Politics
Congresswoman Urges Support For Safe Drug Consumption Sites Ahead Of International Overdose Awareness Day This Week
A U.S. congresswoman from New Jersey was among the speakers who called for support and expansion of safe consumption sites for illegal drugs during a webinar on Monday. Hosted by the Drug Policy Alliance (DPA), the event drew attention to a week of programming intended to build momentum around the facilities ahead of International Overdose Awareness Day on August 31.
The sites, which advocates refer to as overdose-prevention centers (OPCs), allow people can bring and use their own drugs under the supervision of trained staff.
OPCs already operating in some countries and in New York City, where supporters say they’ve prevented numerous overdose deaths. The first state-sanctioned center in the U.S., meanwhile, is set to open this fall in Rhode Island, while Minnesota and Vermont have also authorized OPCs at the state level.
Rep. Bonnie Watson Coleman (D-NJ), who in 2021 sponsored a bill to federally decriminalize all drugs, said during Monday’s webinar that OPCs are an “important part” of a “necessary shift” away from punitive drug policies and toward a more health-centered approach.
“OPCs save lives,” Watson Coleman said. “They are places that those struggling with addiction can be safe and get the help that they need, if wanted. And they keep our community safe of the needles and the syringes by reducing drug usage outside of centers.”
The safe-consumption sites also “provide enormous public health benefits,” she continued. “They decrease hospital visits, prevent infections like HIV through access to clean and safe needles and save our country and local government money.”
As the grandmother of an 11-year-old, “I want her to have safe places to play [so] that she doesn’t encounter things like syringes and needles,” the congresswoman added. “This is very important to me.”
The DPA webinar is one of numerous events taking place this week as part of the advocacy group’s Overdose Prevention Centers National Solidarity Week, happening in about a dozen states between August 25 and International Overdose Awareness Day on Saturday.
The events include community outreach and education, marches and various other awareness events led by community groups and organizations in California, Colorado, Delaware, Illinois, Maine, Maryland, Missouri, New Jersey, New York, Pennsylvania, Texas and Vermont.
Speakers on the DPA webinar also directed people to a video tour of a facility to learn more about OPCs, part of an effort to push back on what they said is widespread disinformation about the centers as well as the relative dangers of drugs like fentanyl to non-users.
Laura Thomas, the senior director of HIV and harm reduction policy at the San Francisco Aids Foundation, said, for example, that misinformation around the risks of coming in contact with fentanyl only makes advocates’ jobs harder.
“The issues around police supposedly overdosing from coming into physical contact with fentanyl,” she said, “it is just not possible to do that, and yet that doesn’t stop news outlets from putting out headlines, videos and so on. Those are all ways that stigma and misinformation are undermining our efforts.”
While California doesn’t authorize OPCs at the state level, Thomas said organizers “have the stellar example of New York for why authorizing legislation is not necessarily a requirement to open and provide overdose prevention centers.”
An unsanctioned OPC that briefly operated in the Tenderloin neighborhood of San Francisco during the COVID pandemic, she added, reversed dozens of overdoses while it was open, “demonstrating that San Francisco can run these services and they can save lives.”
Brandon Marshall, an epidemiology professor at Brown University and founding director of the school’s People, Place and Health Collective, emphasized not only the positive outcomes that have been seen around existing OPCs but also the need to study and evaluate further how different types of facilities might serve different populations across the country.
“We have a unique drug policy context and an unprecedented overdose crisis,” he said. “It’s important to understand how OPCs are going to be most effective at addressing these problems in our diverse communities, be they large cities, small towns or rural areas.”
OPCs might not just be fixed facilities, for example, but “mobile OPCs, OPCs that are integrated into existing health services and even hospital-based OPCs,” which exist in some European countries, he said.
Marshall also emphasized the positive findings from research into OPCs in New York City and elsewhere, for example that OPCs help steer drug users into treatment over time.
“In fact, we know the more frequently someone uses an OPC, the more likely they are to enter substance use disorder treatment,” he said, adding that the centers “also reduce public drug use, drug-related litter and emergency services calls in the communities in which they are located.”
The federal stance on OPCs remains cloudy. On one hand, the Biden administration has let sites in New York City move forward, along with plans for the soon-to-be opened Rhode Island facility. On the other, Biden’s Justice Department has continued to stand in the way of another would-be OPC that organizers are trying to open in Philadelphia. (The Supreme Court in 2021 rejected a request to that hear that case, which was first filed during the Trump administration.)
In response to a question from Marijuana Moment about whether OPC reform might, like cannabis legalization, be led by states and local jurisdictions with that momentum eventually trickling up to federal reform, DPA’s Director of Public Health Kellen Russoniello said that advocates “are going to have to, unfortunately, rely on locals and states taking the initiative here, and that’s already what we’ve seen.”
“I do believe that we are going to need more local action and that there will be strength in numbers that will eventually force the federal hands to eventually announce their support for these,” Russoniello said. Such federal action could take many forms, he noted, including congressional legislation, a Justice Department memo similar to the so-called Cole memo around federal tolerance of state-level marijuana legalization or a budget rider to prevent federal enforcement against OPCs.
“There are different ways to get to the goal,” he said, “but certainly I do think that local and state leadership is crucial here, especially in this moment.”
Russoniello also acknowledged the difficulty in knowing how to proceed amid uncertainty around federal policy.
“It’s hard when the federal government has not announced what their actual policy is,” he said, pointing to the administration’s opposition to the proposed Philadelphia facility at the same time as officials are claiming they’re considering guidelines for how OPCs could proceed. “It’s stifling a lot of local and state leaders from moving forward, because they don’t know where the federal government stands.”
In New York, meanwhile, Toni Smith, DPA’s New York State director, said Gov. Kathy Hochul (D) is the “biggest barrier to our authorization of overdose prevention centers at the state level,” saying the governor is “preventing the state from expanding overdose prevention centers to people who need them.”
“Across the state, 19 New Yorkers a day are dying from overdose, and we are essentially told we need to time our campaign to save lives with election cycles,” Smith said, “because this is a political issue, not a health issue.”
“That is the unfortunate reality that we are often told, that health considerations take a back seat to politics,” she continued. “Part of this week of action is to turn that on its head and really make clear that there is a broad swath of stakeholders…who are demanding overdose prevention centers and are speaking to the value in them.”
In June, Vermont became the latest state to authorize safe consumption sites, as lawmakers narrowly voted to override the Gov. Phil Scott’s (R) veto of the bill.
As for the safer consumption facilities operating in New York City, a study by the American Medical Association (AMA) last July found that the sites had decreased the risk of overdose, steered people away from using drugs in public and provided other ancillary health services to people who use illicit substances. Separate research published by AMA late last year found that the centers have not led to increased crime despite a significant decrease in arrests.
Congressional researchers have highlighted the “uncertainty” of the federal government’s position on the facilities, pointing out last November that lawmakers could temporarily resolve the issue by advancing an amendment modeled after the one that has allowed medical marijuana laws to be implemented without Justice Department interference.
Meanwhile, National Institute on Drug Abuse (NIDA) Director Nora Volkow has tacitly endorsed the idea of authorizing safe consumption sites, arguing that evidence has effectively demonstrated that the facilities can prevent overdose deaths.
Volkow declined to say specifically what she believes should happen with the ongoing lawsuit, but she said safe consumption sites that have been the subject of research “have shown that it has saved a significant [percentage of] patients from overdosing.”
Rahul Gupta, the White House drug czar, has said the Biden administration is reviewing broader drug policy harm reduction proposals, including the authorization of supervised consumption sites, and he went so far as to suggest possible decriminalization.
The National Institutes of Health (NIH) put out a pair of requests for applications in December 2021 to investigate how safe consumption sites and other harm reduction policies could help address the drug crisis.
Gupta, the director of the White House Office of National Drug Control Policy (ONDCP), has said it’s critical to explore “any and every option” to reduce overdose deaths, which could include allowing safe consumption sites for illegal substances if the evidence supports their efficacy.
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