Overdose prevention centers are a tough sell in the US despite successes

“We know that lives are being saved,” said Colleen Daly Ndoye, executive director of Project Weber/Renew, the nonprofit set to open the Providence site next year.

but in Pennsylvania, where the second The nonprofit with similar aspirations is mired in litigation, with the Pennsylvania Senate voting overwhelmingly on May 1 to ban such centers, sometimes called supervised injection sites. The vote came six days after Colorado lawmakers were killed A bill in committee that would have authorized sites in that state.

“We need to prioritize sobriety, not just allow addiction to continue and spiral,” said Pennsylvania state Sen. Christine Tartaglione, a Philadelphia Democrat., who introduced the bill and represent parts of the Kensington neighborhood, the epicenter of the city’s opioid epidemic.

Despite the staggering loss of life from drug-related deaths, the opposite outlook reflects the warnings of overdose prevention sites in the United States. Addiction Specialists and Others facilities as ways to reach people who use drugs where they are – and keep them alive – despite Questions about the legality of the sites under federal law. but even with the success of New York City onpoint nyc, the only government-sanctioned program operating in this country, such facilities are proving a tough sell over concerns they encourage drug use, crime and neighborhood blight. Similar sites operate in countries such as Canada, Australia and Portugal.

Legislative decisions in Pennsylvania and Colorado also dealt a blow to advocates of harm reduction, a strategy that includes overdose antidotes, sterile needles and testing of drug supplies.

Brown University epidemiologist Brandon Marshall said of the votes, “This is a huge step forward in the response to the overdose crisis, especially at a time when we are seeing more support for harm reduction nationally and in red and blue states.” Are.”

Pennsylvania bill banning overdose prevention centers Passed the Republican-controlled Senate with Democratic support. Whether it passes the Democratic-majority House remains to be seen. Democratic Gov. Josh Shapiro, a former state attorney general, has protested publicly facilities.

In Colorado, where Democrats control both houses, the state Senate’s Health and Human Services Committee on April 26 were killed A bill that would have allowed cities to authorize the sites. The House had earlier passed the bill.

Sometimes called “safe consumption” or “supervised injection” sites, facilities allow people to use their own Medicines under the supervision of people trained to intervene with the opioid antidote naloxone if an overdose occurs. Nearly 200 Overdose Prevention Sites operation In 14 countries, according to the Drug Policy Alliance.

The centers are not suitable for every community, but they do Offer a welcoming place to help people struggling with addiction find health care, housing and treatment — and help them survive, said Sean Fogler, a Pennsylvania drug policy expert who runs the public health consultant group Alevist.

“If you give them a clean needle, why would you tell them to go to the bathroom at McDonald’s and close the door, or to go out into the street and hide in the shadows and inject drugs?” Fogler said. “With the supply of the drug today, there’s a good chance you’re going to die.”

Advocates say research shows that overdose prevention sites make drug use safer for participants. At last month’s Harm Reduction International Conference, researchers in France presented a study that found that at two overdose prevention sites there, users were less likely to overdose, go to the emergency room or commit a crime.

A similar study is underway in the United States. Officials announced this on Monday The federal government is funding a study worth $5.8 million over 4 years. On the influence of the New York City and Rhode Island centers. Researchers will measure whether participants suffer fewer fatal and nonfatal overdoses, as well as impacts on crime and littering in surrounding areas.

Despite rising deaths, the facilities have proved controversial in the United States: of more than 107,000 fatal overdoses in 2021, two-thirds of them from the opioid fentanyl. In 2021, 5,168 people died of overdoses in Pennsylvania.

Efforts to set up overdose prevention centers complicated decades-old federal law Sometimes called “crack house statutes”, which prohibit knowingly maintaining a place “for the purpose of manufacturing, distributing, or using a controlled substance”.

In 2019, President Donald Trump’s Justice Department cited the law to prosecute Safehouse, a nonprofit group that would have been the first group in the country to open an overdose prevention center in Philadelphia, where it would have to face the consequences. Strong opposition From the neighbors a federal judge Government in favor of the safehouse, but an appeals court Overturned Decision in January 2021.

Safehouse retorted, saying that such a ban infringes on the religious freedom of board members, who believe they have a calling to “provide life-saving medical treatment to vulnerable populations.” The Biden administration, which has adopted harm reduction strategies, has stopped short of endorsing such containment sites. Settlement talks between the Justice Department and Safehouse have been going on for more than a year.

The Justice Department declined to comment on the status of those talks. Last year, it told The Associated Press that it was “evaluating” overdose prevention sites and “appropriate guardrails.” The litigation became more complicated last month when 20 community groups in Philadelphia asked to intervene, arguing that “the government appeared prepared to change sides” and that they needed to protect “their health, safety and property interests”.

Sonja Bingham, a community activist in Philadelphia’s Harrogate neighborhood, said residents are tired of drug users from nearby Kensington who defecate in the streets, discard needles and vandalize properties. He said he believes the overdose prevention center will bring in more users and drug dealers.

“You can have your addiction, but you have no right to hinder my quality of life,” said Bingham, president of the Friends of Harrogate Park.

Safehouse’s vice president, Rhonda Goldfein, pushed back such criticism, arguing that drug use in prevention centers would curb use on the streets. “It’s not complicated,” she said. “It works everywhere it’s been opened. It should be open here.”

Goldfein declined to speculate on how the Senate bill banning overdose prevention sites would affect the settlement talks if it becomes law.

Right now, the only government-approved Safe Consumption program is run by the nonprofit OnPoint NYC, which operates two facilities: one in East Harlem, the other in Washington Heights. The program connects participants to addiction and mental health treatment, job training and social services. Since opening in late 2021, more than 3,200 participants have used the sites, with staff intervening in 898 overdoses – with no deaths. Staff members have also collected 1.7 million drug baggies, discarded needles and used bandages.

Executive Director Sam Rivera, who recently Name One of Time magazine’s 100 Most Influential People of 2023.

Despite those successes, securing private funding has been an ongoing concern—the prevention centers cost $1.4 million annually to operate. Although New York City authorized the sites and supports their operation, the governor’s office has declined to allocate opioid disposal funds over questions of legality under federal law. Rivera said he hoped the organization would secure funding to continue.

While advocates of future overdose prevention centers await the outcome of the safehouse litigation, they are learning from the experiences of New York, Pennsylvania and California, where last year Gov. Gavin Newsom vetoed a bill This will authorize overdose prevention centers in three cities.

In San Francisco, the city established an emergency harm reduction center in the troubled Tenderloin district early last year Also allowed people to use their own medicines under supervision. At the Tenderloin Center, staff intervened in 333 overdoses in the 46 weeks before it closed in December, saying it was temporary.

Participants were served approximately 100,000 meals, and also received showers, laundry, wound care and treatment, and referrals to therapy.

“The longer people were there, the more likely they were to attend a whole host of other services,” said Alex Krall, an epidemiologist. With RTI International, an independent non-profit research institute.

But participants also described long waiting times and a lack of staff and supplies. And because San Francisco is required to call 911 every single time, naloxone was used to revive someone who died, drawing a constant stream of ambulances to the site, sparking concern with neighbors.

Nevertheless, San Francisco has authorized private organizations to open the sites. The mayor’s office said it supports the concept and is awaiting guidance from the federal government on whether public money can go towards them.

Other communities are not waiting to make such spending decisions. In Somerville, Mass., a largely blue-collar community just north of Cambridge, the city council allocated $827,000 for site preparation, construction and purchase of a prefabricated building for such a center, Although no location has been determined and officials are still awaiting clarity on the legality, said Matt Mitchell, Somerville’s prevention services director.

In Rhode Island, Legislature in 2021 Was granted the right Its overdose prevention program. The state allocated $2.6 million in opioid lawsuit settlement money to fund the pilot’s first year-plus. The site will be located in an existing opioid treatment clinic in an industrial part of Providence with no residential neighbors, which officials hope will reduce community concerns.

Still, staff members are knocking on doors in the neighborhood to answer questions about the facility. Project Weber/Renewal – a long-established harm-reduction group that will run the program in conjunction with the opioid treatment clinic CODAC Behavioral Healthcare – Must prepare design, construction and public-safety plans for approval from the City Council of Providence.

daily android, Project Weber/Renew Key, said it is closely watching what happens with state law and the Department of Justice’s settlement talks in Pennsylvania.

“I want these sites to be open all over the country,” she said. “I want lives to be saved.”