Last year, the District of Columbia opened its first sobering center, or “stabilization” center, to provide short-term care for people experiencing substance-use crisis or emergency. This center provides medically assisted treatment, offers services to continue recovery care, and connects patients with a host of supportive individuals, such as nurses and nurse practitioners, peer specialists, and recovery coaches.
Some people fear this facility will harm the city when they should be relying on evidence-based research supporting their implementation instead. D.C. should institute more harm reduction facilities because they promote community-wellbeing, rather than hurt it.
While the sobering center in D.C. is a necessary example of a harm reduction intervention, it does not provide the same level of care to the extent of a Safe Consumption Site (SCS). These sites help reduce the risk of preventable disease, infection and overdose from injectable drug use by providing medically supervised room for people to inject drugs hygienically and with other help available in case of an overdose occurring. The sobering center also offers less formal treatment plans for individuals who cannot commit to long-term care.
D.C. has experienced an alarming increase in fatal opioid overdoses. Through the end of last July, 296 people died of overdosing, an increase of 17 from July 2022. The Centers for Disease Control and Prevention fatal overdose data rank D.C. as a top area of opioid overdose deaths. To address this public health emergency, the city is providing more services, including harm reduction interventions such as the new SCS, to help prevent and treat individuals suffering from opioid addiction.
The term “harm reduction” refers to approaches that reduce specific health and safety issues associated with drug use. These approaches accept that licit and illicit drug use happen and focus on minimizing the adverse outcomes related to drug use rather than trying to get rid of the drug usage entirely. Harm reduction is a movement for social justice built on respect for the rights of people who use drugs.
Examples of harm reduction approaches to illicit drug use include syringe service programs and overdose prevention centers.
If D.C. opens more SCSs, the community will benefit in multiple ways. One study in Vancouver, Canada, found a 26 percent net reduction in overdose deaths in the area surrounding an SCS compared to the rest of the city. There were also 67 percent fewer ambulance calls for treating overdoses and a decrease in infections caused by using unsafe equipment.
When it comes to implementing this in D.C., these individuals would be taken care of inside a facility instead of injecting drugs on the city streets. With more SCSs implemented, people across the city can access the services from which those near the first SCS are starting to benefit. They would receive treatment, referrals to other community health clinics, and housing services to further help keep these individuals from injecting in public or even decrease their chances of injecting at all.
The main concerns surrounding these harm reduction facilities involve the stigma around drug use and misuse. While SCSs do attract individuals who are using drugs, they are viewed by members of society as dangerous. Community members may be concerned that the SCSs are attracting individuals who are addicted to drugs and encouraging them to remain in their neighborhoods. Some also argue that hospitals are more appropriate locations for treating people who need substance use interventions.
As a D.C. resident who wants my neighbors to have a chance at living healthy lives, I hope those concerned about SCSs will consider how they will benefit their neighborhoods and the city as a whole. If SCSs are viewed using an evidence-based lens, it can be shown that there is a higher chance of individuals using drugs to tackle their addiction and engage in further action to stop misusing drugs. This exposure to proper medical treatment encourages clients to receive help, which will mean that they have an increased chance of shifting drug use from public spaces such as parks and sidewalks to facilities designed for this purpose.
Years of research show how harm reduction strategies provide significant public health benefits, including preventing overdoses and reducing costly healthcare services. Regarding cost analysis, treatment in residential crisis settings (including SCS) is 44 percent lower compared to general hospital care.
It is important to implement more harm reduction facilities to reduce D.C.’s staggering increase in opioid drug addiction and overdose deaths. More people living in D.C. should advocate for places that offer support for those struggling with drug addiction to promote public health.
