Harm reduction: an opioid "vending machine"

Originally published at: https://boingboing.net/2019/04/17/do-no-harm.html


We should be emulating the Swiss model, where they give free drugs and provide them a place to shoot up with medical grade heroin. IIRC, they haven’t had a single OD for people who use the program. And while they don’t pressure people to get off of the drugs, they have had progress in reducing the number of addicts.

Johnathon Haidt has written and talked about the success of this model.


an armored, biometrically controlled “opioid vending machine” that dispenses prescribed amounts of hydromorphone pills

I can see why this might freak people out, since it sounds like it’s straight out of dystopian fiction. However, when looked at from the point of view of real-world medical and societal outcomes it – like Vancouver’s safe injection sites and its version of a “Hamsterdam” neighbourhood – makes a lot of sense despite its squicking out people who don’t suffer from addiction.




I live in the heart of South Minneapolis. Spent needles show up on my front steps from time to time. (And in the nearby bus shelter. And elsewhere in the neighborhood. Syringes are not too common, but the little orange caps are everywhere.)

I’m a great believer in do-what-thou-wilt, it’s-your-trip permissiveness. Mom taught me as a teenager that I must decide for myself whether to shoot heroin or not, it’s not her life to lead.

Furthermore, I don’t feel personally menaced by junkies. I’ve met a few, in my yard and on the sidewalks nearby, no problem, they’re just people, kind of slow-moving but not causing any kind of trouble that I can see.

But dammit, it breaks my heart to find needles in public. It just does. Reminders of our frail mortality, I suppose.

Also – and this is the pointy end of the problem – I’m afraid to walk barefoot in my own yard because I might step on a needle.


Canada might listen to evidence-based outcome-oriented reasoning. Alas, I fear the hard-assed drug warrior ignorance is too deeply rooted in the US for any kind of rational approach that could actually solve the problem. We’re one step removed from the Philippines’ death squads mass murdering addicts.

Of course even in the US, an addiction epidemic perceived as a predominately white people problem will continue to be treated with less knee-jerk violence that racialized epidemics.


I know this is a serious attempt to deal with a serious public health problem but I couldn’t help think of this:



You’d think so, but the crazies running the government in Ontario are doing everything they can to prevent one from opening in Toronto.

And, the newly elected crazies in Alberta are also very likely going to try to shut theirs down.

Vancouver’s Safe injection site is doing well for now, but if crazies are ever elected federally…who knows?


Harm reduction sites are great and save lives. Full stop.

If saving lives aren’t enough of a reason to support them, they reduce petty crime and impacts on neighborhoods because people aren’t post-apocalyptically desperate to source their addictions, and aren’t forced into the back alleys, or rooms run with bad intentions, to shoot up.

As far as this proposal…unattended drug use is a bad idea. It takes away the best parts of harm reduction sites, which is humans watching and being present for overdoses, and having some ability to prevent addicts from leaning on each other.

This isn’t a good replacement for staffed sites.


You mean as is highly likely in a few months?

People keep thinking we’re reasonable. We’re not that far out of the Harper era (and things could get worse).


Don’t make me sad.

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