Safe Injection Sites

ACEP Past President Larry Bedard, MD, FACEP, believes substance abuse disorder patients should be treated with all available resources and dignity. It’s that belief, combined with his knowledge about California’s safe injection site pilot sites, that led him to co-author “Resolution 32: Supervised Consumption Facilities/Safe Injection Sites” with Dan Morhaim, DO, FACEP.

This resolution called on ACEP to support the development of Supervised Consumption Facilities/Supervised Injection Sites (SCF/SIS) in the United States that would collect data to inform policymakers on the feasibility, effectiveness, and legal aspects of whether these sites in reduce harm and health care costs related to injection drug use.

For this topic, there was an interesting divide between the asynchronous testimony before the Council meeting (unanimously opposed) and the live testimony in San Francisco, which was mostly supportive. The debate centered around whether safe injection sites are a proven method of harm reduction. Some members providing testimony believed ACEP should focus on establishing sobering centers instead.

“I like taking on controversial issues,” Dr. Bedard said. He absorbed the Council’s debate over whether ACEP should support safe injection sites or sobering centers, but he feels it doesn’t need to be framed as an either/or situation. Dr. Bedard thinks they work well together. “There’s a significant number of patients who go to a safe injection center that get referred to treatment centers.”

After the Council adopted the resolution, Dr. Bedard reflected on his long history with the Council—he’s been involved for 40 years—and how important the Council is for setting policy that affects EM physicians and patients. He encourages other ACEP members to get involved. “This is how we set policy,” he said. “It’s where we represent not only the best interests of our fellow physicians, but also of our patients.”

From veteran Council member Dr. Bedard to relative newcomers Drs. Fletcher, Saxena, Savino and Werley, they agreed that participating in the 2022 ACEP Council Meeting was energizing.

“I am glad for the diversity in opinions, but also that we really have patients at the heart of the debate,” said Dr. Fletcher. “[Council] is a truly fascinating process… So much is at stake right now.”

“Before I got involved at the local level, I didn’t even know Council existed. I imagine not a lot of ACEP members even know about it or what is done at the meeting,” said Dr. Savino. Now that she’s participated, she better understands how the debate and discussion helps align the College’s work to find solutions to pressing issues. “At the end of the Council meetings, I feel like I actually made a difference.”