Should drug users have a safe place to inject? State panel says yes

Keith Bedford/Globe Staff/file/Globe Staff

A state commission recommended Tuesday that the Legislature approve one or more “safe consumption sites” for drug users, embracing an approach to addressing the opioid crisis that has drawn criticism from Governor Charlie Baker and the US attorney for Massachusetts.

The Harm Reduction Commission, at its seventh and final meeting, agreed on language explicitly calling for pilot sites where people can consume illegal drugs in hygienic surroundings with trained staff who can revive those who overdose.

The report also specifies that any such site should receive local approval and calls for “rigorous evaluation and data gathering” to measure its effectiveness, but provides no suggestions on where such centers would be located. The final report will be provided to the Legislature on Friday and posted on the commission’s website.

A bill to establish a pilot site failed last year after Baker and US Attorney Andrew Lelling wrote strong statements in opposition.

Lelling has said any locations in Massachusetts would violate federal law. On Tuesday morning before the commission’s meeting, Baker said state officials should heed Lelling’s warning.

“For all of us who are involved in this issue, I would much rather focus on stuff that we can do and are doing rather than on something the feds have made very clear they’re not going to permit us to do,” Baker said.

The two legislators serving on the commission — Representative Jeffrey N. Roy and Senator Cindy F. Friedman — said they would advocate strongly for legislation to establish the sites. But neither could predict whether their colleagues would go along. They said the commission had amassed a robust body of evidence that will back up their position and inform the public.

A key concern has been assertions by Department of Justice officials that such sites violate federal law. But commission members learned that there are differing interpretations. The Justice Department recently asked a federal judge to rule on whether a planned safe consumption site in Philadelphia would violate the Controlled Substances Act, and that ruling could go either way.

Some 100 such sites operate in 11 countries and have been found to lessen overdose deaths and injection-related litter in their immediate neighborhoods. None have opened in the United States, but several cities, including New York, Philadelphia, San Francisco, and Seattle, have proposed doing so.

Opponents say such sites “normalize” and encourage drug use. Proponents say that addicted people are already using drugs and dying on the street; a safe place to inject keeps people alive and can link them with health care and addiction treatment.

Roy said he started out unsure of whether he supported the idea, but now he is sold. The commission’s work “was a tremendous learning opportunity” that deepened his empathy for “real people out there who are suffering day to day,” he said. Safe consumptions sites are “one more tool in the toolbox that will allow the Commonwealth to come to grips with the public health crisis of our generation.”

Massachusetts is one of the states hardest-hit by opioid addiction, with about 2,000 people dying of overdoses in each of the past three years.

The commission added the language supporting safe injection sites to an earlier draft that had stopped short of specifically recommending the sites.

In an interview after the commission meeting, Friedman acknowledged discomfort with the idea of establishing places for people to inject illegal drugs. “But it’s not about me. It’s about what is going to work to address this emergency,” she said. The crisis has forced people to “unlearn” what they’d been taught for decades about addiction being a crime or moral failing.

Friedman said she was optimistic about winning support in the Senate. “People really, really care about this and want to do the right thing and they’re willing to at least listen,” she said.

Members of the advocacy group SIFMA-Now (for supervised injection facility in Massachusetts) were in the audience bearing stickers and placards. At various points during the commission’s deliberations, they periodically held up cards reading “Supported by evidence” or “Factually inaccurate.”

A leader of the group, Jim Stewart, said afterward that he was happy with the commission’s final actions.

The 15-member commission, chaired by Health and Human Services Secretary Marylou Sudders, includes two mayors, two legislators, a law professor, four physicians, two members of the public, and others — some of whom are strong advocates for opening such sites in Massachusetts.

Sudders said she had not spoken with Baker about the commission’s work.

A key voice in the debate has been Boston Mayor Martin J. Walsh, who has softened his opposition to safe injection sites but in January declared that the state isn’t ready to host one. Walsh did not attend Tuesday’s meeting.