WORCESTER – A Massachusetts state senator joins a growing chorus of voices endorsing the state enabling pilots of overdose prevention centers (OPCs), also known as safe injection sites or safe consumption sites (SCS). The Massachusetts Department of Public Health, Massachusetts Harm Reduction Commission, the leaders of 14 Massachusetts cities and towns, and the Worcester Health and Human Services Commissioner have all reported favorably on the effectiveness of OPCs. The sites are currently illegal under state law.
Matilde Castiel, MD, the Worcester Health and Human Services Commissioner, travelled to New York City in April 2023 to visit two OPCs there. She has since said she supports a change in state law that allows the sites in Worcester. Castille had previously voiced support for OPCs.
According to the minutes of the Worcester Board of Health meeting on Oct. 3, 2022, Matilde Castiel, MD, the Worcester Health and Human Services Commissioner, was asked what items she would have on her a wish list to fight overdoses, he first item was safe consumption sites.
In the same Board of Health meeting, then-Worcester Director of Public Health Michael Hirsh, MD, suggests having a safe injection test site and said he doesn’t feel like the way things are handled now will make a difference, according to the minutes.
The City of Worcester hasn’t taken an official position on OPCs, despite having one of the highest opioid mortality rates in the state and support for the sites rapidly growing.
While Support Grows for OPCs, Worcester Waits on a Report
At the Worcester City Council meeting on Jan. 23, City Manager Erik Batista submitted the city’s Opioid Overdose Strategic Plan. It made no mention of OPCs.
During discussion on the report, District Five Councilor Etel Haxhiaj raised a motion to request a report from the city manager’s office, via Health and Human Services, for a report on OPCs. District Three Councilor George Russell asked that the report include “alternatives for such a center that currently exist in the city, if such an alternative does exist.” Councilor-At-Large Donna Colorio asked for Health and Human Services to provide city council with “best practices associated with opioid overdose prevention.”
As Worcester City Council has just two staff members for its 10 members (Mayor Joe Petty has separate staff), it is wholly dependent on the administration to provide it information. It is unknown when the administration will report back to the council.
Between 2015 and 2021, annual overdose related deaths in Worcester increased 60 percent, from 155 in 2015 to 251 in 2021. In 2022, the total deaths rose to 141. With a rate of 68.27 per 100,000 residents in 2022, Worcester has the ninth highest rate of overdose death in Massachusetts. Of the eight municipalities with a worse overdose death rate, the populations varies from 1,194 to 101,253. See overdose death statistics at the bottom of this story.
Data released by the Massachusetts Department of Public Health in December reported that 2,323 confirmed and estimated opioid-related overdose deaths in Massachusetts in the 12-month period ending Sept. 30, 2023. Since 2000, the opioid epidemic has resulted in over 25,000 fatalities in Massachusetts.
Sen. John Keenan Supports OPCs after Visiting 5 Cities
An opinion piece by state Sen. John Keenan, published in the Boston Globe on Monday, recounted his experiences visiting overdose prevention sites (OPCs), also known as safe injection sites, in Montreal, Vancouver, Toronto, Quebec City, and New York. Keenan, who represents Norfolk and Plymouth counties, concludes the piece with:
“What I saw and learned in Montreal, Vancouver, Toronto, Quebec City, Philadelphia, and New York leads me to believe that Massachusetts should allow any community that chooses to host a supervised consumption site to do so as a pilot program, using the experience and data to better inform Massachusetts policy makers and residents of the role such facilities can play in efforts to combat the drug epidemic. They can save money, and they will save lives.”
Mass. Sen. John Keenan, Boston Globe, Feb. 5, 2024
Earlier in the piece, Keenan described trouble locating the locations, while having the address, in some cities. He described them as, “Indistinguishable. Nondescript. Practically invisible. Supervised consumption sites blend with their neighborhoods.”
Other Support for OPCs
Keenan is far from alone. A report by the Department of Public Health (DPH), “Overdose Prevention Center Feasibility Report,” concluded that “Establishing OPCs would enable the Commonwealth to reach individuals who may not otherwise be accessing healthcare services, reduce disease transmission, and prevent deaths.”
In 2019, the Massachusetts Harm Reduction Commission final report concluded there have been no overdose deaths reported inside over 100 OPCs in 11 countries across the world. Members of that commission included then-Massachusetts Secretary of Health and Human Services Marylou Sudders and Matilde Castiel, MD, the Worcester Health and Human Services Commissioner.
In 2020, a report by the National Institutes of Health, “Overdose Prevention Centers,” concluded, “Methodological caveats notwithstanding, drug use supervision and overdose management have the potential to provide health benefits to at-risk PWID as well as economic advantages to the larger community.”
The Metropolitan Mayors Coalition letter to Governor Maura Healey said, in part, “OPCs have demonstrated success in other countries and regions in protecting people who use drugs, reducing the amount of discarded biohazardous materials in the public way, preventing unsafe and open-air drug use, and decreasing opioid overdose deaths.”
That letter was signed by the coalition chair and Melrose Mayor Paul Brodeur, Arlington Town Manager Sandy Pooler, Boston Mayor Michelle Wu, Brookline Town Administrator Chas Carey, Cambridge City Manager Yi-An Huang, Chelsea Interim City Manager Edward Keefe, Everett Mayor Carlo DeMaria, Malden Mayor Gary Christenson, Medford Mayor Breanna Lungo-Koehn, Newton Mayor Ruthanne Fuller, Quincy Mayor Thomas Koch, Revere Mayor Brian Arrigo, Somerville Mayor Katjana Ballantyne, and Watertown City Manager George Proakis.
First Year Data from New York OPCs
OnPoint NYC operates the first recognized OPC locations in the United States, with centers in East Harlem and Washington Heights in New York City. When it expanded its services to include what it calls Harm Reduction Wellness Hubs in 2021, it received support from then-Mayor Bill de Blasio and Mayor Eric Adams, Manhattan District Attorney Alvin Bragg, New York City Department of Health and Mental Hygiene (DOHMH) Commissioner Dr. Dave Chokshi and Commissioner Dr. Ashwin Vasan, and among others.
Its two centers in New York City provides services that include a nutrition program, hygiene program (access to bathrooms, showers, laundry), syringe services, connectivity services (access to computers, phone, printer, fax), and peer support.
In the first OnPoint NYC annual report, covering from its opening in November 2021 through November 2022, it reported the following:
- intervened 636 times to prevent overdose death and other associated harms;
- 48,533 utilizations of OPCs;
- 83% of opioid overdoses were resolved without the need for naloxone;
- 1 in 5 participants were referred to housing, detox, treatment, primary care, or employment;
- 100% of OPC participants who wanted to go to detox or inpatient substance use treatment were connected to outside providers;
- Out of 48,533 OPC utilizations, EMS was called 23 times (3.6% of overdose interventions; 0.05% of visits)
- 81% of OPC visits during the first year of operation, participants reported they would have used in a public space or semipublic space if they did not have the option of
using the OPC at that time (of 39,422 visits)
- collected 435,078 units of hazardous waste
Overdose Death Statistics in Massachusetts
The following data includes all Worcester County municipalities and communities with over 20,000 residents statewide. Entries with blank percentage are due to one of the divisible numbers being zero.