A government-sanctioned place to inject illicit drugs? It may come first to Somerville

A man rested after injecting heroin at a safe injection clinic in Vancouver, B.C. More than 120 such facilities operate outside the United States.DARRYL DYCK/Associated Press

Undeterred by the pandemic and legal uncertainties, the City of Somerville has been forging ahead with its proposal to open a center where people can consume illicit drugs with medical supervision, an audacious and possibly precedent-setting move to prevent overdose deaths.

Some of those involved believe Somerville will become the first city in the country to open a “supervised consumption site” — and that it could happen within a year or so — even as attempts have faltered in bigger cities like New York and Philadelphia.

Legislation at the state level would authorize two pilot sites in Massachusetts. But Somerville intends to move forward regardless of the fate of that bill.

“People say, ‘Why Somerville?’” said City Councilor Jesse Clingan, a longtime advocate for the site. “We’re bold enough to do this type of thing.”

Energized with newfound optimism for a changing political climate, advocates and city officials are committed to pursuing a plan that Mayor Joseph A. Curtatone first announced in 2019. The city has commissioned a feasibility study and earlier this month held the first of several town hall discussions, but it has not selected a site or agency to run it.

“Sometimes issues take time to ripen. This issue feels ripe,” said Carl Sciortino, a member of the city’s working group on the project and executive vice president at Fenway Health.

The sense of urgency has intensified, Sciortino said, as overdose deaths reached the highest toll ever recorded nationwide and increased by 5 percent in Massachusetts last year. There were 14 overdose deaths among Somerville residents in 2020, lower than 2019 but double the number in 2018.

At supervised consumption sites — also called safe injection sites, overdose prevention sites, and harm reduction centers — participants bring in drugs obtained elsewhere and inject or inhale them at clean tables within view of trained professionals ready to intervene in an overdose. Drug users would have access to hygienic injecting equipment and may form relationships with employees who can steer them to health care, including addiction treatment.

More than 120 such facilities operate outside the United States, and studies have shown they reduce overdose deaths without increasing crime or litter in the neighborhood. But no sanctioned site has opened in the United States. Government and law enforcement officials say such sites are plainly illegal and neighbors fear they will attract crime or encourage drug use.

If Somerville succeeds with its plans, it would be in keeping with its history of leading the way, said Councilor Clingan. For example, the city made national headlines a year ago when it granted polyamorous groups the same rights as married couples.

Once a blue-collar city known as an affordable haven for artists and recent college graduates, Somerville has undergone gentrification and experienced soaring property values. But its 81,000 residents remain diverse — a third are nonwhite, many are immigrants, and the city’s website boasts that 50 languages are spoken in its schools.

Somerville was a bellwether in the opioid crisis, startled by overdose deaths among young people as far back as 15 years ago, said Sciortino, who represented the city as a state legislator from 2005 to 2014.

“People from all segments of the community have lost friends, children, and loved ones and have been grappling with this reality for quite a long time,” he said. “It creates room to reflect why this is important.”

Mary Sylla, senior staff attorney with the California-based Drug Policy Alliance, was enthusiastic about Somerville’s efforts but skeptical that the city would be the first.

“There are a lot of places that are trying and a lot of people saying, ‘Maybe we’ll be the first,’” Sylla said. “The San Francisco mayor’s office is also looking at sites and working with community groups who would be able and willing to provide these services.”

Legislation pending in a dozen states — including Massachusetts and Rhode Island — would authorize supervised consumption sites, although Sylla expects most of those bills to fail.

But Somerville wants to turn the process upside down, by acting first.

“The moment a community says, ‘We’re ready to go,’ it’s going to force a conversation at the state and federal level as to how they want to handle this,” Sciortino said.

Still, if the Massachusetts Legislature passes bills to authorize two pilot supervised consumption sites, Somerville will be poised to host the first one.

Even as state legislatures wrangle over the issue, the biggest obstacle has been the US government. The federal Controlled Substances Act contains a provision informally known as the “crack house statute” that makes it a felony to “knowingly open, lease, rent, use, or maintain any place, whether permanently or temporarily, for the purpose of manufacturing, distributing, or using any controlled substance.”

Advocates have argued that this provision does not prohibit safe injection sites, because their purpose is to save lives and provide health care. But in January, the Third US Circuit Court of Appeals in Philadelphia disagreed, declaring supervised consumption sites illegal under the crack house statute. The ruling does not have power outside of the Third Circuit, but it influences the debate.

In Massachusetts, Governor Charlie Baker has opposed safe injection sites, saying they are illegal under federal law. The former US attorney for Massachusetts, Andrew E. Lelling, threatened to deploy “law enforcement” if anyone attempted to open a supervised consumption site.

But the Biden administration will appoint a new US attorney.

“What we need is a US attorney who says, ‘Go forth and save lives,’” Sciortino said. “Then Charlie Baker can’t say, ‘It’s illegal.’”

In April, Curtatone, along with the mayors of San Francisco, New York, Oakland, Philadelphia, and Pittsburgh, signed a letter to Attorney General Merrick Garland, urging him to reverse the federal government’s interpretation of the crack house statute or at least “deprioritize” enforcing it. Garland hasn’t responded.

Still, advocates for the Somerville site are optimistic that the legal landscape will eventually tilt in their favor, allowing them to avoid a potentially ugly showdown with law enforcement.

Meanwhile, the train that Curtatone set in motion in 2019 has been quietly put-putting along.

A working group of about 30 community members, first responders, and city officials has been meeting, slowed but not stalled by the pandemic. Last fall, the city awarded a $12,000 contract to a group from the Brown University School of Public Health to draft a needs assessment and feasibility report, which was presented at a virtual town hall on June 10.

The report concluded that Somerville would benefit from a supervised consumption site, and should consider locating it in Davis Square or East Somerville, based on where overdoses have occurred and access to public transit.

An online survey that garnered 615 responses found very strong support for the supervised consumption site. Notably, 56 percent said they would have “no concerns” about such a facility in their neighborhood.

The respondents were “not necessarily representative of the population of Somerville, but it had responses from people who lived in every neighborhood,” said Brandon Marshall, a Brown associate professor who worked on the feasibility study.

At the June 10 town hall, residents had questions, but leaders of the effort did not sense any major opposition. A series of additional meetings will be held, and when the city comes close to identifying a potential site, businesses and residents in the neighborhood will be consulted and their support sought.

“We need to be thoughtful in our process and inclusive, in order to be successful,” said Doug Kress, the city’s director of health and human services.