The US’s First State-Sanctioned Safe Drug Consumption Site Prepares To Open In Rhode Island

On Tuesday afternoon, organizers cut the ribbon on the first state-sanctioned safe consumption site for illegal drugs in the United States. The facility—located in Providence, Rhode Island—stems from a 2021 bill creating a pilot program for overdose prevention centers (OPCs) in the state.

Operated by the nonprofit Project Weber/RENEW in partnership with addiction care provider VICTA, the new facility is expected to begin offering supervised drug consumption services as soon as it receives final licensing approval.

Once that happens, researchers at Brown University will be following the developments.

“The goal is to identify how OPCs operate in the United States,” Brown epidemiology professor Brandon D.L. Marshall said in a university post about the project. “If they are working, what makes them particularly helpful for people? In what ways do they connect people to addiction treatment and care? How can they best be integrated into a community that’s been hard hit by the nation’s overdose crisis? Those are some of the things we’d like to tease out.”

While controversial, overdose prevention centers have been lauded by academics and harm reduction advocates as a promising way to reduce drug-related deaths and connect people with social services, including treatment for drug use disorders.

The advocacy group Doctors for Drug Policy Reform (D4DPR), for example, recently published a paper arguing that OPCs “represent a wise, cost-effective, and necessary use” of funds received through settlements of lawsuits against opioid companies.

Providence Mayor Brett Smiley (D) attended Tuesday’s ribbon-cutting at the OPC in his city to show his support.

“People with substance abuse disorder are going to use,” he said. “What’s different here is that they will use in a supervised fashion with medical professionals on staff so that they do not die, and then there will be services wrapped around.”

Marshall, the Brown researcher, said in an interview with the Public’s Radio that he led a 2011 study that “demonstrated a 35 percent reduction in overdose mortality after the Overdose Prevention Center opened in Vancouver, Canada.”

He also pointed to a study out of France that he said “found a more than 50 percent reduction in overdoses among people who used overdose prevention centers in that country compared to people who used other harm-reduction programs.”

“I would argue that the evidence in other countries is very promising and compelling,” he said in that interview.

OPCs are already operating in some countries and in New York City, where supporters say they’ve prevented numerous overdose deaths. The New York centers operate with city approval but are not sanctioned by the state.

Meanwhile, Minnesota and Vermont also recently authorized OPCs at the state level.

The federal stance on OPCs remains murky. On one hand, the Biden administration has let sites in New York City move forward, along with plans for the soon-to-be opened Rhode Island facility. On the other, Biden’s Justice Department has continued to stand in the way of another would-be OPC that organizers are trying to open in Philadelphia. (The Supreme Court in 2021 rejected a request to that hear that case, which was first filed during the Trump administration.)

Congressional researchers have highlighted the “uncertainty” of the federal government’s position on the facilities, pointing out last November that lawmakers could temporarily resolve the issue by advancing an amendment modeled after the one that has allowed medical marijuana laws to be implemented without Justice Department interference.

Meanwhile, National Institute on Drug Abuse (NIDA) Director Nora Volkow has tacitly endorsed the idea of authorizing safe consumption sites, arguing that evidence has effectively demonstrated that the facilities can prevent overdose deaths.

Rahul Gupta, the White House drug czar, said in June that the Biden administration is reviewing broader drug policy harm reduction proposals, including the authorization of supervised consumption sites, and he went so far as to suggest possible decriminalization.

The National Institutes of Health (NIH) put out a pair of requests for applications in December 2021 to investigate how safe consumption sites and other harm reduction policies could help address the drug crisis.

The Brown University research into the Providence OPC is one of the projects being funded by NIH, the university said.

Lisa Peterson, the chief operating officer at VICTA, one of the groups operating the center in Providence, told STAT News that she expects the facility to save lives and improve quality of life for city residents in general.

“I don’t think anybody wants to continue to see people die, and this is the evidence-based intervention that can supplement the work we’re doing with Narcan distribution and other types of harm reduction,” she said, describing the space as “only one part of a much broader approach to harm reduction.”

“It has positive outcomes on the neighborhood in terms of cleanliness,” Peterson added, “in terms of your kid not walking to school and seeing somebody overdosed on the sidewalk.”

Marshall said in the Brown University post about the research that the team’s primary goal “is to determine how engaging with an OPC impacts the health and well-being of people who use drugs.”

“We will assess outcomes including changes in overdose risk, uptake of treatment for substance use disorder and engagement with other health and social services,” he explained. Researchers will also analyze “whether neighborhoods surrounding the OPC experience a greater change in overdose rates, measures of drug-related public disorder and economic conditions following the opening of the OPC, compared to neighborhoods without such a center.”

Initial conversations with neighbors, business owners and workers in proximity to the OPC “found that 75 percent of people we spoke with are supportive of the center being in their neighborhood,” Marshall said. “While these results still need to undergo peer review, they represent among the highest levels of public acceptability for OPCs ever observed in the United States.”

Operators at Project Weber/RENEW did not immediately respond to an email from Marijuana Moment asking about the timeline for the OPC’s final license approval.

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Photo courtesy of Jernej Furman.