About a year after the Ocean State became the first in the country to legalize harm reduction centers, the Rhode Island School of Design is creating a design studio course that will allow students to reimagine the clinical settings where people who use opioids can use drugs safely.
Harm reduction centers can often be “clinical,” “stark,” and “unwelcoming,” according to Justin W. Cook, a RISD faculty member and the founding director of the school’s Center for Complexity.
This year, after Rhode Island lost more than 400 lives to accidental overdoses in 2021 — the highest recorded in a single-year period — Cook said he’s hoping the Center’s team of researchers and designers can rebuild a system that is “caring, healing, and compassionate” with a more humane response to the epidemic.
Q: Why did you want to look at how designers could play a role in harm reduction centers?
Cook: I think designers have not previously understood how they could play a role in addressing this epidemic, so there are plenty of opportunities for designers to really examine the issue and rethink the system. It’s at the core of what we’re exploring in this studio.
How did you get started?
At first, we assumed that there wasn’t a role designers could get involved in to try to reshape the system. We spent the first six months just listening, going to all the Governor’s Task Force meetings, we’d meet with organizations like RICARES (Rhode Island Community for Addiction Recovery Efforts), and volunteer and observe what was happening to make sense of it all. It really began from a position of humility. Then we forged a partnership with the COBRE (Center for Biomedical Research Excellence on Opioids and Overdose).
‘For a long time, society has thought that people who use drugs shouldn’t have access to spaces that delight them, make them comfortable, or make them feel part of society that values them in communities.’
What challenges do designers face in reconstructing harm reduction centers?
These centers are typically very clinical, with only some exceptions. There are some interesting dilemmas that we need to look at when we are designing harm reduction centers. For example, if you make one of these centers “too nice,” does that not suggest that this is “the place to be?” Does it become a party house?
Addiction happens to all of us. Some of us are addicted to our phones, to exercise, and some of us get addicted to these exquisitely addictive drugs. So we all have that propensity to addiction, but it’s people that use drugs that we assign this “second” or “third-class” citizenship to. For a long time, society has thought that people who use drugs shouldn’t have access to spaces that delight them, make them comfortable, or make them feel part of society that values them in communities. So we’ve long stuck them in spaces that feel more familiar in a criminal justice setting than in a care and well-being setting. These tensions are present, and our students are working on overcoming them in their designs.
So far, what opportunities do you see for designers?
We have a 50-page document that looks at everything we could look at: How you should consider a location for a harm reduction center and the different mediums (like in a tent or on a bus in addition to a standalone clinic), and mobile clinics that are only in place for a day or periodically and how they would be designed. So we’re trying to combine questions that look at aesthetic and spacial parameters while wrestling with some of these dilemmas that emerge from trying to set something up that hasn’t really existed in our own society before. We want to make these spaces more humane.
What else are students looking into?
I have one student who is developing prototypes to redesign fentanyl test strips. The ones that are currently on the market are best for law enforcement or for those who have been trained to use them, and in controlled settings. They weren’t made for street use. So one of the prototypes is a wristband that you’d get when you go to a concert or festival, where a fentanyl test strip would be integrated in. If you’re able to put a test strip on the arm of everyone at a festival, for example, that opens up the possibility for self reflection for those who never thought overdosing was possible for them. Plus, fentanyl is showing up in a lot of recreational drugs like cocaine and MDMA. It would normalize an intervention.
How does this project fit into your own background?
In my own graduate studies, I began doing research in healthcare. I looked at how you could take an architect’s toolkit and apply it to a health care systems’ big questions. I did a project with MIT and Mass General Hospital to redesign stroke care. It was my entry point into taking something that was not traditionally a toolset that is used in these spaces and really applying them to spark change.
What other projects has the Center for Complexity work on?
The Center is a research group that looks at how you can apply creative practices of different kids to complex challenges. We have a diverse group that makes up our team: One person has a long history in politics and English literature, there are sociologists, and there are others that are trained as designers, like myself who has a background in architecture.
In other health care projects, we’ve partnered with the University of California San Francisco around health equity, working with patients to improve outcomes for those who have limited English proficiency. We also have a big project with our global security portfolio, which is about ending the nuclear weapons century. All of these projects are big and complicated, and in partnership with other organizations who have expertise in the particular subject matter.
The Boston Globe’s weekly Ocean State Innovators column features a Q&A with Rhode Island innovators who are starting new businesses and nonprofits, conducting groundbreaking research, and reshaping the state’s economy. Send tips and suggestions to reporter Alexa Gagosz at email@example.com.
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