WORCESTER – The Board of Health voted unanimously to support a pilot of an overdose prevention center (OPC) in Worcester during its meeting on Monday, March 4. For a pilot to launch, the state legislature must vote to change the state law, which currently prohibits overdose prevention centers, which are also known as safe injection sites or safe consumption centers. Federal law also prohibits the sites, but the federal government has deferred to states to make their own decisions.
On Jan. 23, City Manager Eric Batista submitted the city’s Department of Health and Human Services strategic plan to address opioid overdose hotspots in the city. That report made no mention of OPCs. District 5 Councilor Etel Haxhiaj requested a report from the administration during the same meeting. City Council last met on Feb. 13 and meets next on March 12.
In Worcester’s governing system, the elected city council is wholly dependent on the city manager’s administration for information. The mayor has two staff members and the other 10 city councilors have two staff members collectively. The administration receives endless request for reports from council, which creates a large backlog. According to the administration, the report should be presented to the city council “in the near future.”
This Week in Worcester requested a timeline on the completion of the report via a representative of the administration. A response was not received by the time of publication. This piece will be updated if new information becomes available.
That strategic plan, authored by Worcester Health and Human Services Commissioner Dr. Matilde Castiel, notes that between 2018 and 2022, opioid-related fatalities increased by 15.7 percent. In Worcester, during the same time, opioid-related fatalities increased by 17.8 percent. The report also notes that from January to September 2023, state data showed an 11 percent increase over the same time period in 2022.
In September 2023, while testifying at a hearing of the Massachusetts Legislature, Castiel said that Worcester has the highest opioid mortality in the state.
As This Week in Worcester previously reported, support for OPCs is widespread. The Massachusetts Harm Reduction Commission completed its work in 2019. In its final report, it concluded that there have been no overdose deaths reported inside over 100 OPCs in 11 countries across the world. Worcester Health and Human Services Commissioner Dr. Castiel was a member of that commission.
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.”
In a Worcester Board of Health meeting on Oct. 3, 2022, Castiel was asked what items would be on her wish list to fight overdoses. Her first item was OPCs. Worcester Director of Public Health Michael Hirsh, MD, suggested during the same meeting 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. Castile also visited two OPCs in New York City in April 2023.
A 2023 report by the Massachusetts 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 April 2023, the Metropolitan Mayors Coalition wrote a letter to Governor Maura Healey which said that “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.” The leaders of all 13 municipalities in the coalition signed that letter.
OnPoint NYC operates the first recognized OPC locations in the United States, with centers in East Harlem and Washington Heights in New York City. In its first annual report, it reported the following statistics it gathered from its first year in operation, from November 2021 to November 2022. Those statistics include:
- 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
This piece was edited to include the administration’s comment on when the report will be presented to council.
