This New York mayor has a radical plan to help heroin addicts

Is it possible to help drug addicts by giving them a safe, clean, government-run space to shoot drugs?

That's the idea behind injection sites, or consumption rooms, part of a radical harm reduction plan to combat opioid addiction in Ithaca, New York, a small upstate city of 30,000 and home to Cornell University. The sites, proposed by Ithaca's 29-year-old mayor, Svante Myrick, would be spaces where medical professionals can oversee addicts while shooting up — and intervene should an overdose occur. Myrick has said they could reduce deaths and disease transmission, and increase access to long-term treatment options.

"Using heroin is bad for you," Myrick told The Huffington Post. "Dying from an overdose is even worse. We have to keep people alive and get them the resources to get clean. They won't get those resources in public bathrooms and behind dumpsters in alleys."

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Advocates argue that you cannot stop an addict from doing drugs, but you can prevent the spread of HIV or Hepatitis C by providing clean needles, or stop a deadly overdose if medical personnel is at the ready with anti-overdose drugs like Naloxone. Staff at the Ithaca injection site wouldn't help the user shoot up but could provide a sterilized space, basic health services, and counseling toward long-term treatment options.

Republicans in the state Legislature have called the plan "preposterous" and "asinine," and one Cornell law professor has dubbed it a "government-run heroin shooting gallery." Gov. Andrew Cuomo (D) said he hasn't seen the plan and has withheld comment.

In New York alone, heroin overdoses jumped from 215 in 2008 to 478 in 2012. Nationally, heroin use among 18- to 25-year-olds more than doubled from 3.5 percent between 2002 and 2004 to 7.3 percent between 2011 and 2013, according to the Centers for Disease Control and Prevention. And about 90 percent of new heroin users are white — rural and suburban young adults — which many say has shifted the national attitude on addiction away from the punitive toward the rehabilitative.

Though novel in the United States, supervised injection sites are not a new concept. The first was opened in Berne, Switzerland, in June 1986, followed by programs in Germany, the Netherlands, Spain, Norway, Luxembourg, Denmark, and Greece. Seventy-four consumption sites currently operate in Europe. France has plans to open three sites this year. Ireland has four planned across four cities. Vancouver, Canada, has the only two injection sites in North America.

Insite, the larger of the two Canadian sites, has produced a host of data for more than 30 peer-reviewed medical journals, showing its program has resulted in a reduction in the number of public injections by addicts, decreased needle sharing, and increased use of detox services and long-term addiction treatment. One cost-benefit analysis published in the International Journal of Drug Policy in 2010 reported the site prevented 35 cases of HIV infection and three deaths, indicating a net benefit of $6 million — money saved in public health and policing dollars.

About 700 people visit Insite each day.

In the last six months, there's been a push for injection sites or similar "safe spaces" for intravenous drug users in New York City and Boston. Maryland's House of Delegates has a bill on the floor with similar harm reduction measures, and Seattle's mayor has floated the idea publicly. Yet there are a host of hurdles to clear before any U.S. medical provider can legally supervise someone using illegal drugs.

Title 21 of the federal Controlled Substances Act, the so-called crack house statute, specifically addresses "maintaining drug-involved premises" as being "unlawful." But some have speculated that if states support injection sites through legislative mandate, executive action, or at the ballet box, the issue could be treated like marijuana in Colorado — technically illegal under federal law, but tolerated.

Injection sites are just one of a multipart plan Ithaca is debating to address its local opioid epidemic. Ithaca's police chief, John R. Barber, said he cannot support any space where illegal activity takes place, but believes in other aspects of the plan. The Tompkins County district attorney, who helped craft the plan, said she was "prouder than ever to be an Ithacan."

Myrick, one of the youngest mayors in the country, was first elected to the city's Common Council at 20, while attending Cornell University. He grew up in and out of homelessness, with a father addicted to crack cocaine. "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," he has said.

If injection sites have a chance at winning popular support, Ithaca, with its progressive history and track record of expansive public programs, could be the place.

Kevin Cuddeback, owner of Gimme! Coffee, has installed keyed locks to prevent addicts from shooting up in his coffee shops. He supports the plan and said addiction should be treated "as a mental health issue rather than a criminal justice issue."

President Obama recently echoed that belief. "The only way that we reduce demand is if we're providing treatment and thinking about this as a public health problem and not just a criminal problem," he said at the National Rx Drug Abuse and Heroin Summit in Atlanta.

Injection sites may just be an option in that new approach, but not without a heated public debate.