Does Ithaca really need a government-run heroin shooting gallery?
Mayor of Ithaca proposes the first of its kind in the U.S.
I’ll never forget my one and only visit to a heroin shooting gallery.
It was my first summer of law school, and I was working at the Manhattan (New York County) District Attorney’s Office. It didn’t pay much; we were paid $100 a week, in crisp $100 bills handed out at the cashier’s window every Friday. Seriously.
The extra-curricular part of the job was the most interesting. We took a tour of the Medical Examiner’s Museum, not open to the public. Use your imagination as to what we saw there. We viewed an autopsy; the one I attended was of a guy found burned in a dumpster. I walked out on it.
But by far the most exciting part was my police ride-along. My law school friend and I randomly were assigned to the same patrol, West Harlem on a Friday night. The cops we rode with thought it was really funny to have two young Harvard Law School students with them that night, so they decided to show us a good time.
The cops organized, purely for our benefit, a raid on a shooting gallery in an abandoned tenement. They gave us strict instruction — there would be no lighting in the hallway we were going to run down, so stay close to them, and whatever we do, don’t touch the walls which were covered in bugs and filth.
Six or more patrol cars, sirens blaring and lights flashing, then sped the wrong way down some street, converging on the building. We ran out with the cops, and trust me, we stayed close to them and didn’t touch the walls.
We then ran up a back staircase and on either the second or third floor found the shooting gallery. There probably were 15-20 junkies shooing up heroin. When we all arrived, they paid us almost no attention. They didn’t run or try to get away; they just kept injecting themselves. One had overdosed, so the paramedics were called and they injected him with Narcan, which snapped him out of it. I asked the cops what would have happened it we didn’t show up, and he said the guy would have died and the other junkies would have thrown the body out the window and stolen his stash.
This is all a long-winded way of getting to this story about a proposal by the Mayor of Ithaca to set up a government-run heroin shooting gallery. Naturally I took an interest in the story since I live in Ithaca.
The concept is that bringing the junkies, of which there are many in central upstate NY (in addition to the Meth problem) in from the cold, both figuratively and physically, would help prevent overdoses and the spread of AIDS from dirty needles. It also might present opportunities for rehab.
This chart demonstrates the steep rise in Heroin overdoses:
Cody Derespina at Fox News reports, reports on the Ithaca proposal, Mayor wants to open supervised injection facility for heroin in NY city:
One upstate New York city is planning an unconventional approach to combating a growing heroin epidemic: Letting addicts shoot up on government property under the supervision of medical professionals.
Ithaca Mayor Svante Myrick unveiled his controversial proposal to open a supervised injection facility during an interview with The Associated Press released Monday. The facility would provide a space for users to inject pre-purchased drugs with clean needles under the watchful eye of healthcare professionals who could, in theory, keep them safe and direct them to addiction services.
“My father was a drug addict. He split from the family when I was 5, 6 years old,” Myrick told the AP. “I have watched for 20 years this system that just doesn’t work. We can’t wait anymore for the federal government. We have people shooting up in alleys. In bathroom stalls. And too many of them are dying.” ….
The 28-year-old Democratic mayor has proposed what would be only the second supervised injection facility in North America. The only current one is in Vancouver.
I was quoted on some of the legal issues:
“The city would have to be sure it’s dotted all the legal i’s and crossed all the legal t’s before it gets into assisting the use of a narcotic,” said William Jacobson, a professor at Cornell Law School in Ithaca who also writes for the Legal Insurrection blog….
While drugs themselves wouldn’t be sold at an injection facility, they would be openly carried and used there, and staff would assist in the use of them. That immediately puts facilities in the crosshairs of the federal government. Title 21 of the Controlled Substances Act specifically addresses “maintaining drug-involved premises” as being “unlawful.”
Though the federal government has so far shown a general inclination to stay away from enforcing federal drug laws in states where marijuana has been legalized, heroin is an entirely different animal.
“Marijuana is so widely used – it’s considered, in effect, decriminalized in most places – that it’s a totally different situation talking about heroin,” Jacobson said. “It’s a major narcotic.”
“I think it opens up potential liability,” Jacobson said. “I would think the city would also want to check with its insurers to make sure if there’s a claim raised if someone is injured or overdoses the city is not liable. There are multiple levels of legal issues that have to be considered – putting aside the public policy issue of whether, in fact, this is a good thing.”
I have mixed feelings about such a location from a public policy perspective. The heroin scourge is real, I’m just not sure normalizing the use helps the problem.
[Featured Image source: NYT Video]
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The whole “watchful medical professionals” thing sounds very nice. Very clean and safe. I’ll bet it will be every bit as clean and safe as a VA hospital. On a good day.
And then there’s that thing about “opportunities for rehab.” What are they going to do – give them a pamphlet? Because the medical professionals who work there will very quickly get bored with giving them lectures. And no one is going to ask for a referral.
If they’re lucky this will be futile. If they’re not lucky, it will be a complete disaster.
There are many bright people out there who may have an opinion about this: why the dramatic upturn in heroin overdoses?
I am not a social scientist (oxymoron?). But a good guess for rapidly increasing heroin use might be price and availability. There are social factors, for sure, but those may be a big factor.
It’s not just in rust belt areas either. For example, in the non-transient community on Cape Cod – meaning people who live there year round and typically work in services to those who don’t – there is a very high and escalating problem with heroin primarily among the younger population and even high school age kids.
Part might be due to the increased regulation of prescription narcotics by the FDA. They have moved things like hydrocodone (Vicodin) from a schedule II to a schedule III drug. For legit patients who need these type of pain medications, this, along with a lot of other complex regulations, has caused a lot of problems. Prescriptions have to be hand carried, there are limits on the ability to get refills and just a whole bunch of regulatory hoops.
Doctors are afraid to prescribe because they don;t want to run afoul of the FDA. People who have a legitimate need for pain treatment are suffering because of over regulation that is designed for people who are not legitimate users. Sometimes these people have the choice of either living with the pain, deciding the pain makes life a constant misery and they kill themselves or they turn to street drugs. Try living with long term serious pain and you will see how it takes over your entire life.
They usually don’t know anything about street drugs. How to use them, how much to take or what the product they get actually is.
But, regulators gotta regulate. As with many things there are a lot of unintended consequences to these regulations.
We are in the middle of a governmental swing in emphasis. A few years ago, “activists” were pushing hard against strict Federal regulations, to get more pain medications to patients. More pain medications were prescribed.
A side effect of legitimate pain medication using addictive drugs is — drug addiction. Some people progress from legitimate prescription to use of heroin.
Illegal drug dealers will do anything for a profit, and that includes cutting their drugs with something else. Some of those combinations are deadly.
With the higher rate of deaths, there is now pressure from the Feds to tighten up on prescriptions and people with real pain who lose their prescriptions can and do turn to the illegal stuff.
I recently saw an interview with the producer of this new Frontline documentary (quoted in the link below) on the heroin problem. She echoed the two posts above exactly. She also noted that law enforcement movement today is to treat the heroin epidemic as a public health issue much like the AIDS epidemic of a few decades ago.
Of some note in the discussion was that the problem is being addressed in this manner now because it’s become a white suburban problem, not just a minority ghetto problem, or a poor rural white problem. That may or may not be a criticism, but I did find it interesting.
The documentary starts tonight on PBS (see below):
http://www.pbs.org/wgbh/frontline/article/watch-a-cops-surprising-interaction-with-a-heroin-user/
“With toughness and clarity, tonight’s two-hour special investigates how pills and heroin began taking a toll in new communities, largely white and suburban; how the national conversation around addiction is being reframed from a criminal justice issue, to a public health one; and how cities across the country are now reimagining the war on drugs and experimenting with radical new approaches like LEAD.”
Chasing Heroin begins Tues., Feb. 23, on PBS and online at a special time: 9 p.m. EST/8 p.m. CST
I should clarify…heroin becoming a new “white suburban problem” needing a medical solution was part of the discussion when the interviewer brought it up, not as part of the documentary. The interviewer was pointing out that critics are saying that, and they’re asking why wasn’t this issue addressed as public health instead of criminal isssue when it was a minority/poor problem.
A graph of actual heroin use rates over time versus the number of mentions of “heroin epidemic” in the media is interesting.
I can’t help but wonder, cynically I admit, if it has to do with the increasing number of users who “look like us.”
This is probably a stupid question, but what incentive do the heroin users have to go to a government run ‘heroin shooting gallery’, as long as heroin use is illegal, and they know it’s BYOH?
Sounds a bit like a liberal ‘feel good’ solution.
Guesses?
– Free sterile needles
– Safe/private environment
– No drug dealers/addicts/criminals to deal when your stoned after you shoot up
– Don’t get hassled by family/friends at home
– No police issues either
– Family/friend encouragement to get help while at facility
“Well, you know Fred, institutions are the problem, not mankind. ”Man was born free, and he is everywhere in chains.””
“Let’s pass a bill, John, to throw millions of tax dollars at the heroin shooting gallery and let’s call it Planned Potentialhood.
“You know, Fred, I like that idea. That makes me feel so good about myself, helping my fellow man.”
Tolerance is intolerant. Normalize it.
The pro-choice cult has a tradition of encouraging the “just do what feels good” mental cases.
It’s all “=” or rather congruent.
Oh, well. Perhaps the alternative is equally disagreeable.
When I worked at an indigent hospital, I saw first hand the results of our “war on drugs”. Of the thousands of patients that we took care of, about half were there for a drug related problem. In the case of heroin, there are several issues. First there is the dose of the drug, it is usually unknown depending on the street cut. Then there is the case of dirty needles and equipment. This is really expensive when it gets to taking care of these people as the equipment transmits AIDS, Hep C, and bacterial endocarditis. Now, why are they using heroin? Because it is cheap when compared to other drugs at this time. How do you stop all this, you do what Europe did and you make all drugs readily available to the public without a doctors prescription or visit. The countries that do this do not have drug problems. As a doctor I am amazed at how stupid our system has become. It is like the TSA on steroids. My patients that need pain medications and other drugs for chronic conditions can’t get them or it they do they have to jump through numerous bureaucratic hopes that make them feel less than human. Why can’t a person go to the drug store and by what they need, consider the cost savings. Will some people be harmed? Sure, but they will be victims no matter what. The other 99% of us will get our freedom back and better medical treatment.
I find it hard to believe the most effective solution is a simple as increasing access and perhaps reducing cost. I’m all for the libertarian approach for the most part. But alcohol is freely available and we still have a serious problem with alcohol related violence, driving, etc. Granted, each drug’s effects are different, but will the negative impacts of heroin simply wane because it is cheaper and more readily available?
To me it takes more than just decriminalizing. I can only hope we get the federal government out of it in the near future (next president???) so that each state and community can experiment. Even many of the European solutions have failed to one degree or another, so local communities don’t have to start from scratch.
At the end of the day, it is not the problem of government. That is not the way our system was set up. Government had no place in this until 1913 when the progressives took over. Everything they put in has gone to pot. Our current efforts are making the drug problem worse, just like they did with alcohol in the 30’s. Get the government out of our lives.
I hear you David. In NH – the morons are blaming the heroin epidemic on the doctors. The story goes like this: The docs give out pain meds like candy, people get addicted and when they can’t afford their prescriptions anymore they go for the cheaper heroin. The solution – of course – is to make it really hard for any legitimate patient to get a script for a narcotic, then they won’t get addicted to pain meds and seek out heroin! Voila’. The cognitive dissonance is real. Who cares if we’re writhing in pain?
Couldn’t agree more, david7134.
How long does it take for the government to figure out the war on drugs has never worked?
The answer is self-evident.
The answer is, the government has always known it doesn’t work.
It simply creates a massive profit incentive for criminals, which we then spend billions of dollars on interdiction/criminal justice/revolving-door incarceration (where they get more drugs)/political efforts, meanwhile illicit drug production/use doesn’t change in the least, it simply finds alternatives.
All of the “wasted” money has never been wasted.
It’s been given exactly to the parties in/out of government that lobby for it and have control of it. This isn’t tinfoil hat conspiracy nonsense.
Not that groups like police don’t feel good about what they do when fighting the criminals. They should. But I’ve spoken to many that know that drug users are not the root of the “drug crime” problem. Users are committing crimes to buy drugs that have inflated prices because the drugs are illegal.
We’ve pissed away trillions of taxpayer dollars with nothing to show for it. NOTHING.
Illicit drug users are going to use drugs.
Legitimate drug users need drugs.
Duh.
Government employees don’t care that the war on drugs hasn’t worked. It pays their salaries and justifies their power over other people.
As for the recent “heroin epidemic”? Amy in FL linked to a graph of actual cases versus reports. My take? Just the latest “crisis” demanding we “do something” (which of course means more government).
How do you stop all this, you do what Europe did and you make all drugs readily available to the public without a doctors prescription or visit.
That would be great! I wouldn’t need to waste money on a doctor. I could just go buy any drugs that I think might cure my illness, and start taking them till it does.
Or I kill myself, whichever comes first.
When I see my patients, I instruct them on their illness and drugs and give them what they need with instructions as to how to use the medications as they see fit. What is amazing is that they do much better. Now, if you can’t follow instructions, read a label, look up a problem, then you do need to have your hand held and led around like a child. Americans have not been free for so long, they do not know what it is like.
Another thing, I have friends in India. They can buy what they need without a doctor and they do well and don’t over dose. It is amazing what happens when you are allowed to be free.
My parents lived in Manila, Philippines, for years, and my sister is still there. Same as India. Want to buy drugs, go to drugstore, ask for it, pay for it. No prescriptions needed. Works fine.
Rinardman, no one is talking about banning doctors. If you still want to consult a doctor, you’ll still be free to consult a doctor. If you have a medical issue, consulting a medical professional is probably the right thing to do, and I assume you and most other legally-competent adults are smart enough to know that.
Why is it that so many “conservatives” assume that without the State forcing them to “do the right thing,” no one will will be smart enough to just do it on their own anyway? Everything will just spin out of control! It’ll be anarchy!
My pool pump stopped working this morning. I am legally allowed to go out to Home Depot, buy whatever tools take my fancy, and have a go at fixing it myself. I might break it even worse. I might even electrocute myself! But it’s not illegal for me to do it. Luckily, I am a sentient adult human being who knows the limitations of her own skills and knowledge base, and even though the State isn’t forcing me to, I’ve made the decision to call in a guy who specializes in pumps to fix it for me.
Have a little faith in yourself, brother. You’re almost certainly capable of running your own life. And if you’re not, we can find a guardian or responsible adult to care for you. But you don’t need the strong arm of the State as much as you think you do. I promise.
Rinardman, no one is talking about banning doctors.
I’m confused. Where did I say anything about ‘banning doctors’?
Also, what part of ‘That would be great!’ don’t you understand?
Have a little faith in yourself, brother.
Oddly, I have more faith in myself than I do you. Weird, huh? 🙂
Certainly communities need to address their own problems. But this seems to have priorities out of whack. They have essentially removed one of the obstacles of shooting by supervising. It’s almost like creating the next “safe space” but not for speech and to make shooting easier and safer.
The priority should be that the addict must first agree to some level of treatment before being given access to the center. At a minimum.
just another form of ‘assisted suicide’.
Would a doctor be violating the Hippocratic Oath by supervising heroin users? What about liability if these people leave the center and then commit some kind of crime? Frankly I am surprised that there is this big an issue in Ithaca. My immediate reaction, NIMBY.
Bad idea, not gonna significantly drop the numbers of people using this drug. Isn’t most heroin still produced outside of the U.S.? If so then the best solution to getting this problem under control would be better border security and catching more of the drug runners before they have a chance to distribute this poison in our country.
I love that the chart only goes back to 2002. Wasn’t heroin the drug of choice in either the 70s or 90s? My guess is if the researchers were honest and actually mapped out the usage of heroin over the past 80+ years you’d see a cycle of high usage and low usage, much like with cocaine and other drugs.
But that doesn’t support their narrative so we won’t mention that.
This isn’t even a graph of usage, it’s a graph of “heroin overdose deaths” (though how many were purely due to heroin and how many to poly-drug ODs (or deaths “involving” heroin but not necessarily caused by it), I don’t know. Plus, they use raw numbers of deaths, and not death rates, so that ignores the fact that we added 31.3 million people to the USA over the charted timeline. And then, take a look at the actual numbers of deaths: of course, even one death is very sad, but these aren’t huge numbers we’re looking at given that we’re a nation of 320 million people. Compare that to the between 210,000 and 440,000 deaths each year due to medical errors.
Finally, a couple of pieces from Reason looking at what we’re actually talking about when we’re talking about the “soaring” rate of heroin use the in the US: here and here.
I’m fine with making heroin use less dangerous. Injecting rooms are one way; decriminalization is probably a better way. Of course, that’s based on my own particular bias that when you have a problem, the solution is probably more likely to be “less government” rather than “more government.” Your mileage may vary. But by and large, I worry a lot more about real problems that are actually more likely to kill me and mine through no fault of our own, like antibiotic resistant bacteria and preventable medical error, than I do about heroin overdose deaths.
The gov is not there to fix a personal responsibility problem. The drug use is a symptom of bigger problems which can’t be fixed by laws or “safe” injection centers. There isn’t a problem that a person has which can’t be made worse by drug use. Most users know that drug use is a death spiral and continue to use those drugs anyway. Why not just walk into a mine field? It might just be that current gov policies and a tanking economy have left people so desperate that suicide by drugs is a viable option for them.
There are few problems, including drug use, that aren’t made worse by more government.
Interesting discussion, though, there seems to be an area where the medical, i.e. pain management & prescription, and recreational/troubled users overlap with no corresponding and distinct solutions proposed, but then perhaps none are suggested, just cater to them all. (My personal opinion is that currently, our “culture” has both glamorized and is far too indifferent regarding the use of drugs, but that’s just me.)
OTOH, as a parent who lives just down the road from Ithaca in the organized crime operation known as New York State, here’s a suggestion: if we’re to try this wonderful experiment, let’s do it in two places – Albany and Manhattan.
Just what we need in Ithaca – a safe place for junkies to shoot up. Hey every heroin addict, we’re having a party! We’ll supply the chips and dip, but BYOH (bring your own Horse). Why won’t this program attract heroin users to Ithaca? And they have to buy their own drugs. With what money? They can’t afford their prescription drugs, so how will they afford their heroin? They’ll steal our stuff and sell it, that’s how. And the laws of economics will kick into high gear. Higher demand for heroin will be met with a larger supply from the pushers, gangs and other scumbags. Maybe there is a good reason why there is only one other program like this in North America. Your tax dollars at work, Ithaca.
Look at what happened to the area in Vancouver BC (it’s kind of like an American city).
This ain’t Europe. Our druggies aren’t theirs and our support system is so different I’m not sure there’s any comparison possible. I know our criminal justice system is entirely unlike theirs.
If there is a solution it is an American one. Making it easier to shoot heroin is not a solution. It’s not even kicking the can. It’s tossing out a couple more cans then kicking them into someone else’s yard.
Let’s have the DEA seize this facility and all the pot dispensaries in Colorado & Washington. Sell them off to reduce the deficit. Finally put those civil asset forfeiture laws to good use!
My understanding of heroin addiction today is from the perspective of being a parent; my knowledge of it in the 70’s is from being a sister to hippie brothers.
In the 70’s, heroin was the most expensive drug on the streets; since it is both highly addictive and was hard to get (most was smuggled in from the Middle East, as I recall – the poppy fields in Afghanistan, I believe), addicts committed muggings, robberies and worse to get their always-increasing hit or fix. Running drugs, smuggling, dealing were also ways that an addict could get their dope and have the money to buy more (because a heroin addict ONLY cares about their next fix). Supply was low, demand was high (the social mores of the day, “tune in, turn on, and drop out” may ring a bell). I watched an addict – the boyfriend of an ex-sister-in-law’s – do nothing but shoot up, be useless and live in a drug-induced stupor, and then go nuts till he got his next fix. He died of overdosing, eventually, after running drugs to get money for his expensive habit – getting caught, but not caring – and continuing to use till he OD’d. Heroin addiction destroys lives.
Fast forward to today. The teens (and even younger) are able to get drugs almost anywhere, anytime. It’s illegal, but seen as socially acceptable, as no big deal – their parents often are users of some form of drugs: legal – like alcohol, prescription drugs, or maybe pot; and illegal – pot, cocaine, meth, etc. They are quickly moving from pot to designer drugs like Ecstasy, meth and “bath salts,” then to heroin. Heroin is incredibly cheap compared to many of these other drugs, in most places; moving up the drug-abuse chain to heroin is easy and cheap, as the supply is high – mostly due to our porous borders and the current policy of looking the other way unless it’s high political season. I’ve seen many families, personally, lose a child, have near death overdose experiences, go in and out of rehab or jail……all related to heroin. Heroin addiction destroys lives.
Legalization sounds like a solution; you will always have people with addiction problems (either genetically inclined, chemical-imbalance/mental disorder, weak personality, or whatever other human weakness that leads us to use drugs and abuse them). I see legalizing drugs as making it easy for deeply wounded, addictive personalities, or the bored and weak-willed to get and abuse. More teens, disillusioned and in despair about the way our nation is going, their job prospects, the cost of education and etc., all lead them to want to “feel something” – so they cut, they drink, they go to raves; they then get into drugs to feel the high….and get hooked. Since heroin is so cheap and readily available, it’s a quick transition, and more affordable, for them.
People die from this. To me, it’s an illness – but the patient needs to WANT help. Almost like a person with a mental illness, or chronic disease: you can tell them they need help, but they are the ones who have to go to the doctor, take their medicines/get their treatments, and live through it all.
A friend of mine is a parent of a drug-addicted child (now 23). She said the time it takes an addict to get the drugs out of their system completely – no traces, not just a clean urine test – is THREE YEARS. Every moment, of every day, of every week, of every month, of every year……for THREE YEARS…..that is why it’s so hard for addicts to “kick the habit” for good.
Bottom line: they need help. This will only enable them, not help them. It reminds me of the methodone programs of the 70’s – where the drug addicts were given methadone to supposedly help them wean themselves off heroin. It didn’t work……most either went back to heroin, or just became addicted to methadone. In other words, they were still addicts, with the illness of addiction. And we paid for it – yes, they went to public clinics to get the methadone, which was legal.
This is wrong-headed, Ithaca. The Professor is absolutely correct: you will have HUGE liability issues, legal responsibilities, and it will not help these people….because they don’t want help. They want to get high, escape, feel euphoria and then be numb. Because that is what happens to heroin addicts: they only care about the drugs, the fix, the next hit. They don’t care about the needles being clean, the stuff being cut with rat poison, or the place they are being filthy vs. sterile.
They. Are. Addicts. They. Need. Help. Don’t enable them; HELP them – REALLY help them – by getting them cleaned up, off the drugs. And get the economy back on track so these kids can get jobs, can earn a good income, can afford to go to college, or trade school. Help them to not feel so hopeless, but giving them a positive, an incentive, an opportunity…. If they have a reason to hope, and not feel trapped and hopeless, they may see a REASON to not live in despair, to seek help to kick their addiction – before a near-death experience makes it all to real….or worse.
Government enabling is NOT the solution.
This idiotic proposal in Ithaca reminds me of the Washington, D.C. City Council’s recent vote approving a bill to make periodic payments to 200 of the city’s convicted criminals deemed most likely to re-offend, as a reward to them for obeying the law and not committing crimes. Self-imposed extortion paid to a band of habitual offenders, because society’s reward for not committing crimes, to wit, avoiding incarceration and having the opportunity to earn an honest living and better one’s life, is apparently not incentive enough for people to become law-abiding citizens, according to these apparatchiks. I’ve never seen anything so foolish.
The Left is perpetually coming up with transparently idiotic social engineering schemes that are devoid of a modicum of policy merit or basic common sense.
After reading all the comments and consulting my college freshman son, I offer this: he’s in favor of it, because it is modeled on a program that saw considerable change in the behavior of some of the addicts. Apparently many addicts are in emotional pain, and exposure to a clean place and real medical people truly helps. That, if it worked, would be great. And, if the shooting gallery supplied the heroin, it would tank the local market for heroin. There is an economic truth in that last statement.
I still find that hard to square with a society that took an effective allergy remedy off the shelves and put it behind the counter, allegedly due to misuse by dieters. The drug I am referring to is phenylpropanolamine hydrochloride (Dimetap). This drug had been used by many millions of people (and me, for many years) for its intended purposes. Ah, but word got out that it suppresses appetite, and it was abused by dieters.
If we are going to take Dimetap cold and allergy medicine off the shelves because some young women abused it for weight loss, how in the name of all that’s holy do we allow a mind-stealing, addictive drug like heroin to be sold at all?