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Providing Places For Addicts To Inject Could Help Fight Opiate Abuse

Between 2012 and 2014, the number of confirmed opiod-related overdose deaths in Massachusetts skyrocketed by 57%. Recently, the New Bedford City Council declared the opiod crisis a public health emergency. One addiction specialist in New Bedford says it’s time to consider the idea of a supervised injection facility for heroin addicts. A few other communities around the country also are exploring the idea, but overcoming the opposition – and the legal hurdles – could take years. 

New Bedford is currently in a stranglehold of opiate abuse. Local police and fire personnel now carry overdose-reversing drugs like Narcan. And doctors who prescribe opiates face ever-tighter regulations.

But the overdoses keep happening with alarming regularity…behind dumpsters in alleyways, in fast-food restaurant bathrooms.

“People are overdosing in the middle of intersections. They’re driving, and they have to be revived,” said Carl Alves with the New Bedford agency Positive Action Against Chemical Addiction, or PAACA.

While these incidents are still shocking, they’ve become almost commonplace. And that’s prompted Alves to explore the idea of opening a supervised injection center in New Bedford. Addicts could inject heroin at these facilities without fear of being arrested, and with medical personnel on site who could intervene to prevent overdoses.

“Whether this is here or not, people are gonna continue to use,” Alves explained. “What we’re trying to do is move it from some of these public settings and into a more controlled setting, where at least people can be supervised.”

Alves is quick to point out that supervised injection centers s would not provide or administer drugs for addicts.

“They do not provide anything other than support in the event of an overdose,” said Alves.

Recovery coaches also would be available to offer addiction counseling, and to try to get the addict on a pathway to treatment.

But opponents say these facilities would only enable addictive behavior. New Bedford Mayor Jon Mitchell is one. He said the city already is attacking the opiate crisis on several fronts.

“I don’t think part of that effort ought to include the facilitated use of heroin or other opiates,” Mitchell said. “We are concerned that we will accelerate the trend of addicts coming to New Bedford, which has been a problem in years past. In the absence of legislation, it would also be illegal to do that.”

One lawmaker is trying to craft that legislation, but she’s in another state. New York Assembly member Linda Rosenthal will introduce a bill during the next legislative session that would allow supervised injection sites in her state, even though current Federal law bars them.

“Federal law prohibits recreational marijuana, yet they still have it in Colorado and other places. So there are ways to insure that what you’re doing will not run afoul of the federal law,” said Rosenthal.

Rosenthal said one of her biggest hurdles is that most people don’t know anything about supervised injection facilities. She likens it to 20 years ago, when the idea of needle exchanges was first proposed.

“People were like, ‘You’re really enabling people to use drugs, when, in fact, it’s just adjusting to the reality that people who are addicted are going to use, and they will spread HIV/AIDS, hepatitis C, other blood-borne contaminants by using old and used needles,” Rosenthal said.

Like needle exchanges, Rosenthal said supervised injection sites also could help prevent the spread of HIV and Hepatitis C.

Some officials in Ithaca, New York are hoping Rosenthal’s bill passes. Ithaca is a bucolic college town about 350 miles west of New Bedford, struggling with its own opiod crisis. The city’s 29-year old mayor, Svante Myrick, said he’s determined to find an out-of-the-box solution.

“At this point, there’s not a serious mind in the country that thinks we can arrest our way out of this problem,” he said. “We’ve been trying that for 45 years. It’s failed. So if we’re not going to arrest our way out of it, then what are we going to do to bring people in?”

Myrick put together a committee to come up with recommendations, one of which was to open a supervised injection facility in Ithaca.

Although the idea has almost zero acceptance in the US, other countries like Canada, Switzerland and Australia have had supervised injection sites for years. Even so, Myrick said he can understand the objections that most people have.

“I mean, that’s what I thought when I first heard about it,” he said.

But Myrick added that statistics from countries that do allow supervised injection facilities show that they yield positive results.

“People who go to supervised injection facilities are 30 percent more likely to enter treatment,” he said.

Back in New Bedford, PAACA Director Carl Alves said that in addition to sorting out the complex legalities, the community at large will need to warm to the idea that a supervised injection facility could help, rather than hurt.

“I’m not the czar here that can make that decision. But I certainly want to advance the conversation,” he said.

It may still be too early to get that conversation going. On a recent evening, residents, physicians and treatment advocates held a Town Hall meeting at the Ziterion Theater to discuss the city’s opiod crisis. The issue of supervised injection sites never came up.

Copyright 2016 GBH