First State-Sanctioned Safe Drug Consumption Site In The U.S. On Track To Open This Fall In Rhode Island

“People who use drugs deserve compassion and care, and we hope this space can be utilized by a broad base of individuals.”

By Matthew Bonn, Filter

Claire Macon in Providence, Rhode Island, has one of the rarest job titles in the United States: overdose prevention center manager.

“We plan to have the overdose prevention center open in the fall,” she told Filter.

The site will be run by Macon’s employer, Project Weber/RENEW, which has served people who use drugs in Providence, together with people living with HIV, sex workers, trans people and people experiencing homelessness, for almost 20 years. The organization currently runs two drop-in centers and conducts street outreach.

Overdose prevention centers (OPCs, also known as safe consumption sites among other terms) are facilities that are proven to save lives. They avert any overdoses and provide vital resources for people using state-banned drugs on the premises. Almost 200 authorized OPCs currently operate in 14 countries.

Despite an unprecedented overdose crisis, it took the U.S. until November 2021 to open two of them—run by OnPoint NYC in Manhattan and authorized by New York City. The outcomes speak for themselves. By summer 2023, the organization reported having averted over 1,000 overdoses among more than 3,700 participants.

But the first state to officially authorize OPCs was Rhode Island, which enacted a bill to create a pilot program in July 2021 (Minnesota followed in May 2023, and Vermont in June 2024)

“Rhode Island was the first state in the US to legalize OPCs, so we have taken a different pathway than NY by going through the legislative process,” Alexandra Collins, PhD, a medical social scientist in the Department of Epidemiology at Brown University in Providence, told Filter. “Overall, I think the site in Rhode Island will be like many integrated OPC models—offering harm reduction and social support services, but also clinical and treatment supports through VICTA, the OPC clinical partner.”

Since that 2021 bill was signed into law, it’s been a long road to getting Rhode Island’s first OPC up and running, however.

As Filter previously reported, the relevant regulations took effect in February 2022, then late that year the state began accepting proposals for sites, to be funded with some of Rhode Island’s opioid settlement money. But the planned location and health care partner described by Filter in 2023 both ended up changing.

That was mainly due to various timelines for the move not aligning, Macon explained, which resulted in the switch to a partnership with VICTA, and a new location for both OPC and drop-in center: 45 Willard Ave.

“This definitely was a challenging decision to make but it does feel like a positive one,” Macon said. “Our new building is near the Rhode Island Hospital campus, directly off the RIPTA bus line, a little less than a mile away from our current Providence drop-in center.” 

The Providence City Council ultimately authorized the current plans in February 2024, and work to open the OPC has been gathering pace since then.

The organizers aim to capitalize on the success of OnPointNYC and different models in Canada, helping to create a blueprint for other states and jurisdictions to follow or adapt, according to needs.

“People who use drugs deserve compassion and care, and we hope this space can be utilized by a broad base of individuals,” Macon said. “By co-locating the center in the same building as our drop-in services like drug checking, case management, laundry, hygiene services as well as healthcare practitioners, we hope to also expand the ability for people who use drugs to access a diverse set of resources.”

One part of the plan that hasn’t changed since 2023 is that the Providence OPC “will absolutely have inhalation booths” as well as injection booths, Macon confirmed. “We are firmly committed to [ensuring that] a diverse population of people who use drugs are able to access resources, and having inhalation booths is integral in that.”

So, too, is the fact that the center will be staffed by people with lived experience, something Macon said “is fundamental to our core principles and values” at Project Weber/RENEW.

It sounds outstanding. People will get to use their drugs in a supportive environment, with all drug-use supplies and many other resources available on site. They can be tested, and if necessary linked to care, for blood-borne diseases such as HIV or hepatitis C. They’ll also be able to hang out, wash their clothes and take a shower.

“The OPC will really serve as a community space for people who use drugs in Providence, and be a key component of providing not only harm reduction services and supervised consumption, but also wraparound support for people,” said Dr. Collins, a member of the People, Place and Health Collective whose research focuses have included harm reduction interventions like drug-checking and OPCs.

“One of the biggest differences between New York and Rhode Island is that the Rhode Island site will be regulated by the Rhode Island Department of Health,” Macon noted. “We are very fortunate to have support from a state law that authorizes OPCs, as well as support from our local Department of Health and Opioid Settlement Committee. We are also happy to be included in a five-year, federally funded evaluation to research the impact of the RI and NYC OPCs.”

That study, as the Brown Daily Herald described in July 2023, “will evaluate the impact of the nation’s first publicly recognized OPCs…located in New York City and, by 2024, in Providence.”

Researchers at Brown and NYU plan “to measure overdose rates—both at the OPCs and in their surrounding communities—as well as usage rates for substance use disorder treatment and recovery services, in addition to other indicators such as the number of people using the OPCs who access associated housing programs,” the article continued. “A second phase of the project plans to examine the impacts of safe injection sites on the specific neighborhoods in which they are located.”

Collins emphasized how for many people, the site will be a critical protection from arrest and other harms associated with using drugs on the street. “We are facing an ongoing housing crisis in the state as well, so the OPC will be a really important space for people to be able to use inside.”

It can’t come soon enough. In July, Gov. Dan McKee (D) and his Overdose Task Force reported that 404 people in Rhode Island lost their lives to overdose in 2023. That was 7 percent lower than 2022, but still far higher than in previous years. The rate actually increased among Rhode Islanders aged 35–44. And the rate for Black residents, despite an 11 percent drop compared to 2022, remained higher than for white residents. Among Rhode Island municipalities, Providence, with 53 fatal overdoses per 100,000 population, was second only to Woonsocket (67) on that grim metric.

“Rhode Island is such a small state, and given the extent of the overdose crisis, many people have been impacted in some way…either through family, friends, or their own experiences,” Collins said.

This reality has driven the powerful advocacy that has brought the state to the brink of opening its first OPC.

“Community organizers, harm reduction workers, and people with lived experience have been working in coalition with lobbyists and local policymakers since 2018 to approve the implementation of overdose prevention centers in Rhode Island,” Macon said. “Harm reduction work has always been driven by the community, and we wouldn’t have been able to do this without all of the collective support of our community here.”

“The OPC legislation is the outcome of years of tireless advocacy efforts by front line service providers and community members” Collins agreed. “I can’t underestimate how much time and effort went into getting this legislation passed, but also getting authorization passed by the Providence City Council so it can open.”

The federal government has yet to support OPCs, however. And in the current political climate, threats are never far away.

“I am definitely concerned about the upcoming election and what it may mean for progress we have made in terms of evidence-based interventions, and funding for organizations providing front line services to folks who use drugs,” Collins said. “There is a risk that a change in administration could lead to efforts to stymie OPC efforts. However, the momentum at the state level around OPCs I think is really important, and hopefully will…stop any potential backsliding.”

Over 100,000 people are dying of overdose in the U.S. every year. Each case is a preventable personal, family and community tragedy. The evidence for OPCs has been demonstrated around the world: not a single recorded overdose death at such a facility, reduced deaths in surrounding areas, reduced HIV and hepatitis C transmissions and increased referrals to health and social services.

The Providence site is set to add to that data—but most importantly, to save and transform people’s lives.

This article was originally published by Filter, an online magazine covering drug use, drug policy and human rights through a harm reduction lens. Follow Filter on Facebook or Twitter, or sign up for its newsletter.

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Photo courtesy of Jernej Furman.