Should health agencies in the Mahoning Valley give needles to addicts?

In 2001, facing a 20-year opioid epidemic, Portugal decriminalized all personal drug use, meaning people carrying drugs for personal use could no longer face prosecution or jail. The approach, met with public support, offered people access to services like safe injection sites and counseling and showed demonstrable success in declining opioid related deaths, the spread of infectious diseases, and drug use all together. As the rest of the world faces a similar crisis, Portugal could be a model response.

Despite hesitance and not complete buy-in, European countries are seeing signs of success from implementing drug consumption rooms. While the United States has been hesitant to adopt this tactic as a solution for fear of normalization of drug use, countries with these facilities are reporting less “injection-related litter in public spaces,” increased public awareness, less stigma, and fewer overdoses.

Rather than treat opioid users like criminals, Vancouver has deemed it a public health crisis. The city, especially its downtown east side, witnessed 1,500 deaths in just one year from opioid use. Its approach is unique and multi-pronged – making Narcan, an overdose antidote, available to everyone, opening safe injection sites, and having a police presence – without arrests – on blocks where using remains high.

Harm reduction is a quickly growing practices that aims to reduce drug-related deaths and the spread of disease often caused by dirty needles. Although public perception is still widely negative, the industry has seen success by using the act of offering clean needles as a first point of contact to offer other health and medical services.

Supervised injection sites in Canada have prevented hundreds of heroin overdose deaths. Now, New York City is looking to follow Canada's lead with a city-wide initiative to establish safe injection sites. While the Trump Administration is not in support of such sites, experts believe that it is unlikely that the federal government would interfere with a site if a city is in support of it.

In Mahoning County, Ohio, a needle exchange program helps prevent addicts from contracting communicable diseases that might create further barriers to sobriety. The needle exchange also creates an interface for addicts to interact with resources that can help them achieve and maintain recovery from addiction.

In Maryland, people are being trained to administer naloxone, the drug that can save people from an opioid overdose, in order to combat the opioid crisis. Some people are even trained on street corners. Already 20,000 people have been trained, and more states are following suit.

Two columns on how Iran is treating its massive epidemic of injecting drug use by tackling it as a health problem, effectively lowering H.I.V. rates among drug users using an approach to drugs known as harm reduction.

In less than three and a half years, Safeworks, the only supervised drug-use site in Calgary, saved thousands of people from opioid-overdose deaths and helped users for whom abstinence-based treatment didn't work. The government of Alberta deemed the site a scene of "chaos" and ordered it closed once two new sites open. Safeworks supporters oppose the disruption in harm-reduction work that move would bring, considering how critical personal relationships built on trust are to this kind of service.

Bupreneophine (also known as Suboxone) is a highly effective medication to treat opioid use disorder and addiction. It is life-saving, both in reducing the risk of fatal overdoses and helping people function better as they get treatment for their disorder. But prescribing and dispensing it is in many ways more highly regulated than the prescribing and dispensing of opioids themselves. A researcher who surveyed pharmacies found that many refuse to dispense the medication out of fear of regulatory sanctions or because of misplaced moral objections to medication-assisted treatment.