Kelsey O'Connor

koconnor@ithacajournal.com | @ijkoconnor

Ithaca Mayor Svante Myrick wants the city to be the first in the U.S. to offer a supervised injection facility, where heroin users would be able to shoot up under the care of a nurse. The facility is one piece of a comprehensive new approach he wants Ithaca to take against the scourge of addiction.

A comprehensive approach following the four pillars of treatment, harm reduction, public safety and prevention will be announced officially Wednesday, when Myrick and the Municipal Drug Policy Committee unveils "The Ithaca Plan: A Public Health and Safety Approach to Drugs and Drug Policy."

A supervised injection facility fits into the harm reduction category, and is just one part of a much larger plan that will include steps like creating an Office of Drug Policy, a 24-hour Crisis Center, a Law Enforcement Assisted Diversion program and a medicated treatment facility.

"I think we need a comprehensive plan because I think every community does," Myrick said. "I mean I think the federal government needs a different plan but they’re not doing it, and the state’s not doing it. So we sort of had to do it ourselves. And we did it ourselves not because we’re the heroin capital of America, our problem is no worse than anywhere else, but we do lose people just like you’re seeing everywhere across the country."

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The Vancouver model

There are only two sanctioned facilities for injecting illegal drugs in North America, both are in Vancouver, British Columbia.

One of the facilities, Insite, is in downtown Vancouver, on its Eastside, which is known to have a high concentration of homelessness and drug use. Insite was founded in 2003.

About 700 people visit Insite each day, according to Anna Marie D’Angelo, senior media relations officer for Vancouver Coastal Health. Insite is open to the public, whereas another similar facility in Vancouver, the Dr. Peter Centre, is client-based.

D’Angelo said people who come into Insite are screened and must be a long-term drug user. If they are not long-term users, Insite will connect them with social services. After being screened, people receive an “alias” for each time they come back. Each time they come in, users are given clean needles and inject in a booth with a mirror.

“It’s all very visible, and there’s [nurses] there that are supervising, so if you do overdose, they’re right there, they can provide naloxone … afterwards you go into what’s called a ‘chill room,’ where you stay there for a little bit longer in case there’s a reaction, then you leave,” D’Angelo said.

Right above Insite is a place called “Onsite,” D’Angelo said, which is a detox facility.

“It’s a harm reduction model. You do reduce the harm that illicit drugs are doing to you, but you’re also connecting the client to care,” she said. “It’s just not someplace where you inject, there’s a whole kind of process.” Insite also offers other services like wound care, counseling and referrals to other health and addiction services.

As a result of the facility, overdoses have gone down in the area, as well as the transmission of disease like HIV and Hepatitis C, D’Angelo said. According to a 2011 study published in The Lancet, overdose death decreased by 35 percent within 500 meters of Insite after the facility opened, compared to 9 percent in the rest of Vancouver.

Insite and the Dr. Peter Centre are small parts of a larger perspective, D’Angelo said. “Insite is just a very small program that we have. Our budget for Insite is $3 million per year – $1.5 [million] plus Onsite – but we spend over $200 million in addiction prevention and treatment.”

Funding comes from the province of British Columbia, and the facilities remain open because of an exemption from Canada’s drug laws. After a lengthy legal process, in 2011, the Supreme Court of Canada unanimously supported Insite's operation.

In a commentary in The Lancet that accompanied the study, Dr. Chris Beyrer, of the Johns Hopkins Bloomberg School of Public Health in Baltimore, said “Supervised injection facilities clearly have an important part to play in communities afflicted by injection drug use.”

Myrick said an Ithaca facility would be modeled after Vancouver's, though smaller.

"I think it will be smaller, and not just because we're a smaller city, but because our problem is a bit smaller," Myrick said. In addition to being smaller, it would be more discreet, Myrick said. "What you don't want to do is normalize drug use. You don't want to romanticize it, and you don't want to advertise it."

A supervised injection facility would be groundbreaking not just for Ithaca, but for the United States. Myrick said he expects to face big hurdles, possibly at the local, state and federal level.

The Ithaca Plan

The supervised injection facility is one part of a comprehensive plan that will be revealed Wednesday. Since 2014, the Municipal Drug Policy Committee, commissioned by Myrick, has been working on a new approach to fighting drug addiction. The task force will lay out a local strategy called "The Ithaca Plan: A Public Health and Safety Approach to Drugs and Drug Policy" that will focus on treatment, harm reduction, public safety and prevention.

According to a news release issued Monday, "Bucking the tide of punitive responses to drug use, this report is rooted in public health and harm reduction principles and charts a new way for cities across the U.S. to respond to drug-related problems. This groundbreaking report aims to prevent drug use and sales, reduce overdose deaths and infectious disease, decrease rates of incarceration, expand access to treatment, and save taxpayers money."

More than 20 recommendations have emerged from the committee, the release stated.

On Monday, as people learned of the plan for supervised injection facility, many were quick to oppose the idea on social media. Many were also quick to applaud it.

To those who oppose it, Myrick said he understands.

"What we’re proposing is different, and different is scary. And you don’t want to seem like you’re condoning drug use. So I think even people who oppose this are opposing this with good intentions. They want people to get healthy and they don’t want people using drugs, and neither do I. The only thing I can say to people who oppose it, it’s not enough to be angry about the problem if all you’re going to do is what you did before. If you keep seeing the same problems and proposing the same solutions, then you’ll never make progress. So it’s not enough to get angry, you’ve got to get smart, and you’ve got to be willing to try," Myrick said.

Kassandra Frederique, New York state director at the Drug Policy Alliance, said in a news release that municipalities play a vital role in reversing "failed drug policies."

“Ithaca is leading the way by showing how cities can create effective and innovative solutions to drug problems by listening to their citizens and local experts and by drawing on the rich research base about what works. We applaud Mayor Myrick, the Municipal Drug Policy Committee, and the hundreds of Ithacans who participated in this process and hope other cities across New York will follow their lead,” Frederique said.

Aside from the supervised injection facility, other recommendations include:

Research Heroin Assisted Treatment : Heroin Assisted Treatment (HAT) is a form of medical care that involves the carefully regulated and controlled prescription of heroin for people who have failed on other drug treatments. Research has shown that HAT can reduce drug use, overdose deaths, infectious disease, and crime, while saving money and promoting social integration.

: Heroin Assisted Treatment (HAT) is a form of medical care that involves the carefully regulated and controlled prescription of heroin for people who have failed on other drug treatments. Research has shown that HAT can reduce drug use, overdose deaths, infectious disease, and crime, while saving money and promoting social integration. Create of an Office of Drug Policy : One the central problems with drug policy in Ithaca and elsewhere is that agencies often work at cross pursues with little coordination. By creating a central Office of Drug Policy, Ithaca will be able to coordinate its response to drugs and work to implement the recommendations in The Ithaca Plan.

: One the central problems with drug policy in Ithaca and elsewhere is that agencies often work at cross pursues with little coordination. By creating a central Office of Drug Policy, Ithaca will be able to coordinate its response to drugs and work to implement the recommendations in The Ithaca Plan. Open a 24-hour Crisis Center : A central finding of the Municipal Drug Policy Committee was the need of a centralized place to help people navigate the treatment and social service systems. Creating a centralized crisis center will facilitate entry into treatment, provide a much need space for people in immediate crisis, and help coordinate across systems of care.

: A central finding of the Municipal Drug Policy Committee was the need of a centralized place to help people navigate the treatment and social service systems. Creating a centralized crisis center will facilitate entry into treatment, provide a much need space for people in immediate crisis, and help coordinate across systems of care. Implement of Law Enforcement Assisted Diversion : Law enforcement officials frequently act as the first point of contact for drug-related offenses, but criminalization generally results in more harm than good. Law Enforcement Assisted Diversion (LEAD) is a pre-arrest or pre-booking diversion program that has been piloted and evaluated in Seattle, WA. Instead of arresting and booking people for certain petty offenses, including low-level drug possession and sales, law enforcement immediately directs them to housing, treatment, and other services.

: Law enforcement officials frequently act as the first point of contact for drug-related offenses, but criminalization generally results in more harm than good. Law Enforcement Assisted Diversion (LEAD) is a pre-arrest or pre-booking diversion program that has been piloted and evaluated in Seattle, WA. Instead of arresting and booking people for certain petty offenses, including low-level drug possession and sales, law enforcement immediately directs them to housing, treatment, and other services. Create a Youth-serving Apprenticeship Program with Local Businesses: Economic and community development build healthier and safer communities. Strong emphasis on youth employment, like an apprenticeship program, can improve academic achievement and lessen the likelihood of boredom, disengagement, and lack of civic engagement, all of which are factors contributing to drug use or illicit involvement in the drug trade.

A news conference discussing the comprehensive plan will take place at 9:30 a.m. Wednesday at the Tompkins County Public Library.

State health officials did not respond to a request for comment.

Includes reporting from the Associated Press.

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