://www.sideshowtoy.com/wp-content/uploads/2016/11/batman-v-superman-dawn-of-justice-wonder-woman-half-scale-prime1-studio-feature-902891-1.jpg)">https://www.sideshowtoy.com/wp-content/uploads/2016/11/batman-v-superman...

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We are legalizing HEROINE

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We are legalizing HEROINE

Huh? Movies and cartoons with Pearl White and Penelope Pitstop have always been legal.

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It'd pay for itself

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How much money would be saved for each overdose resulting in an ambulance rushing someone to the hospital which was prevented. How much money would be saved on having to treat new cases of HIV, Hepatitis C, Endocarditis, skin infections? All of the cost-benefit analysis I've come across indicate that these types of facilities more than cover their cost to operate while also being incredibly effective. Also, money isn't the only thing, how much time would be saved so that EMS, Nurses, Physicians, and Police could focus on everything else they have to do in their day?

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This is not a new idea

This was not invented in Boston. This has been tried in other cities, and subject to a great deal of outcomes research. There is mounting evidence that it effectively takes drug use off the street, halts progression of drug abuse, and is an effective conduit for people to get the treatment that they need.

It won't make the epidemic go away, but it may keep things from getting worse.

https://www.ncbi.nlm.nih.gov/pubmed/ and https://scholar.google.com/ are your friends when it comes to examining the evidence with whatever search terms that you prefer. "supervised injection" should get you started.

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I dunno

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It looks like the councillors have done some research and have found mixed results. I might not agree with this, but studying it cannot hurt (as opposed to just doing it IMHO)

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And ...

Please enlighten us (referring to the outcomes research, preferably) about how doing it can hurt?

IMHO doesn't have a registered DOI.

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The inspiration for the

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The inspiration for the proposed injection site, which would be staffed/studied by a local medical/academic institution, hails from Canada: The Vancouver project in Downtown Eastside (DTE), now entering its second decade. In DTE homelessness continues to rise, trash and quality of life issues including underreported crime, theft, assault and drug dealing are common. Despite fervent claims to the contrary, but well known to locals, DTE is a hot spot for stolen goods. It is home to no less than 170 not-for-profit organizations. The city council has even gone so far as to reduce the street speed to 30 km/hour (18 miles an hour) to protect addicts unable to demarcate the road from the sidewalk.
Does this sound familiar to those familiar with Methadone Mile? DTE and Methadone Mile both appear to be a pipeline to and a magnet for vulnerable populations many from out of the area.

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Links?

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You are citing a lot of numbers and outcomes. Please link to your sources.

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Here's an idea

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Go up top and read what Adam was kind enough to write. You know, the article on which we are commenting.

But hey, if your thing is smacking me for coming halfway, I guess that's on you.

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What am I missing here?

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It says that results were "mixed," but doesn't outline what that means. But it does give a 35% reduction rate, before that....

If you know what "mixed" means, please do tell.

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Sigh

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Okay, I don't know if I have the skills for literacy training, but here's what the city councilors are quoted as saying above-

In their request, the two admitted to mixed feelings:

A study of the Safe Injection Site in Vancouver, Canada demonstrated a 35% reduction in opioid related overdose deaths and a significant increase in access to drug treatment. However, impacts of Safe Injections Sites on host communities have been mixed. ... Safe Injection Sites are controversial and wrought with medical, ethical and legal
questions for communities. Furthermore, the Boston City Council has a responsibility to promote thoughtful conversation that represents all perspectives while working to promote the safety and wellbeing of all

Beyond that, I cannot help you.

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Oh, good, we read the same thing

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Then you conceded "beyond that, I cannot help you." So it seems you can't add anything substantive to the issue and conversation on this. If you can't see what I questioned above and come out of it with at least simple questions like "what _are_ the impacts on the host community, and what are the pros and cons of those impacts" then it's not me that needs a literacy test, it's you that needs to be able to think more critically.

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All I said was

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It looks like the councillors have done some research and have found mixed results. I might not agree with this, but studying it cannot hurt (as opposed to just doing it IMHO)

Which lead people to ask why I thought that, which amazed me since, as I noted above and with my original quote, I read it in the article itself.

If you want the answer to the question, I would imagine the best thing to do would be to contact the City Council, because, once again, they seem to have done some research on the matter.

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Hospice care

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End of life care for people they imagine are unable to strive for anything moreR

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Wait.....

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We want to make it ok for them to shoot up using illegal drugs? Will they be set up with comfy rooms to zombie out in while they are high? Should we get waiters to serve them more illegal drugs? Get real.

Melnea Cass & Mass Ave looks like a warzone because of these idiots. They made a bad choice to give themselves the sickness. Dont give me the addiction is a disease, they didnt catch this or develop it like cancer, they got this by bad decision making. But hey, we are a soft society now, lets give them all hugs and tell em, dont worry, go get your dope and come back to room 302 here and we'll have someone watch you drool all over yourself and it will cost you NOTHING!!!!

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So...

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Where are they going to put the safe injection sites? I'm thinking an area with the least amount of political power.

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Please please put it right

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Please please put it right next to Pabu in the Millennium tower.

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They would need multiple locations

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The idea of fewer needles on the ground sounds great, but the improvement would probably only be in a small area.
I can't even bring myself to take the T 5 miles to go out to dinner. I can't imagine someone with a heroin addiction is going to travel far for this service.
So, we would need one near every T stop?

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Not really contributing to the conversation

I just wanted to compliment Adam on the (probably unintentional) juxtaposition of an article on shooting up with a photo of re-enactors shooting upward on the front page. After a long day, it took me a minute to untangle the fact that it was two separate articles.

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BLAH BLAH BLAH BUT DOING

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BLAH BLAH BLAH BUT DOING DRUGS IS A MORAL FAILURE BLAH ENCOURAGING USE BLAH REMOVING MOTIVATION TO GET CLEAN

BLAH BLAH BLAH ADDICTION IS A DISEASE WE NEED TO HAVE COMPASSION BLAH BLAH BLAH

If this keeps needles out of playgrounds and means local coffee shops allow customers to use their bathrooms again, I'm for it. Saves the system money on ambulance rides, as well.

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It's illegal

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It's against state law and federal law so why waste time discussing this. And enough of dumping in the South End.
How about at Carney Hospital? Oh right, that won't happen.

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Actually, no

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They come in and get a prescription for their one dose.

You might want to read about how these programs work before commenting.

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Who is the target audience for heroin center?

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Is this targeted mainly at the homeless? It may not be a bad idea but there would have to be a lot of thought beforehand. Sending ambulances, fire trucks and police all over the city numerous times a day, treating many uninsured, isn't a great concept either although I doubt an addict who has a private space and is hiding his addiction would want to be there.

Questions: Who would supply the heroin or is it BYOB BYOH? I could see that being a problem. Even if the city tests it, as others have said, what happens when the addict dies on site? Wasn't methadone supposed to solve this? They'd also have to separate the males, females, transgender and juveniles. Handicap accessible? Would the addicts be in hospital beds or a living room setting? Food? Would police be on scene for the inevitable fights and dealing? It's a crime to be "knowingly present where heroin is kept" so that would be an issue. Would treatment be mandatory on first visit or will they come and go as they please?

Legalization, regulation and taxation is the only answer. The war on drugs is over and we lost. Take the billions spent on enforcement and offer treatment if they want it. Make using in public illegal, like the open container law. Make unsafely discarding a needle a felony and enforce it.

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Headline misleading

While there is a hearing today, it's not a "Hey this is a good idea let's do it" hearing, this is a "Hey state, how dare you have meetings about putting one of these things in Boston without even letting Boston be involved in such a big decision" hearing.

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You may not like the idea, but please read

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Heads up, I'm pulling some of this from my response in another thread.

Supervised Consumption/Safe Spaces are not that novel an idea. Vancouver has had such a space operating since 2003 called Insite - http://www.vch.ca/public-health/harm-reduction/supervised-injection-sites . The outcomes have been widely positive, supported by the local and national government (they've now allowed clinics to open in Toronto), overdoses drop, quality of life for non-users has improved, and communicable diseases have decreased. I'm happy to send out plenty of research to anyone skeptical or interested.

Here's how they work:

You're allowed to stay while you're using, but you can't just hang out in there, as there is limited space. Once you've used, you have to leave within a certain amount of time so that others may use the space. It's not intended to be a place to congregate and be social, and is in fact designed to keep you from socializing as each spot is separated like school library desks. Certainly, there are other services offered by the agency that focus on health advocacy, testing, etc., but once they've used, they can't stay in the consumption space as spots are in very high demand.

Some folks fear it would be a spot for drug users to hang out all day, but what's actually wrong with offering drop in services as well, I'm sure the Boston Public Library, various Dunkin Donuts, the Tufts, BMC, and MGH Emergency Department waiting rooms would love to stop filling that role. We need more day-time homeless shelters, and services for those that utilize them. If you disagree, you have no right to look in disgust as you drive down Melnea Cass and think, "Someone should do something about those people". They're there because where else do they have to go?

If there's concern around whether letting people get high and wander around would create a problem, consider a couple of things:

1. Bars release "high" patrons all night long up until 2am, and those folks are actually a greater health risk to themselves or the community when intoxicated than IV opioid users.

2. These folks are using in public spaces already and then wandering around, this would create more spaces where they wouldn't have to put others at risk or create a problem for city officials, citizens, or business owners.

The most likely utilizers will be street drug users that hang out in the area nearest to the center. Kids from Andover will likely not be heading down to hang out there, but those folks are also at a much lower risk of overdose death. Injection drug use is most risky when it's done alone, in a place where someone won't be found. If I am a homeless person, I'm going to find a place to hide while using (in an alley, a Dunkin Donuts bathroom, hospital bathroom etc..).

I honesty cannot think of one logical reason as to why we shouldn't embrace these types of services. It would reduce the burden on police, reduce the impact on retail owners, reduce the overdose rate and the resource drain/trauma on EMS and Hospital EDs, it would reduce the presence of active drug use on the street in view of children, would reduce the number of discarded syringes in our parks and sidewalks or thrown into city barrels and restaurant toilets,
it would literally improve the lives of people who find folks with addiction to be despicable, while also improving the lives of people who live with addiction, at the same time. It would improve my life because I'd see less of my patients die, I'd have a place to collaborate with to re-engage or connect with new patients, provide education and outreach.

It'd improve the day to day experiences of every cop, doctor, restaurant manager, parks service worker, landscaper, janitor, and tourist in Boston in a way that has evidence showing that it works, and would also save the city money.

Finally, It would be one more way to remember that just because someone is in a bad place in their life, and that we find them offensive, disgusting, scary, or shameful, that they are a still a human, they are still worth some basic dignity, and that they matter.
If you don't think that they're worth that, at least you wouldn't have to look at them so often. You could start to pretend that they don't even exist.

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