Damien Trimingham was a bright kid. He was well-liked and a successful athlete. He came from a good family. He did not seem destined for a life of addiction— and indeed he wasn’t.
At just 22, Damien died of a heroin overdose.
The police did not notify his worried family for three days.
That was in February of 1997, and now almost two decades later, his father Tony, a psychotherapist, has become a leading voice in harm reduction.
On Sept. 30, he recounted his son’s story to a crowd of more than 200 at “Out of Harm’s Way,” a panel discussion in Manhattan.
“It was, of course, a shock even though we knew that death was a possibility with heroin use,” he said. At the time of his death, Damien was trying to stay clean. His father said, “That’s one of the ironies of heroin use, that the people who die are often the ones trying to give it up.”
He continued, “I was to find out later that no one has ever died in an injection center anywhere around the world, even though there are many overdoses.”
That’s when Tony latched onto the idea of safe injection facilities (SIFs). Although they aren’t legal in the United States (yet), there are around 100 SIFs operating around the world, in places like Canada, Spain, Germany, Holland, and Norway.
The idea is that SIFs provide a safer environment for injection drug users. Staff are available to teach safe injection practices and clean syringes are free for the taking. Crucially, there’s also naloxone available to treat overdoses immediately, without any fatalities.
Predictably, SIFs tend to face some initial resistance, but in Australia, Tony was instrumental in turning the tide of public opinion.
The year that Damien died, the Australian government proposed a heroin prescription program, but ultimately the prime minister vetoed it. But the time seemed ripe for harm reduction and so Tony took action. He wrote a letter to the local paper, describing his son’s death and explaining how unnecessary it was. The paper published his piece on the front page, and it sparked debate.
After four years of lobbying and advocating, Tony said, “We got our injection facility, thank goodness.” He added, “It was a hard road because there were opponents.”
Overall, though, he said it’s often apathy and not opposition that is the toughest obstacle. “Most of the general public don’t really care,” he said. “They’re not pro, they’re not against. It doesn’t affect them.”
Like Australia, Germany has safe injection sites, and another of the panelists—former Frankfurt drug czar Werner Schneider—documented the history of his city’s harm reduction efforts. Frankfurt began exploring harm reduction in earnest in the 1990s in response to a significant uptick in heroin use. That exploratory work quickly led to the creation of a safe injection facility.
Schneider said, “The most important result of this program was a tremendous reduction of drug-use related death cases.” Simultaneously, the city witnessed a decrease in criminality and also a decrease in public concern about drug use as a major citywide problem.
Like Frankfurt, Vancouver experienced a ballooning heroin problem in the ’90s. Canadian Senator Larry Campbell—a former law enforcement officer who was also the mayor of Vancouver—told the crowd that as overdose deaths skyrocketed, so did HIV and incarceration rates.
After a decade as a cop and two as a coroner, Campbell got tired of watching the bodies pile up, and so in 2002 he ran for mayor.
“I ran on the platform that I would open a supervised injection site in Vancouver,” he said.
He did that, but keeping open North America’s only safe injection facility, Insite for Community Safety, was a struggle. Although the federal government initially offered the program a three-year legal exemption, once that initial approval expired, Insite had to sue to keep its doors open.
Campbell said that SIFs are a crucial part of the shift from punishing addicts to treating addiction as a medical problem.
“Addiction is a medical disease. Addiction is not a criminal offense. No one starts out life saying, ‘You know what, I think I’ll be an addict,’” he said.
“You can address this as a humanitarian gesture, a humanitarian idea, that we’re all people … but I recognize that there are those who don’t move from a humanitarian end but from an economic end.” That works, too, though, because Campbell explained that safe injection facilities can save on welfare, police and prison costs.
“So whether you believe in humanitarianism or economy,” he concluded, “this is an idea that works. It’s good, and it’s time.”
Liz Evans, a nurse who works with Insite, concurred. She said that Insite is estimated to have saved $14 million in 10 years. “Over 2 million injections have taken place and not one has resulted in death,” she said.
Over time, the community has come to accept the program. Evans said that the last poll taken showed that 76% of Vancouver residents supported the safe injection site.
By bringing users off the streets, it has created a better environment with less public injection around the facility but also, she said, the presence of a safe injection facility seems to encourage people to get help. “If you’ve just come to Insite once, you’re 33% more likely to come to detox or treatment,” she said.
Evans pleaded for “peace” in the War on Drugs and said, “The controversy today should not be around where … a safe injection facility makes sense. The controversy today should be over how we have allowed the status quo to persist for such a long time.”
She added, “In Vancouver, drug users will tell you that Insite is a symbol of care. This is a humane space where we are able to reverse a pattern of exclusion.”
The panelists—and moderator Amy Goodman of Democracy Now!—drew an enthusiastic crowd, and the evening was punctuated regularly by bursts of applause. (One comment that drew particularly raucous support was a question Tony posed to the crowd: “Who in here supports safe injection facilities?”)
Although many audience members came from in and around New York City, some traveled much farther, with four- and five-hour drives from Binghamton and points north.
One of those longer commuters was John Barry, the executive director of an upstate New York syringe exchange called the Southern Tier Aids Program (STAP).
“We need one of these,” he said.
He acknowledged that growing political will and legal support for SIFs could be difficult, but he didn’t see it as impossible: “I think the dominoes have to fall in the right order.”
This story was originally published on The Fix.