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Lecture 1

HSAD 335 Lecture Notes - Lecture 1: Opioid Epidemic, Nimby, Naloxone

Health Services Administration
Course Code
HSAD 335
stephen gambesica

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Safe injection sites, a possible solution to the opioid epidemic
Problems are part of our everyday life. Our problems can vary depending on where we
live and how we live, but when our everyday problems lead to devastating situations, we can no
longer avoid the problem. Today we are facing a crisis that we can no longer avoid. With more
than 64,000 deaths from opioid and other drug overdoses, it no longer remains a personal issue
rather it has become a national crisis.
An overdose is often a lonely way to die. The drug overwhelms the body’s basic
functions, eventually stopping the brain’s drive to breathe. Obviously, this is a horrible way to
die but what if there was a way to save people from being overdosed? What if we could decrease
the risk of being overdosed? Overdose from a drug can be reversed with drugs like naloxone,
which saves thousands of lives a year, however, someone must be there to notice the sign of an
overdose. This solution can be implemented through the use of safe injection site, however, cities
like Philadelphia is struggling to implement these sites.
Many people today acknowledge the safe injection site as a possible solution but only a
few cities have tried to implement it. The chief of staff of the Philadelphia public health
department stated this as one of her biggest challenges. She states that many people support the
safe injection site as a possible solution but nobody is willing to put it near their homes. They
explain their objection through the natural psychological phenomenon "Not In My Backyard"
(NIMBY). People hold the belief that these sites will promote drug use and increase crime in
their neighborhood. One of the people who is opposed to the safe injection site has stated at a
public hearing in Philadelphia that "You're not thinking about me and what I experienced
growing up and you're not thinking about my children who will be exposed to this as long as we
live." However, research instead suggests that these sites lead to increases in public order, with
fewer discarded needles on the street and less drug use on the sidewalk, and have no impact on
drug-related crimes.
All evidence so far shows these facilities have proved extremely effective in decreasing
overdose deaths in the country that has implemented the safe injection site. If lawmakers are
serious about ending the opioid crisis, American cities and states should follow their lead. We
are in a crisis and we need to take some kind of creative approach to this problem rather than
sitting home debating about the issue. Currently, Seattle and San Francisco are both on track to
open sites, and Philadelphia recently approved the idea as well. Boston, Ithaca, and New York
City are considering their own facilities.
Vancouver was the first city to open a Safe injection site in North America. The site
opened in 2003. It has led to a 35 percent reduction in overdose deaths in the immediate vicinity
compared to 9 percentage decrease in rest of the city. However, these improvements have not
been acknowledged by the Trump administration. Rather than taking harm reduction approach,
the Trump administration wants to solve the issue of drug addiction under federal law. President
trump wants to use the law enforcement and the old approach of being “really really tough” on
those who don’t follow the law. Also, in response to proposed facility in Vermont, the attorney
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