Last week, California Gov. Gavin Newsom (D) vetoed a bill that would have allowed the state to launch a pilot program for supervised openings in California’s largest city injection facility.
Sometimes called SIFs, Safe Consumption Places, or Overdose Prevention Centers, these are places where people can legally take or inject pre-obtained illegal drugs under supervision to prevent overdose.
In his veto letter, Newsom said he had long been a supporter of harm reduction strategies, but argued he was concerned about rolling it out without “local leadership involvement” like sites and plans to maintain those sites.
He warned that the “unlimited number” of sites the bill would authorize “could have an unintended consequence in San Francisco, Los Angeles and Oakland” and exacerbate “drug consumption challenges” .
Melissa Moore, J.D., director of civil system reform at the Drug Policy Coalition, said the bill has authorized “four specific jurisdictions” — San Francisco, Los Angeles, Los Angeles County And Oakland — opening an overdose prevention center and not inciting the kind of site explosions the governor described.
“Unfortunately, what we’re doing right now is the worst case scenario that Governor Newsom and others are trying to use as a fear tactic… We’ve lived In the reality that public bathrooms are closed because there are fears that people will overdose and die there,” Moore said.
Allowing services for people who are at the most vulnerable times in their lives, “I don’t really see any downsides,” she added.
A benefit of state licensing is legal protection for doctors, nurses, social workers, and other licensed individuals Dr. Alex Kral, an epidemiologist at RTI International, a nonprofit health research organization explain.
Withou on that cover, the licensing board might say, “Look, we don’t approve of that,” he said.
While clinicians can work in these facilities, they may be putting their careers at risk, Kral noted.
In addition, with the unauthorized release of city, county and state public health funding, projects will continue to struggle to open and pay for the work they are doing, Moore said. would be safe and sustainable and could be recommended to state legislatures.
California Senate Republican leader Scott Wilk applauded the governor’s veto. “People battling addiction need help, not legal venues,” he said, covering some of the issues surrounding the debate on the merits of the harm reduction model. )
Moore said she was encouraged by comments from San Francisco City Attorney David Chiu reiterating his support for the plan and suggesting it. The governor’s veto won’t stop the city from launching the center.
In response to the crisis there, a temporary safe injection site in San Francisco’s Tenderloin district has been operating out of tents since the beginning of the year, but funding is expected to run out in December.
HealthRIGHT 360 CEO Vitka Eisen, who runs the nonprofit that runs the site, hopes it will remain open or that multiple sites can be launched in the communities that need them most.
“We didn’t give up on that goal,” Eisen said.
First two public r by OnPoint NYC The operating Cognitive Overdose Prevention Program opened in New York City on November 30, 2021.
A site in East Harlem is operated by medical staff and has a health clinic on-site. The other, located in Washington Heights, employs a “peer-to-peer” model, which means the employee in charge has lived experience with a substance use disorder.
Analysis of the first 2 months of the program Efforts published in JAMA Network Open July 2022 found that work Personnel responded 125 times to help “reduce the risk of overdose” and administered naloxone 19 times and oxygen 35 times, as well as monitoring breathing and blood oxygen levels 26 times. Staff also conducted 45 interventions in response to “stimulant-related overdose symptoms.”
In total, EMS were called to the scene 5 times and clients were sent to 3 times Go to the emergency room. No fatal overdose occurred at either site or during hospital visits, and more than half of those who used the sites used other supports.
“OnPoint not only offers a fact center for overdose prevention, but also has on-site showers…there are laundry facilities, there’s a pop-up center and lots of support for mental health, general health and wellness , acupuncture for people with withdrawal…all of these things under one roof, and I think it really shows the potential of an overdose prevention center,” Moore said. Switch to 24-hour mode.
“To do this, it’s very important to have state mandate in New York,” Moore said, something that advocates have been urging New York Gov. Kathy Hochul (D) to do for some time .
Now, private charitable funds are being used to support the overdose prevention portion of the site’s program, Moore said.
Philadelphia nonprofit Safehouse plans to open its own of safe injection sites, but is awaiting the green light from the federal government after the Justice Department under President Trump sued Safehouse in 2019.
Provisions of the Controlled Substances Act, known as the “Cracked Housing Act,” make it illegal to operate, own, or rent premises for the purpose of using, selling, storing, or manufacturing drugs .
Moore noted that the Biden administration appears to be less “hostile” toward such sites than the Trump administration. Under President Biden, the White House funded harm reduction programs for the first time in its budget, albeit less than needed, but Moore was encouraged.
Safe House Vice President Ronda Goldfein, Esq., said the group continues to have “productive conversations” with the Department of Justice (DOJ) about opening their website.
While New York City is not awaiting approval from the Justice Department, Goldfein said Safehouse has always felt strongly that it would be better to open “in the light.” Not only would this reduce stigma, she said, it would also allow for easier access to institutional partners and funding to ensure the program’s sustainability.
As she said MedPage Today The organization also has no tendency to ignore court orders before.
“Ideally, we have an agreement that allows for appropriate boundaries,” or what the Justice Department calls a “guardrail,” which both parties can agree to.
The DOJ’s current deadline to respond to Safehouse’s claim is September 22. (The response date has been pushed back several times since the end of 2021).
While Goldfein said she doesn’t want the matter to be over before September, she expects answers “by the fall.”
She is optimistic that the settlement in Philadelphia will encourage other jurisdictions. “If the Justice Department said, ‘If you do x, y and z, we’re not going to prosecute you in Philadelphia,’ it’s hard to imagine they’re going to prosecute you in New York or California,” she said.
Other Cities in Rhode Island
July 2021 , Rhode Island Gov. Daniel McKee (D) signed a law authorizing a 2-year pilot of safe injection sites, becoming the first state in the nation to do so.
The state began accepting applications in March, but to date, Rhode Island Department of Health spokeswoman Annemarie Beardsworth said no applications have been received.
“Given all the approvals required by the municipality, this will be a month-long process and[s] state level, as outlined in Rhode Island’s regulations. Current pilot program will end in 2024,” she noted in an email.
Momentum continues around expanding overdose prevention sites, which are being built in cities like Chicago and Baltimore, Moore said.
In July, BRIDGES C The Baltimore Sun reported that a coalition of local advocates set up a “Nomü Nomü Arts Collaborative in Mount Vernon, Rhode Island” Modeling Overdose Prevention Space”.
Maryland Governor Larry Hogan called the sites “absolutely crazy.” The Coalition noted that the city lost more than 1,000 people to drug overdoses in 2020. “This is an intervention, one of many interventions, that saves lives,” she said.
Shannon Firth has been covering health policy as a Washington correspondent for MedPage Today since 2014. She is also a member of the site’s corporate and investigative reporting team. Follow