Political leaders expressed concern Monday about a proposal backed by the Massachusetts Medical Society to open the first clinics in the country where people could inject opioids and other street drugs under doctors’ supervision.
“It’s pretty unorthodox,” Governor Charlie Baker told reporters at the State House. “But I’d like to see why they came to this conclusion and read about it and what they think the benefit of it might be. . . . The question for me would be: Is this going to help people get better or not? And I don’t know the answer to that.”
The governor pointedly noted that the medical community shares some of the blame for creating the opioid epidemic, by overprescribing the drugs to treat pain.
“Since the medical community had a lot to do with getting us into this crisis of opioid addiction nationally,” he said, “I do appreciate the decision made by the medical society to step into this discussion.”
Others echoed the governor’s hesitation.
“I think I’d really have to hear a very convincing argument to convince me,” House Speaker Robert A. DeLeo said. “But, again, if they have that convincing argument, then I’m open to it.”
The state medical society endorsed the clinics at its convention Saturday and urged lawmakers and the Baker administration to set up a pilot program that would allow up to two of them in the state.
The society, which represents 25,000 doctors and medical students, pointed to evidence that similar facilities in Canada and Australia have led to fewer overdose deaths and communicable diseases such as HIV. For example, the society said, Vancouver, Canada, saw a 35 percent drop in the number of lethal overdoses after it opened an injection clinic in 2003.
“The science supports that there’s a benefit to it, and it doesn’t do harm to the community,” said Anna Marie D’Angelo, a spokeswoman for Vancouver Coastal Health, which runs that city’s clinic, called Insite.
At the clinic, she said, users bring their own drugs and line up in the morning before the doors open at 9 a.m. Many have been addicted to heroin for 20 to 30 years, she said, and come because they’re afraid that if they shoot up on the street, they’ll die.
But, she said, “they have an addiction that’s so strong they have to continue on.”
The users are ushered into a waiting room, where they register with the clinic, and are given an alias for use on future visits. Then they’re brought into an injection room with booths, where they’re allowed to inject with a clean needle, in front of a mirror.
Nurses monitor the process, and then bring the users into a “chill room,” where they wait for 20 minutes and can drink juice or coffee.
About 500 to 700 people inject drugs in the clinic every day, D’Angelo said, and clinic staff treat about eight overdoses a day — usually from people injecting fentanyl or carfentanil, two powerful synthetic opioids.
“Potentially, if those people had been doing that in an alley or rooming house, they would die,” D’Angelo said.
She said that 3.5 million users have injected drugs since the clinic opened, during an HIV epidemic, and not one person has died.
If the clinics were to open in Massachusetts, they would no doubt face local opposition.
John McGahan, president and chief executive of the Gavin Foundation, which runs drug treatment programs in Boston, said finding a location would be difficult, because the clinics would attract dealers who would sell drugs outside the clinic doors. That would invite violence from thieves who would try to rob the dealers.
“If you live in that neighborhood or owned a business there, would you want something like this sited there?” McGahan said. “I know I wouldn’t.”
McGahan said he would prefer to see more resources devoted to treatment programs.
In Vancouver, some of the problems that McGahan raised have not emerged, D’Angelo said.
Drug dealers worked the area prior to the clinic opening, she said, but crime has not increased as a result of the clinic.
She said many business owners initially opposed the clinic, but local shop owners now say they would rather have users inject inside the clinic, rather than in their doorways or alleyways.
Montreal, she said, is planning to open a mobile injection clinic, which could dispel concerns about a permanent location attracting crime. In the United States, the county board of health in Seattle voted earlier this year to open two local injection sites.
State Senator William N. Brownsberger, a Democrat from Belmont, has sponsored a bill that would set up a licensing and oversight process for the clinics in Massachusetts. But he said the legislation probably won’t gain traction until a municipality or a nonprofit makes a concrete proposal to open one of the clinics, which he said would force lawmakers to focus on the issue.
Dr. Jessie Gaeta, chief medical officer at the Boston Health Care for the Homeless Program, said her organization would support an injection clinic, if it’s deemed necessary by city and state officials. Last year, the organization opened a space near Boston Medical Center where drug users can go after injecting opioids and be monitored by medical staff.
That program, “doesn’t necessarily go far enough,” she said. “This really goes a step further.”
Levenson can be reached at firstname.lastname@example.org.