As Toll Of Opioid Crisis Rises, Vermont Senate Considers Safe Injection Sites

Jan 5, 2018

The rising toll of opioid addiction has policymakers looking for new ways to save lives, and Vermont lawmakers are giving serious consideration to a bill that would open the door to supervised drug injection sites.

At a press conference back in late November, reporters decided to get Gov. Phil Scott’s take on the idea of so-called safe injection sites. Earlier that day, a commission out of Chittenden County, which included medical professionals and criminal justice officials, had just come out in favor of a supervised injection facility for Burlington.

The governor did not sound convinced.

“At first blush, admittedly, I don’t understand it myself,” Scott said. “I’m not sure I quite understand how that’s helping the situation.”

Sarah Evans says the governor’s reluctance is understandable.

“I know that this is hard sometimes for people to understand and to accept, that if you give people a safe place to use drugs, they’re more likely to stop using drugs,” Evans says. “It seems counterintuitive.”

Evans, who formerly managed day-to-day operations at the first supervised injection site in North America, delivered that message to the Senate Judiciary Committee during a hearing Thursday.

The facility Evans oversaw — called Insite — opened its doors in Vancouver in 2003. It’s been the subject of considerable medical research since, and Evans says the findings are incontrovertible.

At the Insite safe injection clinic in Vancouver, B.C., Richard Chenery injects heroin he bought on the street back in May 2011.
Credit Darryl Dyck / AP/File

“Insite users are actually twice as likely to get into detox and treatment as people who don’t, and they know this because they had a control group,” Evans told lawmakers.

The same research also showed that users in the region surrounding Insite were 35 percent less likely to die of overdoses. And then there’s this:

“The total number of deaths at any supervised injection or consumption space anywhere in the world ever, is zero. So I think that that alone is a statistic that’s worth pausing and reflecting on, and kind of reason enough to consider opening such a site,” Evans said.

"Safe injection facilities are an important step in recognizing that people who inject drugs have not forfeited their human rights, including the right to safety and health." — Dr. Patricia Fisher

Outside the Senate committee room where Evans spoke last week, Chittenden County State’s Attorney Sarah George said she appreciates why Gov. Scott and other opponents of the concept feel the way they do.

“I had the same reaction,” George said. “When I first was told about them by a co-worker actually, even I had like had this kind of visceral reaction like, ‘Ugh,’ I don’t know about this.”

Dr. Patricia Fisher told Senate lawmakers that safe injection sites could protect users from avoidable health conditions.
Credit Peter Hirschfeld / VPR

And yet, George is now leading the push for a bill that would insulate safe injection sites, and the people who run them, from criminal liability. George is the one who assembled the safe injection site commission that ultimately recommended the creation of sites in Vermont.

“After months of reading research, and at some point trying to find research against it than for it, because the for-it was so overwhelming, and not being able to find any valid research against it, it because so common sense to me,” George said.

Dr. Patricia Fisher, a hospitalist at University of Vermont Medical Center, is another safe injection site convert. Fisher says she first viewed the concept as being at odds with a doctor’s oath to do no harm.

Then she began witnessing the effects of unsanitary injection practices on her patients. During her latest week on the job, Fisher says three of the 16 patients she treated were there with injection-related conditions. A 26-year-old man arrived with heart failure, and would die without a heart valve replacement. There was also a 23-year-old woman with blood clots all over her body.

“The third individual was a 19-year-old who lost his right eye after injecting drugs into his face,” Fisher says.

Fisher says these outcomes are entirely avoidable. Provide addicts with a safe, sanitary space to shoot up, and Fisher says Vermont can increase the chances of recovery. The goal, ultimately, is to keep people alive until they’re capable of getting clean. And at safe injection sites, they also have access to medical professionals who can connect them to treatment services.

“Safe injection facilities are an important step in recognizing that people who inject drugs have not forfeited their human rights, including the right to safety and health,” Fisher says.

Bennington County Sen. Dick Sears, the chairman of the Senate Judiciary Committee, says he’s interested in pursuing the legislation, though he says it remains to be seen if the full Senate will get behind it.

“The testimony today, it indicates that it may actually help to reduce the amount of opiates that folks are using, and anything that can reduce the demand, I’m all for at this point,” Sears says.

Even if Vermont lawmakers give safe injection site workers criminal immunity under state law, the U.S. attorney for the district of Vermont has indicated that the feds would not turn a blind eye.

Nonetheless, State’s Attorney George says she thinks a Vermont law could give her, and other Chittenden County officials, the security they need to move forward with opening a site. And even Gov. Phil Scott, despite his initial objections, says he’s open to learning more.