A Case for Safe Injection Facilities: SIFMA NOW

There are plenty of risks that come with injecting drugs into one’s body, from communicable diseases and infections, to overdoses and death. As overdoses continue unabated, some concerned citizens are advocating for safe injection sites.

Supervised Injection Facilities in Massachusetts NOW (SIFMA NOW) is a Boston-based coalition dedicated to bringing safe injection facilities, where those struggling with substance abuse can inject drugs in a hygienic environment under medical supervision, to the Commonwealth. While the coalition is composed of medical professionals, lawyers, activists and politicians, many key members are people who use drugs. All these individuals form the steering committee, which meets weekly to discuss ways to move forward.

According to Aubri Esters, a person who uses drugs and organizer of the steering committee, the group was formed during the Opioid Hackathon in September 2016. During the hackathon, the organizers discovered the many barriers preventing the formation of safe spaces for drug users. Sarah Casey, a harm reductionist and steering committee organizer, said that although safe injection facilities exist in other parts of the world, there isn’t a single facility in the United States. (A county in Washington state is attempting to open a safe injection site, but despite support from officials such as the mayor of Seattle, other politicians are pushing back against the effort).

Barriers include lack of education within the community about the benefits of such spaces, and laws that criminalize addiction, which is a medical issue. According to Casey, over 100 safe injection facilities can be found in countries such as Spain, Canada, Switzerland, Germany and The Netherlands, which opened its first safe injection site in the early 1970s.

Casey added that in the United States, underground facilities currently exist to provide safe spaces and predate the current opioid crisis.

“Currently we lose five to six people a day in Massachusetts to drug overdoses, ” Esters said. “The most important point to keep in mind is that these deaths are preventable.”

According to Esters and Casey, experts in the public health field agree that something different needs to be done. “These facilities increase the number of people that will eventually seek long-term treatment,” said Casey.

Esters, who was once homeless for nine years, has lost many friends due to drug overdoses. That’s why it’s her personal passion to advocate for spaces where those still using drugs can feel respected and dignified while being taken care of.

In order to address the barriers to providing safe injection sites, SIFMA NOW hosts panel discussions and screenings to educate the community on the benefits.  

“There is a real chance for education and discussion if we can engage with the community,” Esters said, adding, “It sounds very radical to think about how these facilities will function, but it’s not.”

SIFMA NOW has been working closely with the Drug Policy Alliance to form a bill that authorizes public health workers to pursue new measures to reduce harm and stigma against people affected by substance use disorders.

Senate bill 1081, “An Act to authorize public health workers to pursue new measures to reduce harm and stigma for people affected by substance use disorder,” would allow people to use “pre-obtained drugs” with medical supervision. The bill has currently been referred to the Committee of Substance Abuse and Mental Health at the Massachusetts State House.

“Although the bill is still being debated and discussed, it’s encouraging to see it at the State House,” Casey said. Esters said the response from the community has been uplifting, from physicians to activists to local community members. According to her, at a microcosmic level, success is when she meets someone who thinks forming supervised injection facilities is a crazy idea but after six months of engaging in a dialogue with them, they change their mind.

Casey said that SIFMA NOW’s goal is to open supervised injection facilities across Massachusetts immediately.

SIFMA NOW is raising its profile through social media campaigns. It also continues to host events in the area to involve the community.

“I want to live in a community where everyone is respected, and currently that is not the case,” Casey said. Esters added that there is a real opportunity to learn from each other by working together as a coalition to keep people healthy and safe, even when they are actively using.

[Ed. Note: A previous version of this article misspelled Sarah Casey’s last name as “Cassey.” The error has been corrected. The goal for SIFMA NOW has also been corrected to accurately reflect their mission; rather than just lobbying for medical community support, they seek to open safe injection facilities as soon as possible.






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