Opinion: OD prevention sites are unsightly but necessary

They call them “overdose prevention sites.” I’d never heard of them until I saw the picture in the LA Times of a drug user literally falling down in the middle of a city plaza where dozens of people were openly consuming fentanyl, meth and other deadly drugs. What makes it a “prevention” site is that they are less likely to overdose out in public, with public health workers circulating around the plaza handing out Narcan, the overdose reversal medication, helping people into a sitting position and reminding them to breathe. The police who were there reportedly gave some of the street vendors a hard time; the drug users they leave alone or help out.

The San Francisco location, at United Nations Plaza, has been shut down, and the question whether it or a similar location will reopen in that city is an issue now facing the mayor.

The question of whether the example should be followed elsewhere in an effort to combat accidental overdoses is a question for the rest of us.

The numbers are striking. According to the Centers for Disease Control and Prevention, more than 100,000 Americans died of overdoses in the year ending last June. In San Francisco, 550 drug overdoses were reported last year by the coroner. In the plaza, according to published reports, more than 330 overdoses were reversed. Lives saved.

In Los Angeles, a spate of high school overdoses has led to concerns that schools be equipped with Narcan, sparking the usual, usually futile debate about whether having life-saving equipment encourages people to risk their lives. There has also been talk of establishing an overdose prevention site in Los Angeles. And the same questions are raised.

No one wants one in their backyard. Even the pictures are shocking. On the other hand, the argument is unanswerable. Do we value human life or not? If using drugs in an open and safe space will save lives, exactly what is the argument against it? That shooting up will look more attractive? There is nothing attractive about the pictures, or the people in them. There is a reason you don’t want this in your backyard, no matter how much police protection surrounds it. It isn’t for people in rehab, God knows. This is for people who would be going down the drain. This is what the drain looks like. Shouldn’t we do everything we can to save them?

Apparently at the San Francisco sites, overdoses were reversed in a courtyard that you couldn’t see into if you were just passing by. Certainly, it’s nothing anyone would want to watch. But we have fought a symbolically fraught and horrifyingly ineffective war on drugs for so long that it only seems to make sense to look for public health solutions to tragedies that just aren’t going to be avoided by building more prison beds.

Overdose prevention sites are a threat to our comfort level. But the epidemic of dangerous fentanyl mixed with recreational drugs isn’t much comfort either. Nor is there any comfort to be had in the faces of the homeless drug users who stare back from the newspaper stories. This is real life. There is a choice to be made, and ultimately it is ours, to choose life.

— Susan Estrich is a columnist with Creators Syndicate.


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