The Massachusetts Commission on Harm Reduction issued a report on March 1 recommending the development of supervised consumption spaces (SCS) which would, as the Commission writes, “primarily aim to reduce the acute risks of disease transmission through unhygienic injection and prevent drug-related overdose deaths.”
Produced by the state organization founded in August 2018 by Governor Charlie Baker to make “recommendations regarding harm reduction opportunities to address substance use disorder,” the report offers a succinct outline of what would be required to establish these highly contested but effective harm reduction spaces.
The Commission emphasizes the importance of “local approval,” the proper professional licensing of potential SCS staff, the “rigorous evaluation” of potential outcomes for individuals, as well as the impact on the area surrounding an SCS.
Initially, the Commission envisions “a pilot program of one or more supervised consumption sites” that are purposed for “keeping people alive.”
In addition to its specific SCS recommendation, the Commission asserts that Massachusetts “must foster a culture of harm reduction throughout the state and expand the array of harm reduction resources.”
Currently, the state’s efforts are “primarily focused on increasing access to naloxone and the expansion of needle exchange programs.” The Commission affirms this work, and endorses its continued development.
The Commission emphasizes that SCS should be inclusive of drug consumption beyond just injection opioid use—but the sites would be responding primarily to the opioid-involved overdose crisis in the state. Massachusetts ranks among the 10 states with the highest rates of opioid-related deaths; it has seen a recent decline in these deaths, to which naloxone access has surely contributed, though non-fatal overdoses have increased.
The Commission notes the significant legal hurdles faced by SCS. Employees and clients of the sites would have spotty legal protection due to state criminal and civil laws. Additionally, the threat of a federal crackdown looms; the Commission notes the “federal government’s strongly stated current stance against supervised consumption sites.”
This threat was recently highlighted by a lawsuit filed by a US Attorney for the Eastern District of Pennsylvania—as Filter reported—calling for a judge to declare a proposed SCS there illegal before it even opens.
Even though the initiation of SCS face considerable challenges in the US, Massachusetts is far from alone in considering their development. The report name-checks other US cities considering SCS, like Baltimore, Denver, Philadelphia, San Francisco and Seattle/King County.
The recommended Massachusetts program has received support from the Massachusetts Medical Society, which also recommended the creation of supervised injection facilities back in 2017. “We support the commission’s recommendation and recognize that there will be a myriad of obstacles to overcome on the way to the establishment of a pilot supervised consumption site in Massachusetts,” said Dr. Alain A. Chaoui, president of the Society, in a press release. “Dismissing any proven life-saving measure is tantamount to giving up, and we will never give up on any patient, especially those who are most vulnerable.”
Photograph: Vancouver Coastal Health via Drug Policy Alliance