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The Battle for the Bathroom: How Public Restrooms Are Changing the Opioid Epidemic

The Battle for the Bathroom: How Public Restrooms Are Changing the Opioid Epidemic

The United States is in the middle of a drug crisis the likes of which the world has never seen. The Centers for Disease Control and Prevention report that an astounding 91 Americans die every single day due to opioid overdose. That’s almost 34,000 deaths in a single year. In fact, the problem has become so widespread that opioid addicts have begun getting high in the public restrooms of restaurants, gas stations, shops and other small businesses. And while this spilling over of addicts into the public sphere undoubtedly points to the growing epidemic itself, it’s also starting conversations about alternative methods of combating the problem.

Shooting Up in Public Restrooms

It’s happening in cities all across the country. Seattle, New York, Denver, Los Angeles, Chicago. Just as opioids are a problem for the whole country, business owners across the U.S. are dealing with opioid abusers using their restrooms as a safe spot to get high. In fact, some addicts even know the best places to go by heart. Which ones are open to the public, which are left unguarded, and which are overseen by a staff that really doesn’t care one way or the other. Navigating the particulars of each, though, can become increasingly tough, especially when a manager catches wind of what’s going on.

Combating the Troubling Trend

Some business owners in heavily populated areas have begun incorporating measures to prevent such bathroom abuse. Doors with a keypad, posted security personnel that check for a receipt, and even blue lighting to make it harder to find a vein are all becoming more and more common. But no matter what kinds of blockades there are, a street savvy addict will always find a way around them. Grabbing the door as a customer walks out, snatching a receipt from the garbage, bringing along a flashlight. For every measure, there will always be an equally effective countermeasure. And while beefing up security is certainly a temporary solution, this growing annoyance for business owners points to an even bigger problem: how can we effectively combat this opioid epidemic when, despite our efforts, it only continues to get worse?

The Biggest Drug Crisis in History

It’s not hyperbole to say that the opioid epidemic officially has become the deadliest drug crisis ever. Opioid overdoses now kill more people than gun violence and are well on their way to beat out vehicle related deaths too. One factor that’s undoubtedly responsible for this terrifying trend is an enormous upsurge in the number of painkiller prescriptions being prescribed to the public. Synthetic opioid analgesics like Vicodin, OxyContin, and Fentanyl hit the market in the latter part of the 20th century and since then have only grown. In 2012 alone, over 259 million opioid prescriptions were written.

Prescription Pills and Heroin: More Related Than You Think

Researchers have also demonstrated that there is a clear link between prescription pain pills and potential future heroin abuse. Four out of five heroin users have misused prescription pain pills in the past. What’s more, a 2014 survey showed that an astounding 94% of people in treatment for opioid addiction reported that they had actually turned to heroin because it was a cheaper, easier to obtain alternative to prescription opioids. The takeaway from all of this is that prescription opioids are being prescribed more frequently these days. And the more prescription opioids someone is exposed to in their life, the higher the likelihood is that they’ll end up turning to heroin in the future. Plain and simple.

A New Type of Conversation

The United States has been waging a war on drugs for decades. And despite spending an extravagant amount of money during the 40-year effort (over $1 TRILLION to be more precise), not much has actually changed. Drug use hasn’t really declined, overdoses remain unimpeded, and it seems like things are actually getting worse as time goes on. In light of this, many people have begun looking at opioid drug addiction a different way. Rather than enforcing drug abstinence through harsh penalties and punishments (which are only poised to get worse as of now), maybe we should start looking at addiction as an actual disease.

The Harm-Reduction View of Addiction

Taking the “treatment” approach to substance abuse isn’t completely novel. In fact, many countries already have punitive measures against illicit drugs that are far less strict than the United States. What’s more, such countries have taken steps to lessen the severity of co-occurring diseases and the risk of overdose, especially when it comes to intravenous drug use. Vancouver, for example, created the continent’s first “safe injection site.” Here, individuals that abuse injection drugs like heroin can shoot up with a medical staff nearby. In its 14 years of operation, the facility has seen over 4,000 potentially fatal overdoses – and zero deaths. Cities like Seattle, New York, and Los Angeles are currently in the process of getting funding for such sites.

Other Harm-Reduction Strategies

While it might be hard for some to come to terms with what many believe to be a “radical” approach, other examples of this harm-reduction model are being readily adopted as well. Needle exchange programs are being readily adopted now that that federal roadblocks for funding have been lifted. Such programs have not only been proven to be effective at reducing the transmission of deadly blood-borne pathogens like HIV and hepatitis, but they also correlate with a dramatic decrease of risk behaviors in the surrounding area – by as much as 80%. What’s more, some business owners are even teaching their employees how to administer Naloxone, a fast acting drug that can reverse a potentially deadly opioid overdose within minutes. Instead of simply keeping an addict out of their bathrooms, they can instead learn how to save their life.

Harm-Reduction: A Different Approach to the Opioid Epidemic

Opioid abuse has spiraled out of control. That much is clear. But what we can do to prevent it from growing even more is still a bit hazy. The best approach is undoubtedly to attack the problem at its root by making opioid prescriptions harder to obtain and less freely handed over to patients. But while such guidelines and regulations are still in the works, the future of dealing with an increasingly addicted public may lie in the harm-reduction approach. And that might mean creating a space for drug use that’s safer than a public bathroom.


American Society of Addiction Medicine (2016). Opioid Addiction 2016 Facts and Figures. Retrieved from Bebinger, Martha (2017, May). NPR. Public Restrooms Become Ground Zero In The Opioid Epidemic. Retrieved from Centers for Disease Control and Prevention (2016, Dec.). Opioid Overdose: Understanding the Epidemic. Retrieved from McHugh, R., Farrow, R., (2017, May). Today. Safe Injection Sites Are a Radical New Approach to Battling Addiction. Retrieved from Quan, Douglas (2016, March). National Post. Vancouver’s Supervised Injection Site, The First in North America Opened 13 Years Ago. What’s Changed? Retrieved from