Rhode Island’s first safe consumption site (SCS) is expected to open in Providence in early 2024. If approved by the city this summer, the long-awaited center will be run by people with lived experience, and have booths for inhalation as well as injection. It will likely be the country’s first state-operated SCS.
In July 2021, Rhode Island enacted a two-year pilot program to evaluate SCS, also known as overdose prevention centers or in this case as “harm reduction centers.” It was the first state to authorize SCS, but has yet to open any.
In November 2021, New York City began operating what are currently the only two authorized SCS in the country, collectively called OnPointNYC. Regulations for Rhode Island SCS didn’t take effect until February 2022, and since then the main barrier has been funding. But in late 2022 the state began accepting proposals for SCS to be funded with a portion of its opioid settlement payouts. On April 18, peer-led harm reduction nonprofit Project Weber/RENEW announced that it had been awarded a $2.6 million contract to open the center.
All that remains is a vote in favor from the city of Providence, which will be held in early summer. Though approval is not guaranteed, Project Weber/RENEW Executive Director Colleen Daley Ndoye told Filter that the center has strong support from local stakeholders, the city council and the mayor.
Today we announced we will be opening the country’s first state-regulated overdose prevention center in 2024. This is the result of many years of hard work by so many on our staff and in the state. We’re ready to make history and save more lives. 💜Read:https://t.co/Y0HXaCneK0 pic.twitter.com/wO84fomIpF
— Project Weber/RENEW (@WeberRenew) April 18, 2023
Project Weber/RENEW currently operates two local drop-in centers as well as street outreach. It’s planning to renovate the Providence building selected for the center in collaboration with CODAC Behavioral Healthcare, which has operated a methadone clinic there for decades. Though CODAC is moving to a new location in early fall, it will remain in a limited-service capacity to partner with Project Weber/RENEW and supervise the medical components of the center’s wraparound services. These include methadone and Suboxone access for participants who want them, but the center has no intention of pressuring anyone into treatment.
The clinic’s patients will be able to stay at the current location if they want, but Ndoye said that the “vast majority” are likely to move to the new one—which will make it easier for them to access the SCS without worrying their counselors will be nearby and see them with illicit drugs. Once CODAC moves out, Project Weber/RENEW moves in.
“The location is like a dream,” Ndoye said. “If you could create a location, you would create this location.”
The site has railroad tracks on one side and a five-lane highway on the other. Its next-door neighbors are a scrapyard and a used car dealership. At the same time, it’s near two bus stops and in the immediate vicinity of encampments and other overdose “hotspots” where people are at high risk due to using alone. Accessible to the people it’s intended for; out of the way of everyone else.
“It’s really, really, really ideal, in terms of NIMBYs,” Ndoye said. “Nobody can say, ‘I’m a [concerned] neighbor,’ because they’re not a neighbor. There aren’t any neighbors … it’s the best of both worlds.”
Organizers are currently working out the blueprints to renovate the building, with the hope that once they have access they’ll be able to open within a few months. Those renovations include specifications for a new HVAC system—the building has to be properly ventilated.
“To only have this be open to people who are injecting would further exacerbate inequality.”
A 2021 cost-benefit analysis by the Rhode Island Department of Health acknowledged that smoking drugs at the future site would be allowed, but didn’t factor it in “due to the limited availability of outcome estimates … in the scientific literature.”
Safer smoking is often left out of discussions around SCS, and thus inhalation booths are left out of SCS themselves. Incremental as the progress around SCS has been, it still tends to leave stimulant users behind. But OnPointNYC included safer smoking, and Dennis Bailer, who will be one of the Rhode Island center’s codirectors, pushed for inhalation booths as a central racial equity issue. Ultimately, smoking booths were codified as a requirement of the new center’s design.
“In Rhode Island we have a greater population of white people who are injecting drugs, and a greater population of people of color who are smoking,” Ndoye said. “And so to only have this be open to people who are injecting would further exacerbate inequality.”
Most of Project Weber/RENEW’s operations are being modeled off OnPointNYC, which at publication time has averted 848 overdoses. Supplemental oxygen will be used to avert overdoses in the early stages, and injectable naloxone if the oxygen alone isn’t enough. The center is receiving 50,000 Narcan doses from the opioid settlement funds.
If the center opens on schedule, it will have about two years before the new end-date in March 2026.
Through Brown University’s School of Public Health, the center is also getting a forensic spectrometer to offer drug-checking via what’s commonly known as FTIR. This is a non-destructive technique that identifies all known substances in a given sample—not just fentanyl—and only takes a few minutes. Participants can learn which substances are in the bag they brought with them to use on the premises, and that knowledge often informs if or how they do so.
The original pilot was set to expire March 1, 2024. After an unsuccessful attempt in 2022 to extend the authorization and buy more time for SCS to get underway, a two-year extension was approved in March 2023. If the center opens on schedule, it will have about two years before the new end-date in March 2026. Though the contract is only for one year, opioid settlement funds would likely be what covers the second year, too.
In the meantime, organizers are focused on finalizing the blueprints so that they can begin renovations the moment the site is vacated.
“The building is—well, it’s pretty grim. One of the reasons that we are doing so much rehab is that we do want to make it a more welcoming and respectful space,” Ndoye said. “We certainly do not want to have this be a carceral-looking space. We [want to] make people feel like we care about them, because we do.”
Photograph via Wikimedia Commons/Creative Commons 3.0