Lawmakers in Colorado, New Mexico and New York have approved bills to authorize safe consumption sites where people can use currently illicit drugs in a medically supervised setting and receive substance misuse treatment resources.
As policymakers across the country grapple with an overdose crisis, three more states are seeking to prioritize harm reduction, with legislation to establish safe consumption facilities advancing out of the Colorado House, New York Assembly Health Committee and two panels of the New Mexico House. The latter bills now head to the floor of their respective chambers for consideration, while Colorado’s measure goes to the Senate.
Earlier this month, the Colorado House approved a bill from Rep. Elisabeth Epps (D) that would permit cities throughout the state to authorize the establishment of overdose prevention centers.
The “Local Control of Life-saving Overdose Prevention Centers Act” would provide people with access to sterile consumption equipment, fentanyl testing tools, counseling, substance use treatment referrals and “other harm reduction services,” the bill text says.
It was amended to make it so municipalities would have to hold a public hearing before permitting the establishment of the safe consumption sites. It then passed the full House in a 43-21 vote last week.
“Preventable drug overdoses are a public health crisis that impact every Colorado community and are a matter of both local and state concern,” the measure’s findings section says. “For far too long, Colorado has disproportionately favored a criminal justice approach to substance use disorders instead of prioritizing public health.”
“Overdose prevention centers are proven to save lives and increase community safety,” it continues. “OPCs lead to decreased rates of communicable disease transmission, severely decrease in-public drug consumption, greatly reduce public litter of drug consumption equipment, and, in their surrounding neighborhoods, are associated with reduced crime.”
A bill from Rep. Tara Lujan (D) would establish an overdose prevention program under New Mexico’s existing harm reduction program, expanding the services to allow people to access safe consumption facilities.
The House Health & Human Services Committee passed the legislation last month, and it cleared the Judiciary Committee earlier this month, with a minor amendment on data collection.
“The overdose prevention program shall provide participants with a safe and hygienic space to administer and consume previously obtained controlled substances under the supervision of personnel trained in overdose reversal,” the bill text says.
“Controlled substances shall not be sold, purchased, traded or otherwise provided to harm reduction or overdose prevention program participants, except as otherwise allowed by law,” it clarifies.
While the state Department of Health would need to collect data intended to help in “planning and evaluating efforts to combat overdose mortality and other negative health outcomes associated with drug use,” the legislation prohibits officials from collecting personal information of participants such as their full name, address or date of birth.
That provision was amended in the Judiciary Committee to create an exception where personal information could be compiled “as required by law for testing, treatment of infectious disease or other medical treatment.”
In New York, the bill from Assemblymember Linda Rosenthal (D) passed through committee on Tuesday. It would require the state Department of Health to authorize at least one overdose prevention center that provides a sterile environment for people to use pre-obtained substances, with medical personnel on site to prevent overdose deaths and make referrals to treatment.
The facilities would need to also maintain syringe exchange services, educate clients on safe consumption practices, provide naloxone to reverse opioid overdoses and collect aggregate data on participants and their experiences. Staff and participants would be given immunity from prosecution for the sanctioned activities.
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“We have a moral obligation to use every tool in our toolbox to address the opioid overdose crisis plaguing our family, friends and neighbors across the state,” Rosenthal, whose earlier version of the legislation moved through the same committee last session, said in a press release. “For decades, far too many New Yorkers struggling with addiction were cruelly left to languish behind bars instead of receiving the care they required and deserved.”
“Authorizing [overdose prevention centers] would send a clear message to the entire country: New York State is using medically and scientifically proven harm reduction methods to save lives and connect people to services,” she said.
New York City has led on sending that message, opening the first city-authorized safe consumption sites in late 2021 that officials say have already saved lives.
A study published by the American Medical Association (AMA) in July found that the the New York City facilities have decreased overdose risk, steered people away from using in public and provided other ancillary health services to people who use currently illicit substances.
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At the federal level, National Institute on Drug Abuse (NIDA) Director Nora Volkow tacitly endorsed the idea of authorizing safe consumption sites last year, arguing that evidence has effectively demonstrated that the facilities can prevent overdose deaths.
While Volkow has frequently promoted harm reduction policies to treat addiction like a public health issue, her remarks about safe injection facilities stand out, especially as the Justice Department is in active litigation that started after the Trump administration challenged the opening of such a center in Philadelphia.
DOJ and that nonprofit recently agreed to transfer the case concerning the legality of safe drug consumption sites out of federal district court and to mediation before a magistrate judge in order to finally reach a resolution after numerous delays.
The department said last year that it was actively “evaluating supervised consumption sites, including discussions with state and local regulators about appropriate guardrails for such sites, as part of an overall approach to harm reduction and public safety.”
Meanwhile, the White House drug czar said last year that 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.
While the Biden administration is investigating the clinical efficacy of such facilities, Office of National Drug Control Policy (ONDCP) Director Rahul Gupta said that the proposal to lift the existing federal ban is on the table.
Gupta previously said that it’s critical to explore “any and every option” to reduce overdose deaths, and that could include allowing safe consumption sites for illegal substances if the evidence supports their efficacy.
The secretary of the U.S. Department of Health and Human Services (HHS), Xavier Becerra, has also signaled that the Biden administration would not move to block the establishment safe injection sites, stressing that “we are literally trying to give users a lifeline.”
But a department spokesperson later walked those remarks back, stating that “HHS does not have a position on supervised consumption sites” and the “issue is a matter of ongoing litigation.” In any case, it would be up to DOJ to decide whether to pursue operators of the facilities under the Controlled Substances Act.
At the state level, Rhode Island became the first state in the U.S. to legalize a safe drug consumption site pilot program in 2021.
In a pair of setbacks for advocates, Vermont’s governor vetoed a bill last year that would have simply created a working group tasked with crafting a plan to open safe consumption sites and the governor of California vetoed a bill last year to permit a pilot program for the harm reduction centers.
Photo courtesy of Jernej Furman.