Alameda County organization demonstrates safe injection site for drug users

“Hello, sir. What do you need today?” Braunz Courtney says with a welcoming smile, standing comfortably behind a buffet of sterile syringes and pipes.

“I need some medium sharps,” his client Vernon, 64, responds.

Courtney, the policy director at HIV Education and Prevention Project of Alameda County (HEPPAC), makes a neat bag of syringes and supplies and hands it over, then points to a bold white structure nearby. “Check that out,” he says. “It could be a possibility really soon.” He’s gesturing toward Safe Shape, a small pop-up prototype of a Supervised Injection Facility.

Supervised Injection Facilities (SIFs) are legally sanctioned sites where people who use drugs can inject or smoke them under medical supervision and in sterile conditions. No exchange of illegal narcotics takes place onsite; rather, the facilities function primarily as safe places for the consumption of substances like heroin, crack and crystal meth.

By providing a sterile environment, HEPPAC staffers are trying to minimize the health damage of injection drug use. According to Greg Scott, professor of sociology at DePaul University and the creator of Safe Shape, addicts often use drugs in septic environments, in isolation or in highly stressful environments, which raises the risk of disease, botched injections and overdose. Though no official SIFs exist in the United States, there are around 90 sites in 66 cities around the world.

On September 2, as a follow up to Oakland’s observance of Overdose Awareness Day, HEPPAC partnered with the Drug Policy Alliance to host Safe Shape’s exhibit at Qilombo Community Center in downtown Oakland. New and returning needle exchange clients toured the structure, which guided visitors through a mock safe drug consumption journey: from supply station to consumption station to chill room to information station. The chill room is where users would experience their highs under observation by medical professionals seeking to prevent overdoses, and could receive HIV and Hepatitis C testing or wound care. On their way out, visitors would receive personal hygiene supplies, like condoms and tampons, and pamphlets informing them of health care and recovery services.

Scott has been working with a Chicago syringe exchange program for 15 years. He said syringe exchange is just one step toward responsible, humane treatment of drug users. “Supervised drug consumption is a concept that’s based in humanitarian ideals and is backed by science,” and Safe Shape, he says, “is a tangible form that invites you in and helps you access ideas about harm reduction, public drug use, the need for drug consumption spaces, and more generally, how to elevate our standard of care for each other as community members.”

Vernon, who declined to give his last name, makes his way from the HEPPAC tent to the bold, stark white Safe Shape tent and walks inside. When he emerges, he stands silently for a few moments. “This should have been the first thought,” he says, “as opposed to the last.”

SIFs fit under the umbrella of “harm reduction,” which is a method of care that aims to reduce the harmful consequences of drug use rather than focusing on abstinence-only treatment.

Laura Thomas, the California deputy state director of the Drug Policy Alliance, a non-profit organization that does advocacy and legislative lobbying to end punitive drug policies, said that harm reduction emphasizes recognizing drug users’ “humanity, giving them dignity, respecting them as human beings, and not shaming and stigmatizing and criminalizing them.”

Studies of SIFs in Canada, Western Europe, and Australia indicate very positive results, said Thomas, particularly at reducing “harms to the individual like overdose, HIV, Hepatitis infection, and harms to the community or neighborhood like improperly disposed of syringes.”

She said they also effectively connect drug users to services. “They do all of that without increasing drug use, without increasing crime,” she said. The reluctance of United States’ legislators to support SIFs comes with a price, Thomas said: “There’s a cost of people’s lives, there’s a cost in taxpayer dollars, there’s a cost in families losing a loved one to overdose.”

Later in the evening, the New Parkway screened two short films about the need for SIFs in New York and San Francisco. The first, Making a Place Called Safe, directed by Scott, examines the physical and mental health needs of members of the San Francisco Drug Users Union, an organization that advocates for drug users. The second film, Everywhere but Safe, directed by Matt Curtis and Taeko Frost, follows several current and former drug users in New York state as they explore what it would mean to have a safer consumption space. The films both highlight the dangers of public drug use and the perils of isolating and stigmatizing drug users.

In a discussion that followed, the filmmakers and local activists issued a call to action to audience members to help bring SIFs to Oakland. Courtney later reiterated that if the city were to adopt Safe Injection Facilities in East, West and central Oakland, “it would really benefit the communities. I think they would really start to see a difference.”

“Oakland specifically has a problem with heroin and crack. They don’t call it ‘Dope City’ for nothing,” Courtney added.

An estimated 17,534 adults over the age of 18 in Alameda County are injection drug users, according to the 2014-2016 Alameda County Comprehensive HIV Prevention Plan, published by the Oakland Transitional Grant Area Collaborative Community Planning Council and the Alameda County Office of AIDS Administration. A 2007 study of the only North American SIF, Vancouver’s Insite, found that people who used their facility were 30 percent more likely to seek treatment than people who did not.

There will be opposition to these facilities, said Scott. “It’s not about enabling drug use. It’s about supporting drug users in a quest to stay as healthy as possible for as long as possible.”

He continued, “That’s what medically-supervised drug facilities do. You can’t willfully stop using drugs if you’re dead.”