One sign of the extent to which the overdose crisis has shifted public discourse is how few places remain unaffected. Public restrooms are no exception.

    Some businesses have been taking measures to prevent injection drug use in these spaces. This has included the installation of blue lights in bathrooms, under the impression that they deter drug use. In fact, most research suggests that lighting does little to dissuade people from shooting up in public washrooms, so these sapphire fixtures exist as little more than annoying, stigmatizing décor— described by some harm reduction researchers as “symbolic violence.”

    On the other end of the spectrum, Starbucks recently began a pilot program of installing syringe disposal boxes in some of its bathrooms. The move follows a petition started by Starbucks employees, who are voicing concerns about filthy restrooms and accidental needle pricks on the job. The petition has gained nearly 5,000 signatures, while some media reports suggest needle pokes are becoming more prevalent in fast food chain restaurants.

    The coffee giant’s move makes perfect sense at a time when we’re experiencing a sharp rise in infectious blood-borne diseases like hepatitis C and HIV. So why aren’t more businesses following Starbucks’ lead?


    A “No-Brainer”

    According to Ayden Scheim, this “no-brainer” would benefit not only employees, customers in general and injection drug users, but also, for example, people with diabetes who use syringes for insulin.

    Scheim is an associate scientist at the Centre on Drug Policy Evaluation at St. Michael’s Hospital in Toronto and a postdoctoral fellow specializing in infectious diseases and global public health at UC San Diego. He says the effort involved in providing a syringe disposal unit is so minimal that there’s no reason other companies shouldn’t follow suit.

    “I think that people often panic unnecessarily about syringes,” Scheim says. “Nevertheless, people don’t want to come across them and people who are injecting in public washrooms also don’t necessarily want to leave [them] behind.”

    The risk of contracting diseases from a used syringe is pretty small. Per WebMD:

    “About 1 out of 300 health care workers accidentally stuck with a needle from someone with HIV get infected. But for hepatitis B, the odds can be as high as nearly 1 in 3 if the worker hasn’t been vaccinated for it.”  

    Still, the risk is uncomfortable and unnecessary. Those affected are often treated with preventative antiviral drugs with flu-like side effects.

    “It’s almost a daily occurrence that there is blood on the floor or remnants of empty baggies.”

    At a Starbucks in Portland, Oregon, cleaning the bathrooms is a dreaded assignment that can sometimes be kind of scary, according to Allison, a shift supervisor who has been with the company for six years. In August, she was accidentally pricked by a syringe while throwing a trash bag in a dumpsterthe second such episode at her location in the past year.

    “It’s almost a daily occurrence that there is blood on the floor or remnants of empty baggies … we find empty condom wrappers,” Allison says in a call. “And within the last six months or so, there’s been a high prevalence of syringes.”

    After her stick, Allison, who asked me only to use her first name, went to urgent care, where she was prescribed a round of antiviral drugs that gave her minor flu-like symptoms. Her visit and drugs were covered by worker’s compensation.

    While her Starbucks location won’t yet be getting disposals, Allison says the coffee chain is listening to the concerns of her and others. The stores with the greatest need will be getting the disposals first, with others added on a store-by-store basis. “But I do think that there could be more training on how to deal with needle disposal, how to deal with partners who might come into contact with a customer who is under the influence or potentially even overdosing,” she adds.

    “These societal issues affect us all and can sometimes place our partners (employees) in scary situations, which is why we have protocols and resources in place to ensure our partners are out of harm’s way,” a Starbucks spokesperson told Filter in an email. “I can’t emphasize enough that if our partners are ever in a position where they don’t feel comfortable completing a task, they are empowered to remove themselves from the situation and alert their manager. As we always do, we are constantly evaluating our processes and listening to partner feedback of ways we can be better.”

    Filter also reached out to McDonald’s, Burger King, Dunkin Donuts and Intelligentsia to ask whether they have any plans to follows Starbucks’ lead, but at publication time had not heard back.  

    The Coffee Bean & Tea Leaf does have a needle disposal program, with sharps containers available to employees. “The sharps disposal program has been in place for just over 18 months,” Kregg Carney, the company’s director of loss prevention, told Filter in an email. “The Coffee Bean & Tea Leaf implemented the program as an effort to make a safer work place against blood-borne pathogens and other contagions while conducting restroom cleaning duties. If a needle or sharp object is found while cleaning, employees are instructed to never touch it with bare hands. Employees are required to use the company-issued personal protective equipment to dispose of the needle or object in the provided sharps container.”

    Jon Perry, VP of retail for Stumptown, also responded, and said in an email, “We constantly evaluate barista safety and make decisions to mitigate risk. We do not currently have sharps boxes installed in our bathrooms but should the need become apparent, we would address the issue.”


    Maybe Don’t Blame Open Bathroom Policies

    Last year, Starbucks did something else unconventional for a mega-corporation: opening its bathrooms to everyone, not just paying customers. That decision followed a notorious April incident at a Philadelphia Starbucks where an employee called the police on two black men who used the restroom without making a purchase. Now, anyone can relieve themselves at Starbucks, regardless of whether they’re swelling the company’s coffers.

    This new policy has led some to speculate whether opening your bathroom to literally anyone leads to more injection drug use—as well as whether sharps disposals will make the issue worse. However, Allison doesn’t think so, and there’s not much evidence to support either theory. (Research on syringe exchange programs, for example, shows that they do not result in increased syringe litter.)

    “There’s a little less barrier there, but I don’t think that that has made [injection drug use] any more common,” Allison says. “It’s just important to keep in mind that the syringe disposal and the workplace needle pricks are symptomatic of a larger societal problem.”

    In other words, the overdose crisis probably didn’t happen because a coffee company was responding to allegations of racial bias.

    Starbucks was one of her favorite places to inject when she was on-the-go during her time as a heroin user.

    Danielle, a 34-year-old grad student in Phoenix, Arizona, says that Starbucks was one of her favorite places to inject when she was on-the-go during her time as a heroin user. She is now on methadone, but years ago, the chain’s private single stalls were sometimes a godsend when she had nowhere else to “get well.” She says she never left syringes behind because they were hard to come by and she would often reuse them.

    “As a white-presenting woman, I have never had issues being admitted to a Starbucks restroom,” Danielle, who also asked me to only use her first name, says in a call. “I don’t see how it would encourage it. It’s not something that played into my decision-making process, whether there was a box or not. It almost seems absurd.”

    Ultimately, if companies like Starbucks want to discourage drug use on their premises, they might want to lend their not-insignificant voices to lobbying efforts for supervised consumption spaces, places where people can use drugs under the supervision of medical staff, Allison says.

    “I would really like to see Starbucks as a corporation lead the way on supporting efforts of supervised injection facilities in these high-incident areas,” she says. “If they’re really looking to create a safer space for customers and for our partners in our bathrooms in general, having a place for some of those people to be able to go and use safely that is not our bathrooms would be a huge improvement.”

    But Allison is also quick to remind people that Starbucks is, essentially, in the business of selling drugs, and that shaming people who may use drugs in the bathroom doesn’t help the situation.

    Is what safety precautions Starbucks puts in bathrooms really such an important conversation? Yes, Allison argues, because whether to deploy blue lights or sharps containers is part of the much larger discussion about how we frame and treat drug users in society.

    “If you’re coming to Starbucks, you’re also coming to enjoy a mind-altering substance,” she points out. “Thinking about people as people, not just people who are in the bathrooms to use drugs, and thinking about larger societal solutions that we could bring to make the situation and the scenario safer for everyone.”

    This article was edited on January 24 to include a newly received response from The Coffee Been & Tea Leaf.

    Photo by Nick Hillier on Unsplash

    • Troy is an independent journalist whose reporting on drug policy and science has appeared in Wired, the Guardian, Undark, Discover Magazine, Vice and more. He co-hosts the drug policy podcast Narcotica. He lives in Southwest California.

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