Boston City Council considers safe injection sites

The Boston City Council has been actively exploring and debating the possible implementation of medically supervised injection facilities — or safe injection sites — in Boston.

The topic, first discussed by the City Council during their June 7 meeting, got a formal hearing on June 19 featuring several experts and stakeholders related to the opioid epidemic. These two sessions, sponsored and led by Councilors Annissa Essaibi-George and Frank Baker, comes as a reaction to the Massachusetts Medical Society’s recent resolution seeking to open two such sites in the state, one of them potentially being in the South End.

As the United States population continues to face the devastating and often fatal effects of opioid addiction, policy makers have been stretching thin looking for solutions to the problem. According to a report by the Centers for Disease Control and Prevention, more than 33,000 Americans died of an opioid overdose in 2015, with heroin overdose alone surpassing gun homicides. For the first time since 1993, the life expectancy of Americans has declined.

Massachusetts specifically has felt a sobering sense of urgency in tackling the epidemic; the Commonwealth’s rate of opioid-related deaths far exceeds the national average.

According to the Massachusetts Department of Health and Human Services, overdose deaths have rapidly trended upward since 1,361 people succumbed to addiction in 2014, which by 2016 increased by 42 percent to 1,933 confirmed overdose deaths.

“The opioid epidemic is a serious and deadly crisis. On average, six people a day are dying of overdose in Massachusetts,” Councilor Essaibi-George said. “There is not a family in Boston or in the region who has been untouched by this tragedy.”

“I overdosed a week ago while alone,” said Aubri Esters, an advocate for safe injection sites and a drug user. “I got lucky, I survived, but this doesn’t need to happen.”

The concerning statistics are what swayed state officials into considering options unprecedented in the United States. Safe injection sites, which are areas drug users can go to receive clean needles and inject under medical supervision behind closed doors, have never been tried in the country.

However, there are a slew of foreign cities to look at when seeking to understand the effects such a reform could have. A study conducted at a safe injection site in Vancouver reported a 38 percent reduction in overdose deaths, as well as a decline in public drug use and improper disposal of needles; there was also a 30 percent increase in the rate of detoxification, and no reports of negative consequences to the community.

During the June 19 hearing, Dr. Hank Dorkin, President of the Massachusetts Medical Society, presented that utilizing safe injection sites could also save the city and state money. Citing a Johns Hopkins University study, Dr. Dorkin stated that one safe injection site — costing $1.8 million annually — could save the city Baltimore $7.8 million.

Despite the results of the Vancouver and Johns Hopkins reports, city officials are wary of supporting safe injections sites.

“I honestly don’t know how I feel about safe injection sites. My gut is to be very much opposed to them; I hate the idea of normalizing drug use,” Councilor Essaibi-George said during the June 7 meeting. “I do believe in prevention and harm reduction, I do believe in better access to treatment and supporting lifelong recovery.”

Councilor Frank Baker, a co-sponsor of the council hearing order, was much more direct about his position on the safe injection sites. “I don’t think this is a good idea,” he stated. “I’m very, very concerned about this decision, especially where the recommendation is to put [a site] in an area where everybody that I’ve talked to is totally overwhelmed. I don’t know how much more we can handle.”

As an alternative, Councilor Baker pushed for the reopening of the Long Island shelter and using it as an aid site for those dealing with addiction.

Another issue some councilors found with the opening of the injection sites in Boston is the implication of centralizing the epidemic response to the state capital.

Councilors Tito Jackson and Michael Flaherty in particular spoke out against Boston neighborhoods assuming more responsibility than they may need to, seeing a defunding of drug programs in nearby municipalities as a transfer of burden. The town of Lynn, for example, lost $150,000 in state funding for clinicians and case managers in 2017.

According to the Councilor Essaibi-George, this is just the beginning of the discussion in Boston; more hearings are expected to take place as the opioid crisis continues.