After reviewing the topic for more than six months, a state commission is likely to note in its final report next week that safe consumption sites are an effective tool for preventing opioid overdose deaths.
What comes after that, though, remains the question.
The eight members of the 15-person Harm Reduction Commission present at a meeting on Thursday all seemed to agree there is significant evidence that lives are saved when drug users inject or consume narcotics under the watch of medical professionals. But the commission, which plans to complete its study next week and submit it to the Legislature by March 1, was not united on the legal and logistical feasibility of such sites in Massachusetts.
In a two-hour discussion, commission members debated how to frame their findings on safe consumption sites, sometimes called safe or supervised injection sites, to balance the benefits of such programs with the fact that US Attorney Andrew Lelling has said on several occasions that they would be subject to federal prosecution.
“I believe what you’re going to see in the final report — but again, this is a report next week that the commission needs to see — is that safe consumption sites are an important potential harm reduction tool that people need to consider,” said Marylou Sudders, the state’s secretary of health and human services. “I think it’s a hard sell because it’s illegal and there are lots of barriers that the Commonwealth needs to consider.”
The commission, convened last year under a law addressing the opioid epidemic, has spent its time examining research on various harm reduction measures with an emphasis on safe consumption sites. Supporters of the sites argue that thousands of people are already using opioids, so allowing them to do so in locations where they can acquire clean syringes and be closely monitored for overdoses will reduce deaths.
Members of the commission read academic studies and traveled to Canadian cities where such programs exist, and they found that no overdose deaths occurred inside the clinics and that users in them were more likely to seek treatment.
“The data is absolutely clear that within a safe consumption site, no one has died,” Sudders said. “If you see it as an important part of harm reduction, it does save lives.”
Thursday’s meeting, however, unfolded as a debate on whether the final report should simply lay out the benefits and roadblocks for safe consumption sites or if the commission should more forcefully recommend it.
“Our Commonwealth has been on the vanguard of advancing a public-health approach. We were the first state to adopt a universal health coverage model,” said Leo Beletsky, a Northeastern University public health and law professor. “We’ve done a lot of very pioneering work that moves the needle on health care toward more public health approach, so it actually fits in with that overall paradigm.”
Mayor Martin J. Walsh, who had initially opposed the idea but began opening up to it as he worked on the commission, still offered some support for the sites, saying he “would like to see this document headed that way” toward the benefits. He also called for support of more long-term recovery beds and other harm reduction strategies.
The commission’s final decision has not yet been made. Members will submit further feedback before their meeting on Monday when the report will be completed one way or another.
“If this is an emergency, and it’s a crisis, we need to try things,” Friedman said. “It’s not about us. It’s not about my comfort. It’s about whether something is going to work or not. That’s the urgency I want to bring to people.”