In 2022, over 100,000 people died from drug overdoses in the United States—more than from firearms and vehicles combined. These are not just numbers. These are our family members, friends and neighbors who are being lost to the unpredictability of a potent drug supply, and a system that largely treats substance use disorder as a criminal problem instead of a public health issue.
Overdose deaths are entirely preventable. Yet one proven public health intervention remains largely sidelined: overdose prevention centers (OPC). These facilities have proven to increase connections to resources and treatment, reduce hazardous waste in surrounding neighborhoods, alleviate the strain on emergency services, and most importantly, save lives.
August 25-31 marks Overdose Prevention Center National Solidarity Week, created by directly impacted people, service providers and advocates to educate communities and pressure legislators to support the establishment of OPC. It is time for our political leaders to put public health before political convenience and pave the way for OPC to open across the country.
OPC, also known as safe consumption sites, are places where people can consume pre-obtained drugs under the care of staff trained and equipped to prevent and reverse overdoses. In addition to immediate medical intervention, OPC offer a range of services addressing participants’ broader needs.
These can include connecting individuals to long-term addiction treatment; providing access to drug checking that enables informed choices, and safer-use supplies that reduce the spread of bloodborne diseases; offering wound care and mental health services; and supplying essential resources like food, showers and laundry facilities. OPC also save taxpayer dollars by decreasing reliance on emergency services and hospital visits.
In the US, the adoption of OPC has been slow, but recent movement is promising.
OPC have existed worldwide for nearly 40 years, with over 200 sanctioned facilities operational around the globe. Their track record of keeping people alive and the research underscoring their efficacy are nothing short of remarkable.
In the US, the adoption of OPC has been slow, but recent movement is promising. OnPoint NYC, a New York City-based nonprofit, has led the charge—operating two OPC since November 2021 with city approval. These centers have been utilized more than 150,000 times, with staff intervening in more than 1,500 overdoses without a single fatality. Rhode Island, which became the first state to pass legislation authorizing OPC in 2021, is set to open its first facility in Providence in fall 2024. San Francisco has also made strides by funding a temporary OPC, which successfully intervened in 333 overdoses over 11 months.
Minnesota joined the movement in 2023, with the state’s governor (and now Democratic vice presidential candidate) signing legislation that includes over $14 million for establishing OPC. And just this summer, Vermont’s state legislature authorized OPC and provided funding for one to open in Burlington.
These local and state-level initiatives demonstrate the growing recognition of OPC as a critical tool against the overdose crisis. However, for this progress to continue, more state and local leaders must reject the stigma and misinformation which too often dominate drug policy debates. They must look past the fear-mongering, and follow the evidence to save lives.
Federal laws remain a barrier, but not an insurmountable one. Local leaders should not wait to act.
One reason some local leaders hesitate to embrace OPC is fear of law enforcement intervention. However, law enforcement professionals across the country are increasingly supportive of OPC, recognizing that they reduce the need for police officers to serve as first responders in situations better handled by health professionals. Before the launch of OnPoint’s OPC services, four district attorneys agreed not to interfere with the initiative. The Department of Justice has also signaled a willingness to allow states and localities to determine OPC implementation, indicating a potential shift in federal attitudes.
Federal laws remain a barrier, but not an insurmountable one. The 1986 “crack house statute,” 21 USC § 856, was designed to combat drug trafficking and sales, not to prevent proven public health interventions. As many legal scholars and law enforcement officials argue that this statute should not apply to OPC, the legal landscape remains unsettled. In the only relevant case to date, the Third Circuit Court of Appeals ruled that OPC would violate this federal law. However, this ruling only applies in the Third Circuit, leaving the question open in most of the nation.
Nonetheless, local leaders should not wait to act. Just as the early champions of syringe service programs in the 1980s paved the way for widespread adoption during the HIV/AIDS epidemic, saving countless lives, bold action on OPC is needed now.
To clear the path for OPC, state and local governments can take proactive measures. Enacting state or local legislation to authorize OPC can offer some protection against potential federal enforcement. Additionally, states and localities could consider implementing emergency declarations to temporarily permit OPC, and/or direct law enforcement not to intervene.
Every day that our elected leaders delay action on evidence-based solutions to the overdose crisis, more lives are needlessly lost.
Federal action is also critical to the long-term success of OPC. The Department of Justice could clarify that OPC will not be an enforcement priority, similar to its approach to state-level marijuana legalization during the Obama administration. Congress could follow suit by ensuring that taxpayer funds are not used to prosecute OPC, as it has done with medical marijuana. A more definitive step would be for Congress to enact legislation explicitly excluding OPC from the scope of prohibited activities under the Controlled Substances Act. Ultimately, all levels of government must provide the funding necessary to ensure OPC can meet communities’ needs.
Every day that our elected leaders delay action on evidence-based solutions to the overdose crisis, more lives are needlessly lost. This crisis impacts all of us, and it is imperative that we swiftly embrace and scale every viable response.
OPC offer a proven approach to saving lives and improving public health. The success of OnPoint NYC and the momentum in states and municipalities across the country should inspire further action. It is time for our leaders to act decisively and support the expansion of OPC—we have no time to waste.
Screenshot from the Drug Policy Alliance video Overdose Prevention Centers: Got a Minute? used with permission.
This article is part of a short series produced in collaboration with the Drug Policy Alliance to mark Overdose Prevention Center National Solidarity Week. The Influence Foundation, which operates Filter, previously received an unrelated restricted grant from DPA. Filter’s Editorial Independence Policy applies.
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