Follow the data, governor: sites for injections work
Last spring, after signing legislation aimed at curbing opioid abuse at a State House ceremony, Governor Charlie Baker broke down in tears.
Only after a swell of applause from a large crowd of legislators, law enforcement officials, and families of overdose victims was he able to speak. “May today’s bill passage signal to you that the Commonwealth is listening,” he said, “and we will keep fighting for all of you.”
The governor can be an emotional leader. But he also touts his data-driven approach to governance. And the data, it must be said, do not look good.
Last year, almost 2,000 people are believed to have died of opioid overdoses in Massachusetts, according to state officials, a record toll that defied a new wave of treatment and education efforts — including some high-profile measures in the bill Baker signed that spring day.
What the state is doing now is not working — at least not well enough. It’s time for the governor and state lawmakers to consider new approaches, including some radical ones.
At the top of the list: clinics where addicts can shoot up under the watchful eye of doctors and nurses — offering clean needles, drugs that can reverse overdoses, and referrals to drug treatment.
Last weekend, the push for supervised drug-injection sites got a big boost when the Massachusetts Medical Society’s governing body voted overwhelmingly to urge a state-run pilot program that would allow for up to two such clinics in the state.
There are already 90 of these facilities worldwide, and the data — take note, governor — are quite promising. After a clinic opened in Vancouver, in 2003, researchers found a 35 percent decrease in overdoses in the surrounding neighborhood, compared to a 9 percent decline citywide. Ambulance calls for overdoses near a Sydney facility dropped by 68 percent.
There are dozens of peer-reviewed studies — more than 40 now — and some of them have appeared in the world’s most prestigious medical journals.
“This work is published in the Lancet and The New England Journal of Medicine,” said Dr. Thomas Kerr, a professor of medicine at the University of British Columbia who has studied the Vancouver clinic. “It doesn’t get tougher than that.”
The drug-injection sites have their critics, of course. The studies, however, rebut some of the most prominent objections. Intravenous drug use does not increase in the areas where clinics operate, the research shows. And opening a facility does not have a “honey pot” effect, drawing drug dealers and prostitutes to the area.
After studying six years of crime data for the area surrounding the Vancouver clinic, criminologist Neil Boyd told The Globe and Mail newspaper, “our detailed maps confirmed the hypothesis of no impact, no significant changes in relation to criminal offenses.”
A separate study appearing in the journal Substance Abuse Treatment, Prevention, and Policy found no gain in drug trafficking or robberies and assaults in the neighborhood. Vehicle break-ins and thefts actually declined.
There are significant legal obstacles to opening drug-injection sites in Massachusetts. State and federal law bars the clinics, and getting an exemption from a GOP-controlled Washington would be no small task.
But there is some precedent. In recent years, the federal government has looked the other way as states have legalized marijuana; indeed, Massachusetts is counting on that forbearance now as it rolls out its own regulatory setup for legal pot.
And with hundreds and hundreds of people dying of opioid overdoses every year, policy makers should be willing to take some chances here. “We will keep fighting for all of you,” Baker promised, a year ago.
Fulfilling that promise means supporting solutions that work — no matter how controversial.
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