Rhode Island Selects Location For Nation’s First State-Approved Safe Drug Consumption Site To Curb Overdose Deaths

Harm reduction advocates in Rhode Island announced this week that they’ve secured a location for the nation’s first state-regulated overdose prevention center where people can use illegal drugs in a safer environment under the supervision of trained professionals. And on Thursday evening, the Providence City Council gave formal approval to the plan.

News of the plan’s finalization was trumpeted on Wednesday by the group Project Weber/RENEW, which is working with clinical partner VICTA to open the site adjacent to the Rhode Island Hospital campus in Providence. Organizers are aiming to open the facility sometime this summer and provide services on weekdays.

Colleen Daley Ndoye, executive director of Project Weber/RENEW, a peer-led harm reduction and recovery support organization, said in a press release that it’s “imperative to take decisive action to save lives.”

“In 2022, Rhode Island lost 434 lives to the overdose epidemic,” Daley Ndoye said. “This overdose prevention center is a pivotal element in the state’s comprehensive efforts to combat this crisis.”

Both organizations say they’re “committed to working closely with state, local and community leaders before and during the center’s operation,” noting that the Providence City Council “has provided public support of the project.”

On Thursday evening, the council officially approved plans for the facility on what appeared in video to be a unanimous voice vote, with a number of members speaking in favor of its role in the community.

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“This is going to be located in my ward,” said Deputy Majority Leader Mary Kay Harris (D). “I’m very proud of an agency that I know is going to make an impact on the lives of people and change the lives of people who have been suffering in each and every one of our neighborhoods.”

Senior Deputy Majority Leader John Gonclaves (D) said that “Providence is leading the way. The state is also leading the way on harm reduction.”

“When we think about overdose prevention, when we think about substance use disorders and we when we think about the challenges associated with it, specifically here in the city of Providence, this is really a game changer,” Gonclaves said.

Majority Whip Miguel A. Sanchez (D) said the approach is based on “data driven policy that is working in other countries, in New York City,” adding: “It does save lives.”

“Drug use in public places makes folks uncomfortable, right?” City Councilman Justin M. Roias (D) said simply. “And so if that’s the case, then we should find an alternative. And that alternative is: Designate safe-use sites.”

The center is being opened under legislation enacted by Rhode Island lawmakers in 2021. That law, which was signed by Gov. Dan Mckee (D), authorized a pilot program for the sites that’s currently set to expire in March 2026. Project Weber/RENEW said that window should provide “the necessary time for the facility to be opened, operationalized, and evaluated.” It’s funded with state money from an opioid lawsuit settlement.

Staff at the site, according to Project Weber/RENEW, will include “will include experts with lived experience with substance use and recovery, including peer recovery specialists, counselors, and prescribers who can initiate medication for substance use disorder(s).”

Those with lived experience include the center’s two co-directors, Project Weber/RENEW Deputy Director Ashley Perry and Overdose Prevention Program Director Dennis Baller.

The organization already provides a suite of support services drop-in centers in Providence and Pawtucket, including access to naloxone and other safer use supplies; basic needs like food, water and hygiene products; HIV and hepatitis C testing; and connections with an array of other services such as recovery coaching and housing support.

In addition to supervised consumption, the new space will also offer laundry services and showers, the group said.

VICTA, meanwhile—an outpatient treatment program focusing on mental health and substance use disorder—will staff the center with “medical providers, nurses, and counselors on site to provide immediate access to services when an individual is ready for treatment,” the release says. “By offering ‘treatment on demand,’ people using the overdose prevention center can act on their key moment of readiness to initiate change.”

“We know that motivation can be fleeting, and that recovery is not linear,” said Lisa Peterson, VICTA’s chief operating officer. “We are committed to helping people stay as healthy as possible through every stage in their process.”

State officials at the Department of Health will oversee and regulate the center, and researchers from the People, Place and Health Collective at Brown University’s School of Public Health will seek to measure both individual and community outcomes.

Research, Project Weber/RENEW said, suggests people who visit overdose prevention centers are 30 percent more likely to access substance use treatment. Moreover, “Data has shown that no one has ever died at an overdose prevention center worldwide throughout the many decades of their existence.”

The group pointed to data from two overdose prevention centers operating under municipal authorization in New York City, noting that the sites “successfully reversed more than 1,300 overdoses in their two years of operation, with only a handful requiring emergency medical services.”

Late last year, in a little-noticed section of a report on the nation’s worsening drug overdose epidemic, the American Medical Association (AMA) urged states and local communities to consider allowing overdose prevention sites (OSPs) to operate as a public health strategy.

“At this point in the nation’s epidemic, the AMA urges states and communities to consider all evidence-based approaches to prevent overdose death and help connect individuals to health care and treatment,” it said. “The data shows that OSPs help reduce risky drug use behaviors, overdose and death while improving public safety and access to health care.”

Meanwhile the Biden administration has continued fight against efforts to open the sites. The Justice Department has stood in the way of a proposed Philadelphia overdose prevention site, for example, even as some in the two in New York City began operation with approval from local officials. The opposition has chilled some other jurisdictions from allowing similar centers to open.

But studies show the sites “save lives,” AMA said in its report, which found that nearly 3 in 4 people who used the centers did so instead of taking drugs in a public or semipublic location.

“Whether in Canada, Europe or the sites in New York City, thousands of overdose reversals have taken place while there have been no reported fatalities at the sites,” AMA said.

In November, a separate AMA-published study found that the New York centers have not led to increased crime, despite a significant decrease in arrests. While opponents had argued that establishing the harm reduction centers would drive crime, that study, in JAMA Public Health, found that “initial data from NYC do not support these concerns.”

A different 2022 JAMA study found additionally that, over the course of two months in the first year of implementation, trained staff at New York City’s first overdose prevention center intervened in 125 instances to mitigate overdose risk, administering naloxone and oxygen and providing other services to prevent a person’s death.

Even so, a federal prosecutor who has jurisdiction over Manhattan emphasized in a statement to The New York Times in August that the sites are illegal and that he is “prepared to exercise all options—including enforcement—if this situation does not change in short order.”

In 2021, the Supreme Court rejected a request to hear a case on the legality of establishing the facilities. The following year, the Justice Department said it was in the process of evaluating possible “guardrails” for safe consumption sites.

Congressional researchers in 2022 highlighted the “uncertainty” of the federal government’s position on safe drug consumption sites, while pointing out that lawmakers could temporarily resolve the issue by advancing an amendment modeled after the one that has allowed medical marijuana laws to be implemented without Justice Department interference.

Meanwhile, National Institute on Drug Abuse (NIDA) Director Nora Volkow has tacitly endorsed the idea of authorizing safe consumption sites, arguing that evidence has effectively demonstrated that the facilities can prevent overdose deaths.

Volkow declined to say specifically what she believes should happen with the ongoing lawsuit, but she said safe consumption sites that have been the subject of research “have shown that it has saved a significant [percentage of] patients from overdosing.”

Rahul Gupta, the White House drug czar, has said the Biden administration is reviewing broader drug policy harm reduction proposals, including the authorization of supervised consumption sites.

The National Institutes of Health (NIH) put out a pair of requests for applications in December 2021 to investigate how safe consumption sites and other harm reduction policies could help address the drug crisis.

Gupta, the director of the White House Office of National Drug Control Policy (ONDCP), has said it’s critical to explore “any and every option” to reduce overdose deaths, which could include allowing safe consumption sites for illegal substances if the evidence supports their efficacy.

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