SENATOR: SUPERVISED DRUG USE SITES A CONCEPT UNTIL PARTIES STEP UP

 

BOSTON – Massachusetts needs two major things in order for a supervised drug use site to open here for the first time, a lawmaker backing the idea said Tuesday.

Sen. Will Brownsberger is the sponsor of a bill (S 1081) that would allow the Department of Public Health to approve the implementation of "safer drug consumption programs" in Massachusetts, provided the local board of health had already signed off.

"We need an organization to step forward and say they are ready if so authorized to operate a supervised injection facility and a municipality that will accept them in that operation," Brownsberger said at a panel hosted by the Legislature's Harm Reduction and Drug Law Reform Caucus. "Until that happens, basically my bill, the bill we filed, is just a starting point, it's a talking point. It's a shell for something that needs to be worked out in collaboration with a municipality and an organization who are ready to make the work happen."

Safe consumption sites, also known as supervised injection facilities, are locations where people can use drugs they have already obtained elsewhere, with health care professionals or other trained staff on hand in case of complication.

Speakers at Tuesday's panel described the sites as a way to prevent opioid deaths, encourage drug users to enter treatment, and provide a sense of safety and dignity for people who can otherwise be subject to stigma.

"If you ask people who use drugs and particularly people who inject drugs, we want to be responsible," said Aubri Esters, a drug user and organizer for the safe injection facility advocacy group SIFMA-Now. "But if you don't give us a space to be responsible in, it's really hard to do that. So when we see people injecting on the corner, why are they injecting on that corner? Well, maybe they don't have another place to do that. Maybe if you gave them a space that was safe, sanitary and medically supervised, maybe they wouldn't be injecting on that corner and they wouldn't die in those bathrooms."

Northwestern District Attorney David Sullivan called on the state Tuesday to "put our money where our mouth is" on battling opioid addiction, even though supervised injection sites are illegal federally.

"I think we make the call as a commonwealth that we need to take care of each other, and sometimes there are conflicts between federal and state law, and I think we just push forward," he said.

A February report from the Department of Public Health showed that 1,977 people died of confirmed or suspected opioid overdoses in 2017 in Massachusetts, down 8.3 percent from the 2,155 logged in 2016 for the first year-over-year decline in overdose deaths for several years.

Dr. Mark Eisenberg, a primary care physician at Massachusetts General Hospital's Charlestown HealthCare center, said the center has an "amazing addiction team" with over 350 people in treatment, but each month loses a patient to an overdose death. Eisenberg said he personally has lost over two dozen patients in the last decade.

"These patients all have one thing in common," he said. "The last time they used, they used unsafely, whether alone in their bedroom, a restroom of a fast food restaurant, in their car, or in an alleyway. If they'd been able to go to a supervised injection facility, they might be alive today."

The concept of supervised injection sites has support from major players in the state's medical community. The Massachusetts Medical Society voted last year to endorse a state pilot program, and the Massachusetts Health and Hospital Association's Board of Trustees voted unanimously to advocate for the creation of such facilities.

Some top politicians, including Gov. Charlie Baker and Boston Mayor Martin Walsh, have voiced skepticism to the idea.

Baker and Walsh each discussed the idea of supervised injection facilities during a Washington Post Live forum last month, where Baker said most people would consider it "a bit of a roadblock" that supervised injection sites are illegal in the United States. The governor said members of his administration plan to visit Vancouver, where the facilities can operate legally.

"My biggest concern with it is there's very little information that suggested this was a path to treatment, and I am really interested in paths to treatment, because our goal here should be to get people into treatment," he said.

Speaking at the same Feb. 22 event, Walsh said he doesn't understand the rationale behind the facilities.

"I think you actually hurt the addict by doing that because now they're going to be preyed upon more by the drug dealers who know exactly where they are, all day long," he said.

Brandon Marshall, a Brown University epidemiology professor who has studied the impacts of the Vancouver supervised injection facility Insite, said at Tuesday's panel that Insite's programs have presented a pathway to treatment for "significant numbers" of people, with frequent visitors almost two times as likely to get treatment.

The neighborhood around Insite experienced a 35 percent reduction in overall overdose mortality, compared to a 9 percent drop in the rest of the city, Marshall said. He said there have been over 3.6 million visits since Insite opened and no overdose deaths within the facility.

"These facilities clearly save lives," Marshall said.

An opioid bill (H 4033) filed by Baker, which aims to expand access to treatment and strengthen education and prevention efforts, is before the Mental Health, Substance Use and Recovery Committee.

Sen. Cindy Friedman, the committee's Senate chair, said last month that the committee wanted to take extra time to look at its substance use and behavioral health-related bills "and see what, if anything, we should move into the bill that the governor has filed." The committee on Feb. 7 extended its reporting deadline for those 41 bills – Brownsberger's supervised injection facility bill among them -- until March 20.

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