In Plain Site

Safe consumption sites can decrease overdose mortality and drug use—yet, in the US, politics and assumptions hinder legislation allowing such sites.

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Safe consumption sites provide hygienic environments for injecting, inhaling, or ingesting illicit drugs. They also offer opportunities for persons who used drugs to meet with counselors about lowering substance use and other harm reduction precautions. Positive outcomes associated with sites include decreased overdose mortality and drug use. Fourteen countries allow such sites. The US is not among them.

Several cities, including Philadelphia and Boston, have pushed for laws permitting safe consumption sites to no avail. Political opponents suggest that sites will attract persons who use drugs to the area and elevate crime rates.

Davidson et al. evaluated the influence of an unsanctioned safe consumption site on local crime rates. Since the site was operating without authorization, its location was kept hidden. Two nearby control areas were compared to an intervention area surrounding the site. Control area 1 had similar structural and neighborhood features as the unauthorized site. Control area 2 contained a social service agency for persons who used the site.

The authors compared monthly police department incident reports from the intervention and control areas. Report categories included “drugs/narcotics” events (possessing or dealing drugs) and “interpersonal crimes,” such as burglary and assault.

In the top Figure above, crimes in both the intervention and control areas rose in the year preceding the opening of the site in 2014. After opening, interpersonal crimes in the site area decreased at a greater rate compared to control area 1. Compared to control area 2, the site area saw a significant post-intervention decline in the number of interpersonal crime reports, as shown in the bottom figure.  A possible explanation is that crimes related to obtaining materials for drug use (sterile needles, etc.) decreased after the opening of the site. Or perhaps the site helped lower overall drug use, resulting in fewer interpersonal crimes.

Politics and assumptions have hindered legislation allowing safe consumption sites in the US., despite what research has begun to put in plain sight.

Databyte via Davidson PJ, Lambdin BH, Browne EN, Wenger LD, Kral AH. Impact of an unsanctioned safe consumption site on criminal activity, 2010–2019. Drug and Alcohol Dependence. 2021;220:108521.