December 01, 2019

Why Supervised Drug Injection Sites Make Sense

Let's move beyond fear-mongering, start saving lives

SINCE 2000, 17,496 citizens of Massachusetts have died from an opioid overdose. Half of those deaths came in the last five years. That’s like one of at least 245 communities in the Commonwealth disappearing in 19 years. Enough people in Massachusetts have died from an opioid overdose to fill all but 69 of the seats at the TD Garden for a Bruins game.

Nationwide, the Centers for Disease Control estimates 700,000 Americans died from an opioid overdose death in the years spanning 1993-2017. That’s more people than live in the entire city of Boston.

If a stadium the size of the Garden were under attack, if one of our small towns disappeared, or if a foreign nation or infectious disease like ebola wiped out an entire American city, we wouldn’t hesitate to respond decisively. But addiction is also a disease – it’s killing our friends and neighbors – and we need decisive leadership to stop it.

Several bills working their way through Beacon Hill have sparked a debate within our state about harm reduction facilities, which are also called supervised injection facilities. These are places where people battling addiction to opioids can use them under the supervision of a medical professional, stay as long as their high lasts, and then leave without fearing arrest. If the person overdoses, the supervising medical professional will administer a life-saving dose of naloxone and treat the person for an overdose, but other than that, people struggling with addiction are free to come and go.

It’s understandable why this sounds like a crazy idea. Won’t these sites legitimize drug use, make it easier to get drugs, or heighten local crime? These are reasonable and important questions to ask—and to answer.

The answer to those concerns is: no.

And, there’s an even more important question: Will these sites save lives? And the answer to that is an unqualified yes.

That’s why Massachusetts should get past the fear-mongering and move forward with the authorization of supervised injection facilities immediately.

We can learn from the communities that have acted aggressively. Philadelphia recently had this debate, and the city won the right to create a supervised injection site in federal court. They cited data from the more than 100 cities around the world that currently have these sites in a study to gauge the impact on Philadelphia. It found that creating a single center in the city would:

  • Avert between 1 and 18 cases of HIV per year
  • Avert between 15 and 213 cases of hepatitis C every year
  • Prevent between 27 and 76 deaths annually.

Supervised injection facilities help people face addiction. For example, in Vancouver, Canada, which has had harm reduction facilities since 2003, 46 percent of the site’s clients from 2003 to 2006 ultimately sought treatment for addiction. Though it might seem counterintuitive at first, when people come to a centralized location to use drugs, they’re easier for medical professionals and addiction specialists to reach and engage.

Further, the study found that, in addition to saving lives, supervised injection facilities save money. According to a study from the University of Pennsylvania, the facility in Vancouver saved the city $14 million over 10 years, and also saved roughly 940 “life years” purely by preventing the effects of needle sharing.

Imagine if we could save lives and find Boston an extra $14 million to invest in the T, or our schools, or a tax break, or other mental health programs. Vancouver also estimates the city’s supervised injection facility prevented 35 cases of HIV yearly with an annual savings of $1.6 million.

TV shows like The Wire have caused people to fear crime increases in the areas surrounding supervised injection facilities, but in the more than 100 cities around the world that currently have sites, just one (Calgary, Canada) has seen an increase in crime. And it is unclear if the facility’s presence caused the increase, or if police simply arrested more people for drug charges around the facility, driving up crime statistics.

According to the CDC, 130 Americans will die from an opioid overdose every day that we spend handwringing. Perhaps the most compelling reason to authorize facilities is the fact that nobody has ever died at one.

This year, Beacon Hill has held hearings on legislation to establish these sites, and a state task force recommended them as well. But these bills have not yet come up for a vote. Gov. Charlie Baker has previously said he believes that supervised injection facilities are against federal laws. Philadelphia’s recent court victory should encourage him. According to The Washington Post, a federal judge in that case ruled, “No credible argument can be made that facilities such as safe injection sites were within the contemplation of Congress” in both pieces of legislation that Congress has passed concerning relevant federal drug laws.

I urge the governor and all of our state lawmakers to lead decisively and authorize supervised injection facilities in Massachusetts. It’s an opportunity for our Commonwealth to lead on health care again. And, most importantly, it will save lives.


By:  Rep. Seth Moulton
Source: CommonWealth Magazine