As service providers and public health professionals who work with people who use drugs, we know that sometimes people use drugs in our facilities. Particularly in the case of injection drug use, a bathroom or other private area at a trusted services agency may be the safest and most secure location when the alternative is using outdoors, in business bathrooms, or similarly problematic places.
Many programs, and even businesses, have taken steps to improve safety and hygiene in places where people might use drugs. The first goal is to protect clients and staff. When done thoughtfully, such strategies can also foster therapeutic relationships by promoting open and frank dialog with drug using clients.
Examples of steps that can be taken include:
- Training staff on overdose response including the use of naloxone, equipping spaces or individuals with overdose rescue kits, and adopting policies and procedures for overdose management.
This is a sample policy developed for on-site overdoses– it was created for pharmacies, but can easily be adapted to different venues.- Collaborating with participants to develop policies for use of public facilities such as bathrooms or showers, including rules regarding allowed time for use, monitoring, cleanliness, or other issues.
- Installing sharps disposal containers, non-porous surfaces, mirrors, clearly displayed safety information, intercoms, or other items in places where people may use illegal or prescribed drugs.
In the U.S., programs in New York State have perhaps gone the furthest in formalizing practice in this area. Multiple public health agencies and numerous CBOs have adopted policies and procedures in the context of syringe exchange programs, but they may be easily adapted for use by any organization with public facilities where people might use drugs.
- EXAMPLE: Policies and Procedures for Service Providers
Adapted from P&Ps in use by organizations in New York City.
Policies and Procedures for Public Bathroom Management
This document provides guidance on managing public bathroom facilities or other private spaces in agencies serving people who use drugs.
SAMPLE Participant Bathroom Policies and Procedures 2017
Policies and Procedures for Overdose Response
Designed for use by health services staff working in locations where people may overdose, this document provides policies and procedures for managing drug overdoses or other medical emergencies and maximizing participant and staff safety.
SAMPLE Overdose Policy Onsite Offsite 2017
- EXAMPLE: New York State Department of Health Syringe Exchange Policies and Procedures
The following guidelines have been issued by the New York State Department of Health in order to encourage syringe state-funded harm reduction programs to create safer spaces for people who might use drugs on their premises. They are excerpted from the September 2016 version of the Department of Health’s policies and procedures for syringe exchange programs (pp. 10-11, “Staying Safe at a Syringe Exchange Program”). The full document is available online.
↓ click to expand