bathroom with blue lights

As the opioid epidemic continues to claim an average of around 90 lives each day in the United States, public health officials and lawmakers aren’t the only ones looking for ways to minimize harm. Retailers are looking for ways to keep people from using drugs in their restrooms, and the Loss Prevention Research Council, a retail industry-supported group, has resurfaced a decade-old — and highly controversial — way to stop intravenous drug users from shooting up in the bathroom: blue lightbulbs.

The idea behind this approach, which involves switching out normal light bulbs for blue-tinted ones, is that the blue light makes it hard to see a vein and inject into it. But there are some huge problems with this approach. Research has shown that drug users will still try to inject drugs in a blue-lit bathroom, even if it means they could accidentally miss their vein, which increases the risk of infection or soft tissue damage. Additionally, researchers say this quick-fix tactic is a step in the wrong direction and will lead to further isolating and alienating drug users instead of treating them with dignity and care. Brett Wolfson-Stofko, a research associate at the National Development and Research Institutes who is currently researching public drug injection, tells Inverse that blue lights may only deter people from injecting into certain veins, like those in the arms.

“It won’t stop other types of injection, such as groin injections, where it’s all done by feel, as well as jugular injections in the neck,” he says. “Neck and groin injections can be much more risky.”

naloxone
Instead of blue lights, which make intravenous drug use riskier, perhaps retailers could put naloxone in the restroom to help reverse overdoses.

And even if people decide to go elsewhere to shoot up, this strategy doesn’t do anything to encourage people to use more safely or to seek help.

The little bit of available research on the effects of blue lights on drug users paints a pretty clear picture: People who are in the grips of opioid addiction will take unsafe chances when they’re desperate. In one paper, published in 2010 in the journal Health & Place, researchers interviewed 31 drug users about their experience with blue bathroom lights. Out of the people interviewed, 18 said they “were prepared to inject in conditions specifically designed to deter injecting practice.” Of those 18 people, 11 said they were completely undeterred.

“I attempted there and I only managed to inject because I knew by feeling the vein that it was there,” a 44-year-old man told the study’s authors. “But actually, I could not see it.” This experience reveals the dangerous side effects of retailers’ efforts to keep drug users out of their bathrooms, and it runs counter to the assumptions they’re making when they implement this lighting intervention.

“The hardest-core opiate user still wants to be accurate. They want to make sure the needle goes in the right spot,” Read Hayes, director of the Loss Prevention Research Council, tells AP News about the group’s research on using blue lights in a chain of Pennsylvania grocery stores. But it seems that Read and his colleagues aren’t accurately estimating the high level of motivation that drives someone to inject drugs in a grocery store bathroom.

blue lights in Pennsylvania bus station
These blue lights in a Pennsylvania bus station are meant to prevent people from using IV drugs, but could in fact lead them to inject unsafely.

“If you’re experiencing withdrawal from opioids, someone’s going to want to inject as soon as possible, even if the location is less than optimal, such as a restroom,” says Wolfson-Stofko. “So if people are in withdrawal, the blue light is more than likely not going to be a huge deterrent. But it’s going to make it more difficult and more dangerous for people to inject. They’re going to be digging around for veins, which can lead to abscesses, nerve damage, and artery damage.” Beyond the physical danger, though, blue lights also send an inhumane message to drug users.

In another study on blue lights published in 2013 in the Harm Reduction Journal, researchers once again found that blue lights increase the risk of dangerous injection. Additionally, the study’s authors call blue lights a form of “symbolic violence” against drug users, furthering the notion that people with substance use disorder are second-class citizens:

Importantly, we support the suggestion that blue lights are a form of symbolic violence: They aim to tacitly control people who use injection drugs, forcing them to make choices about places to inject that are not in their best interests, and imposing upon them the belief that their own well-being is secondary to the interests of those responsible for installing the blue lights.

Wolfson-Stofko agrees with this assessment, and he says that blue lights do very little to address the real issues at hand in the opioid crisis: “It’s one of these tactics that try to scare people out of using, which doesn’t work. They think if they make it more dangerous for people to use, and they have to inject in more awful contexts, it’ll snap them out of it, but all it does is isolate people more and make it more difficult for them to stop using drugs in a destructive manner.”

blue light toilet
Even if there's a blue light in a restroom, someone could switch it off and use a candle or a cell phone for light.

Unfortunately, this issue of symbolic violence is not brand-new. It goes back at least as far as a 2009 study on the topic, which means that concerned citizens have been pushing this inhumane Band-Aid solution for nearly a decade.

It’s hard to blame the individual store managers who have to deal with the on-the-ground issues of a national public health crisis, as their main concern is maintaining safe and clean facilities for customers. But this approach promises to push the problem further out of sight rather than helping to make things better.

As a more compassionate and effective solution, Wolfson-Stofko and others advocate for greater access to supervised injection facilities, medication-assisted therapy, and low-income housing, which can give people the safety and privacy they need while also connecting them to treatment resources.

“The blue lights are a Band-Aid,” says Wolfson-Stofko. “They’re not really addressing the problem at all, and people are going to get around them.”