A new series of public debates at Binghamton University began on Wednesday night with a contentious debate concerning opposing treatment philosophies for heroin addiction and the promotion of safe injection sites.
A safe injection facility is a legally sanctioned, medically staffed and supervised location where intravenous drug users can go to safely inject controlled substances. They are designed to both reduce the public health issues caused by intravenous drug use and provide a safe and hygienic environment for those addicted to drugs to utilize.
Two debaters participated in the contest. Each of them is an expert in the field of public health, specifically with regards to addiction treatment, and the pair have decades of experience between them.
John Barry is the executive director of the Southern Tier AIDS Program and a supporter of safe injection sites for heroin users. Alan Wilmarth is the executive director of New Horizons Alcohol & Chemical Dependency Treatment Center at United Health Services hospitals and an opponent of safe injection sites.
Barry’s approach centers around a drug policy paradigm referred to as “harm reduction,” which prioritizes harm to individuals as the metric by which policy effectiveness should be measured, as opposed to approaches which emphasize drug use prevention or law enforcement metrics.
“We are trying to keep people alive long enough to quit,” Barry said.
Wilmarth takes a different approach to drug treatment. He believes that injection facilities have not been proven to lower the rate of intravenous drug usage in areas they have been introduced and that other treatment options are far more effective.
He said that allowing heroin use undermines treatment efforts like medication-assisted withdrawal, using methadone or the usage of a drug called Vivitrol, which blocks the effect of opioids for around one month at a time, giving addicts time to detox.
“We don’t stop trying to treat diabetes because someone has a compulsive overeating problem,” Wilmarth said, as an analogy to drug-treatment philosophies.
Much of the debate addressed the situation in the city of Ithaca, which has applied to the New York State Department of Health for a permit to open the first safe injection facility in the United States.
Barry and his organization are involved in the promotion of The Ithaca Plan, which Wilmarth is critical of. He claims that since the Ithaca police chief is not yet on board with the program, there is no feasible way it could be successful since it involves sanctioning illegal drug use. But Barry and his allies continue to contend that the police chief will be swayed and the program will go ahead as proposed.
During the debate, Barry said that harm reduction approaches, like syringe exchanges, are necessary because of the empirical failure of current programs. He claims that 79 percent of people in syringe exchanges have already been through treatment programs.
Wilmarth contended that when it comes to opioids like heroin, there is rarely such thing as a functioning user.
“I have not yet in 35 years met a person who is actively using heroin and is functioning well in their life,” Wilmarth said.
Wilmarth further said that an integrated, individualized and long-term approach, coupled with mental health services, is necessary to truly treat opioid addiction due to the severe nature of opioid withdrawal.
“Most people who suffer from an opioid abuse disorder are so afraid of what withdrawal will be that they will do anything within their power to avoid it,” Wilmarth said.
Heroin overdose is the number one non-natural cause of death in Broome County, according to a report commissioned by Broome County District Attorney Steve Cornwell. From Jan. 1 to Aug. 24, 2016, 48 deaths in Broome County were caused by a heroin overdose.
This new series of debates are being hosted by the Binghamton University Speech and Debate team in partnership with You Defend It, a local organization that partners with universities to organize constructive debates.
According to Joe Leeson-Schatz, director of BU’s Speech and Debate team, debates like this are important to keeping the public factually informed about relevant issues.
“Americans need to be able to agree about facts, even if we don’t agree about the solutions,” Leeson-Schatz said.
The next You Defend It debate will be on Dec. 6 and will tackle the topic of gun control, both on a state and national level.