RIPR Exclusive: Injection Sites Proposed To Curb RI Overdose Deaths

Jan 23, 2018


The Rhode Island Medical Society says it is time to consider a new approach to reducing drug overdose deaths: supervised spaces where drug users can inject heroin or other drugs.

The professional association -- representing some 5,000 physicians, physician assistants and medical students -- organized a private meeting at its offices last Friday to vet the idea.

The participants included local hospital officials, medical researchers and treatment providers.  A member of Governor Gina Raimondo’s policy staff participated in the meeting via speakerphone, Steven R. DeToy, director of government affairs for the Rhode Island Medical Society, confirmed Monday.

The invitation to the gathering, e-mailed to more than a dozen people including state health officials and labor union officials, read:  “SHOULD RI ALLOW A COMMUNITY TO ESTABLISH A SAFE INJECTION FACILITY (SIF) as part of a harm reduction strategy to save lives?”

“It’s a logical move,’’ DeToy said Monday. “I don’t know if it’s going to be particularly politically popular, we reduce hopefully the number of people being exposed to opioids through prescriptions, we still have a large community that continues to use opioids. And we need to figure out how to get them into treatment.”

Support for the sites, is far from unanimous. Law enforcement, elected officials, and the federal government are divided over the legality of safe injection sites.

Joseph Wendelken, spokesman for the State Health Department declined a request for an interview, but said in a statement that safe injection sites in Rhode Island face numerous federal hurdles.

“New research and different harm reduction interventions are constantly being evaluated in Rhode Island,” Wendleken said in a written statement. “However, when it comes to safe injection sites specifically, there are currently a lot of federal law enforcement barriers that would need to be addressed before we as a state could start to engage.”

Creation of safe injection sites in Rhode Island would likely require General Assembly approval of enabling legislation.

“We would hope the proponents would ask us to weigh on language prior to a bill being introduced,” said Rhode Island Attorney General Peter Kilmartin in a statement to RIPR. “So we can not only ensure safeguards for individuals, but also to avoid unintended consequences, not the least of which would be giving immunities to drug dealers who are distributing deadly fentanyl and heroin cocktails.”

The Rhode Island Police Chiefs Association declined to comment on the possibility of such sites locally.

The Massachusetts Medical Society has proposed a pilot program to create safe injection facilities in the Bay State. The idea was met with skepticism from the state's governor, Charlie Baker, who was asked about the idea at a legislative hearing earlier this month.

"The biggest problem I have with it is as far as the data I see is concerned, it has not demonstrated any legitimate success in creating a pathway to treatment," Baker said.

Safe injection facilities have been used since the 1980s in Europe, Canada and Australia but until recently have not been openly debated in the U.S. But that’s changing. As the opioid epidemic rages on -- killing more Americans every year than automobile accidents -- states including California, Maryland Vermont and Massachusetts are considering legislation to permit these sites as part of a harm-reduction strategy.

The approach is often compared with needle-exchange programs for IV drug users, which aim to reduce the spread of diseases associated with drug use. (Rhode Island was among the first states to adopt needle-exchange programs.) Supervised injection facilities are staffed by medical professionals who provide sterile needles and monitor users to prevent overdoses, and offer support services and resources for treatment.

In Rhode Island, proponents of supervised injection facilities say staff also could provide testing for the presence of fentanyl, a synthetic opioid linked to more than half of all overdose deaths in the state.

“If you’re on the streets, and you’re using whatever you can get,’’ DeToy said, “chances are in Rhode Island you’re going to have some fentanyl in it, and you’re not going to know about it.”

updated Wednesday at 11:00 a.m.