Visiting safe injection facilities (SIF), where people inject drugs openly under the supervision of nurses, counselors and trained staff, has strengthened one mayor’s opinion and completely changed another’s within the course of one weekend.
Boston Mayor Martin Walsh admits he was a strong opponent of the harm reduction strategy, but was impressed by what he saw at injection sites in Toronto and Montreal.
Cambridge Mayor Marc McGovern also had a favorable opinion of SIFs when he returned from his trip to Montreal with members of the Cambridge City Manager’s Opioid Working Group.
“You can’t speak against them. There’s something there and it’s something that I’m going to talk more about as I get a chance to debrief with the team that went with me and then start having conversations,” Walsh said. “At the very least I think very soon we have to do more on harm reduction in Boston and in Massachusetts.”
McGovern, however, said this was a discussion to be had with Cambridge City Manager Louis DePasquale and the Opioid Working Group, but he is in favor of opening a SIF in his city after visiting three brick and mortar facilities and one mobile facility in Montreal.
“Having been a social worker I understand that working with folks that are struggling with addiction is difficult,” McGovern said. “But at the end of the day saving people’s lives, helping people get into treatment, helping people get the services that they need in a safe environment takes precedent … these sites are a harm reduction strategy and intervention that is needed and I would support one in Cambridge.”
The numbers from the Public Health Agency of Canada show Quebec, the province where Montreal is located, has seen fewer apparent opioid-related deaths in 2017 than 2016, as has Massachusetts, according to the state’s Department of Public Health numbers.
On the other hand, Ontario — where Toronto is located — was the second hardest hit province for opioid related deaths in 2017, behind British Columbia.
Jessie Gaeta, chief medical officer for the Boston Health Care for the Homeless Program, has been a long-time supporter of the SIF model and mentioned studies highlighting their effectiveness during a meeting on the topic prior to the mayors’ trips to the north. Those studies also highlight that people don’t die from opioid-related deaths when they are under observation by professionals, a point McGovern stressed in a recent interview with Spare Change News.
Despite the data, Massachusetts District US Attorney Andrew E. Lelling said from a legal standpoint anyone operating a SIF would be exposed to federal criminal charges.
“‘Supervised injection facilities’ would violate federal laws prohibiting the use of illicit drugs and the operation of sites where illicit drugs are used and distributed. Employees and users of such a site would be exposed to federal criminal charges regardless of any state law or study,” Lelling said in a statement to the press in July.
A spokesperson from Lelling’s office said the US Attorney’s stance on the subject has not changed.
State Attorney General Maura Healey’s office told Spare Change News the AG does not have a comment on the matter at this time.
Though Walsh has had a change of heart on the SIF model, he was non-committal on if he would support one in Boston.
“These facilities didn’t happen overnight,” the mayor said, “There’s a process we have to go through and a modeling, we have to see how it would be.”
McGovern agreed that these sites wouldn’t happen quickly and said it would take a regional approach and the state for a site in Cambridge to be effective.
“There are a number of hurdles that have to be overcome before that can happen. There will be a number of recommendations by the working group as to how to address opioid use in our city. From what I’ve been told safe injection sites will be part of that report, I’m not sure what the recommendation of the working group is going to be. When I see that it will sort of dictate where I want to go,” McGovern said.
Aubri Ester, co-founder of the SIFMA NOW Coalition and member of the Massachusetts Harm Reduction Commission, a 15-member body that Walsh and McGovern sit on, said she’s concerned with comments on how long the creation of a SIF would take.
“Every year we lose another 2,000 people who are dying from drug overdose and I think it’s foolish to let hundreds if not thousands more die to drug overdose,” Ester said. “We can start opening spaces like this year and save hundreds of lives with one location.”
Ester said SIFMA NOW formed three years ago with the goal of expanding harm reduction options in the state and the obvious goal of opening SIFs across Massachusetts.
She said her group was behind the formation of a harm reduction commission and believes states have the power to open up SIFs when declaring a public health emergency, which she said the opioid epidemic is in Massachusetts.
A spokesperson from City Manager DePasquale’s office said it is premature for him to comment until he reviews the working group’s report and recommendation expected sometime in late February or early March.