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Safe Use Sites—Through the Eyes of a Mother Who Lost a Son to the Opioid Epidemic

While there’s some justice in the wake of Purdue Pharma recently pleading guilty to three federal criminal charges related to their part in creating the nation’s opioid crisis, we are still left with an opioid epidemic of horrific proportions.

My son Ethan died of an overdose at the age of 25—the tragic result of an opioid addiction. In my book Spirit Son, I reflected on what thoughts may have run through my son’s mind in the last hours of his life. After spending a wonderful Christmas holiday weekend with us, Ethan bought heroin before he intended to drive back to his apartment in La Crosse. This was to be the last action of his life. I guessed that his thoughts probably went something like this: “I’ll use just this one more time and then that’s it. I just made an appointment to get back into seeing my counselor and I also reached out to my sponsor—he and I will have lunch together. See, I’m doing what I need to do… this will be a fresh start for me, I’ll be fine. I’ll just pull into this McDonald’s parking lot, snort my dime bag, and stay here until I’m okay to drive. Geez, its cold out here. This parking lot looks safe to use in… lots of space. Lots of people around if I … no, I’ll be okay…”

Perhaps he might have had a fleeting memory of the frank conversation I had with him about the potential lethality of relapsing since he decided to go off of Methadone ninety days prior to Christmas. We discussed that if he were to use even close to the same amount of heroin he typically used before he got clean, that he could die. A person in recovery has a reduced opioid tolerance. To use heroin at the same dosage as before abstinence can be lethal.

Ethan had been in recovery. Ethan was valiantly trying to overcome this addiction.

But, it took only $20 of heroin to kill my son.

If there was a safe use site—sometimes referred to as a safe injection site---in the Milwaukee area, and if Ethan knew where it was, and if there was no shame associated with going to it, and if my son had been encouraged by treatment providers, friends, other heroin users, his parents—anyone---to go there if he was going to relapse instead of a McDonald’s parking lot, he might be alive today.

Safe use sites, where health professionals supervise drug use to prevent overdoses and to offer information about treatment, are places that practice “harm reduction.” This humane concept is based on minimizing the harm of drug use, both for the health of the individual suffering from addiction, and for the health of the public. “There are about 100 safe injection sites operating in 66 cities around the world,” but none in the United States as “these sites remain controversial amid concerns that they enable or normalize use of drugs like heroin” (Bloomberg City Lab, 8-31-20).

Ethan once described craving heroin as being like “a slave to the devil.” The humane and life-saving intervention at a safe use site is not enabling. Instead, it keeps an addiction sufferer alive long enough to be able to try again at healing and sobriety. The hard reality is that once someone dies of an overdose, they no longer have an opportunity to seek treatment. It’s that simple. What if your family member died in a car crash because they weren’t wearing a seatbelt? If somehow you could bring them back for a second chance to get it right and wear that seatbelt, wouldn’t you wish for that?

My son might be alive today, alive with another chance at sobriety that might have lasted. Alive long enough so that his brain could have healed and the insatiable cravings dissipated. Alive because at a safe use site a compassionate health person would’ve seen that he was slipping into an overdose, administered lifesaving Narcan, and saved his life on December 27, 2016.

We have evolved in our level of compassion toward persons with addiction by setting up drug courts. This is a humane way to motivate someone with the disease of addiction who has broken a law to seek treatment, avoid prison, and stay alive to have a chance at a healthy, productive life.

I urge us to further expand our collective compassion by considering how many lives could also be saved by setting up supervised drug use sites as the opioid epidemic rages on in our communities.

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