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R.I. poised to authorize supervised drug use centers

After an intense debate, the House passed a bill for “harm reduction centers” and the Senate is set to vote on the legislation Thursday

Diego Arene-Morley, a peer-recovery specialist with RICARES (Rhode Island Communities for Addiction Recovery Efforts), adds Narcan nasal spray and drug test kits (shown) to the basic needs kits he hands out, near McCauley House.  Rhode Island had a record level of accidental drug overdose deaths in 2020.
Diego Arene-Morley, a peer-recovery specialist with RICARES (Rhode Island Communities for Addiction Recovery Efforts), adds Narcan nasal spray and drug test kits (shown) to the basic needs kits he hands out, near McCauley House. Rhode Island had a record level of accidental drug overdose deaths in 2020.Pat Greenhouse/Globe Staff

PROVIDENCE — Rhode Island is poised to become one of the first states to pass legislation authorizing “harm reduction centers” where people would use drugs while supervised, under legislation that’s heading toward final approval while sparking intense debate.

The aim is to prevent overdoses following a year in which Rhode Island saw a record number of accidental drug overdose deaths.

Although safe consumption sites have long operated in other countries, no authorized site has opened in the United States. Cities such as Philadelphia and New York have moved toward opening them, and a Massachusetts bill would authorize at least two sites in a 10-year pilot program.

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But Rhode Island’s General Assembly is expected to provide final approval on Thursday for legislation that would create a two-year pilot program for centers where people “may safely consume pre-obtained controlled substances under the supervision of health care professionals.”

“Rhode Island has done more in this realm than most states, and we still have a crisis,” said Senator Joshua Miller, a Cranston Democrat. “We would be irresponsible not to use any model that has a record of success like this model has.”

Miller, who sponsored the Senate version of the bill, said any “harm reduction center” is bound to face a legal challenge based on prohibitions in federal law. But he argued that the prevalence of lethal doses of fentanyl-laced drugs makes this step necessary now.

Dr. James McDonald, medical director for the state Department of Health, said the legislation would place Rhode Island among the first states in the country to authorize “harm reduction centers.” He noted that Somerville, Mass., is moving ahead with a proposal to open a center where people can use illicit drugs with medical supervision.

Since such proposals conflict with federal law and may face legal hurdles, McDonald said, “It would be helpful if Attorney General Merrick Garland would give us some direction. That would help states.”

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McDonald acknowledged that the idea of drug consumption sites can make people uncomfortable. But he said such sites have proven effective in other countries in preventing overdose deaths while also offering health screenings, fentanyl testing strips, and opportunities to enter recovery.

“There is a lot of public health benefit in the bill,” McDonald said. “The status quo is people are using illegal drugs, often alone.”

On Tuesday night, the House debated for nearly an hour and a half before approving the legislation by a vote of 62-9. The Senate, which approved another version earlier, is expected to pass the latest House and Senate bills on Thursday, spokesman Greg Pare said.

The bill would require each center to “provide the necessary health care professionals to prevent overdose,” plus “referrals for counseling or other medical treatment.” Before a center could open, the local city or town council would have to give approval, including the location and hours of operation.

The proposal drew opposition from Representative Arthur J. Corvese, a North Providence Democrat, who acknowledged his reaction was as “visceral” as it was “intellectual.”

“The first thing I thought of when I saw this bill was: What kind of a society do we want to live in?” Corvese said. “We set laws and rules and parameters for our people to conduct themselves. But yet we say ‘You want to chase the dragon or shoot up? There is the place to do it – we are going to protect you.”

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While he was born in the 1950s, Corvese said “I’m not stuck there.” In other words, he said, he recognizes that “we have to do what we can within the confines of the law and the financial resources that society has to help people who have addiction.”

But taxpayers should not be asked to fund centers where people can violate drug laws, Corvese said. “There is almost like a moral oxymoron going on here,” he said.

Representative John G. Edwards, a Tiverton Democrat who sponsored the House version of the bill, disagreed, saying, “This bill tells society how we feel about those who have problems. It tells people that we care about all of our citizens – not just the ones who can go to a facility somewhere nice and warm and get what they need.”

He emphasized that in 2020, 384 people died of accidental overdoses, surpassing the previous record of 336 set in 2016, according to the latest state Department of Health data.

“Three-hundred-and-eighty-four people died in our little state, and the vast majority of them died alone,” Edwards said. “This bill will keep people alive. That is the end result.”

Representative Anastasia P. Williams, a Providence Democrat, said she supports the bill, but she pointed out that the program is only coming about now that the opioid crisis is affecting the white population.

“When people of color were in need of these same services, mum’s the word, honey, nobody knew nothing,” Williams said. “It was ‘those crackheads, those junkies – let them take care of themselves.’ But here we found money from out of the sky, somebody’s pocketbook, and we are going to create a program because the white population is being harmed.”

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House Minority Leader Blake A. Filippi, a Block Island Republican, spoke in favor of the bill, saying, “You can’t keep doing the same thing and expect different results. If there’s a war on drugs, we have failed.”

Noting that 384 state residents died from overdoses last year, he said, “If there were two 747s crashing at T.F. Green (Airport) every year, every option would be on the table.”

While he has some concerns about the legislation, Filippi said, “We have to think differently. This is a crisis. This affects us all.”

But Representative Patricia L. Morgan, a West Warwick Republican, agreed with Corvese, saying, “I don’t think this is the answer.”

“I don’t think anybody wants to be an addict,” Morgan said. “But I can’t accept having just a nice, warm spot off the street for people to take drugs, without us at the same time giving them recovery services.”

Miller said providing recovery services along with a safe consumption site is exactly the plan.

“That is the design,” he said. “Safe consumption is a component, but recovery services and intervention are available.” And data show that safe consumption sites in Canada and Europe have a higher success rate in getting people in detoxification centers and recovery, he said.

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If the Senate passes the legislation on Thursday, it would go to Democratic Governor Daniel J. McKee to be signed into law. “The governor will review the legislation when it hits his desk,” spokeswoman Alana O’Hare said Wednesday.


Edward Fitzpatrick can be reached at edward.fitzpatrick@globe.com. Follow him on Twitter @FitzProv.