I spoke on a panel a few weeks ago about safe injection sites, (SCS) also known as overdose prevention centers and supervised consumption spaces. These are places where drug users can use in a clean, safe environment under the watchful eyes of trained individuals, some medical personnel, other people who may have used themselves in the past.  I was one of seven on the panel that included a person with lived experience, an ER doctor, a woman involved in Rhode Island’s efforts to start a SCS, a former commissioner of mental health, a woman who had written extensively about these sites and most important of all, Sam Rivera, who started and runs New York City’s first two supervised injection sites.  

Currently the federal crack house statutes prevent people from running buildings for the purposes of people consuming illegal drugs.  It was designed to stop landlords who knowingly ran crack houses and shooting galleries where many people overdosed and died.  That said, the justice department...

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The best TV show of all time to me is The Wire, a five-season drama about the city of Baltimore and the battles on its streets between the police and the drug dealers. The drama was crisp, the dialogue was authentic and there were no simple answers offered.

The same people who did the Wire have a new show on HBO called We Own this City, a six-part series about corruption in the Baltimore Police Department based on real events.  The series follows cops who get indoctrinated into a corrupt system, and many learn that as long as they do the work — get drug and gun seizures to stack on a table to show the world — they can get away with whatever they want, including making illegal arrests, robbing drug dealers of their money, and sometimes confiscating their drugs only to resell them, and abusing overtime by putting in for hours not worked.  Theirs is a nasty job and they reward themselves lucratively, and while they put some bad guys away, there is a hell of a lot of collateral damage to citizens who get their...

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You know that situation, often covered on this blog, whereby someone requires hospital admission under the MHA, but there’s no bed, and the dilemma emerges about how the situation should be managed until such time as a bed is found?  It can give rise to a perceived conflict between Article 2 and Article 5 ECHR obligations and that’s what I want to cover in this post.

• Article 2 covers the right to life – a positive duty to protect the right to life where they know it may be threatened, inc by known risk of suicide.
• Article 5 covers the right to liberty – duty to ensure the state only interferes with someone’s liberty in some circumstances which must be covered by domestic law.

A scenario for you:  the police attend a report of a vulnerable person in a park and decide they are highly vulnerable, distressed and at risk or self-injury.  Because of an immediate need for care to prevent such injury, the person is detained by the police under s136 of the Mental Health Act 1983 and removed to a Place of Safety, in a mental...

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In EMS, we can’t take pictures of the dead. We can write about them, but we have to change the details so the person cannot be identified. I have done this on many occasions. In my head I have a photo gallery of the fallen in this opioid poisoning crisis. The photos are not blurred, the details, all of them, remembered

Each week, I add more to the collection.

An emaciated man sits on a decrepit couch in the basement darkness, his right leg is folded up on his left knee as he probes his ankle for a vein. There is blood drawn back in the barrel. The small basement area is dirty, nearly a dozen used syringes lay on the table, along with torn heroin bags. In the corner, in a broken laundry basket is a dust-encrusted bird head — the top half of a sport mascot outfit worn long ago.

The woman who lives upstairs, heard him come in last night, and then found him unresponsive this morning. She administered two vials of naloxone, which lay now on the cement floor, and called us. The man is cold to the touch and riggored into position, the needle still in his ankle, his hand still holding the syringe.

One of 100,000 dead in a year alone. Still no end in sight.