Safe Injection Facilities — the Time is Now

Last weekend, the Massachusetts Medical Society endorsed the legalization of safe injection facilities.

I am the sponsor of a bill to create a framework for legal operation of these facilities. The bill is a conversation starter — it needs a lot of refinement as piece of legislation. But the bill speaks to a crying need, now that fentanyl is on the market being sold as heroin.

Safe injection facilities bear no resemblance to the chaotic shooting galleries where people die in the dark, slouched against bare brick. They are quasi-medical clinics where people check-in and then enter an adequately lit individual alcove and, while visible to trained professionals, self-administer the chemicals they have purchased elsewhere. Once it appears that they are not dying of an overdose, they can leave or go to a quiet place.

The facilities offer a unique opportunity to offer drug treatment and AIDS counseling. Properly run, safe injection facilities can be a tool, not only for reducing the harms of addiction, but also for fighting addiction itself.

Injecting a chemical one bought on a street corner into one’s blood – there are few more terrifying thoughts for most of us.

Yet thousands of people in Massachusetts do exactly that everyday – many of them with enough education to know that they are taking wild risks every single time that they do it: Risks of infection, risks of poisoning, risks of deaths from overdose. Even as obvious signs of harm emerge – ugly infected abscesses at the spot of injection, friends dying around them — they continue.

That is the essence of the disease: seeking pleasure or relief from compulsive need with denial of – absolute emotional blindness to — emerging harms. Safe injection facilities are a harm reduction strategy.

Harm reduction strategies are sickening to consider, because they mean accepting the reality of substance use disorder as a chronic relapsing disease – something that people don’t recover from because we tell them to, something that people don’t recover from despite their firmest personal resolutions, something that people don’t recover from even if we punish them for it.  Most people with opiate substance use disorders need medically-assisted treatment and huge ongoing support to have a shot at recovery.

Over the past five years, the death rate from overdose has tripled in Massachusetts. While opiate addiction has been spreading and is now tragically endemic among people of all ages, the death rate appears to be growing much faster than addiction.

Fentanyl is one of a family of highly potent chemicals which, in microscopic doses, feel like heroin and are now widely available on the blackmarket, often sold as heroin. Because they are so potent, they are heavily mixed with inert substances before sale. Mixes prepared by amateurs will inevitably be uneven – some doses from the mixture will be much more potent than others.

As reckless as they are, many addicts use some caution in the injection process and have a sense of their own tolerance and limits. With fentanyl though, they have no idea of what they are doing to themselves and that is why fentanyl is now the most frequently identified chemical in overdose deaths. With fentanyl rampant, we need safe injection facilities more than ever.

The real political challenge for creation of a safe injection facility is finding the private and municipal leadership to create one. In Vancouver, where they have a very well studied SIF, the political conditions may have been rather unique – there is a neighborhood with a very high concentration of drug users who organized themselves politically. In Massachusetts, it remains to be seen whether we have a neighborhood that is willing to host such a facility.

Until we have a concrete, professional proposal for a facility and the support of local officials, it will be hard for the legislature to focus on my proposed legislation.

Published by Will Brownsberger

Will Brownsberger is State Senator from the Second Suffolk and Middlesex District.

102 replies on “Safe Injection Facilities — the Time is Now”

  1. I truly believe that addiction is a disease. Perhaps someone made a wrong choice long ago, but they are at the mercy of the drug forever more.

    We should not be punishing people for having made a bad choice. We should be helping them.

    I support having safe injection facilities. Thank you for pushing this forward.

  2. Thank you for your leadership in this area. It is essential to keep people alive in order to help them. Also, removing intravenous drug use from the streets to safe injection facilities promotes public safety.

  3. I welcome your support of this life-giving measure. As we affirm the humanity of all persons, we support safe injection sites as crucial piece of the solution. Persons using these sites are more likely to be given treatment for the disease of addiction.

  4. Thank you for your compassionate approach to effective solutions to this public health crisis. I support safe injection facilities.

  5. Thank you for being ahead of the curve and being willing to take a political risk on this. People who are not familiar with addiction — lucky people — may misunderstand. Yes, let’s do this. Please keep me posted if there’s anything I can do.
    Janet Kenney

  6. A harm reduction approach is the current best, most humane approach to assisting people in their most vulnerable time. Our government should not treat drug users as an enemy to wage a war upon, but rather a neighbor to be cared for. I think the bill as written carries the fundamental principles of harm reduction (, and would be a great step forward in creating policy that treats drug usage as a matter of public health rather than human integrity (or lack thereof).

  7. I applaud your courageous stand on this issue, Will. I agree with this 100%. Please let me know if there is anything I can do to help support this.

  8. Sen. Brownsberger,

    Thank you for proposing this legislation. It should help to reduce the number of needless deaths and injuries from overdoses, and, consequently, reduce the burden of overdose-related medical costs on our healthcare system.

    I do have a few concerns for the implementation of any safe injection facility. First, what measures would be put in place to ensure that drug dealers will not start operating in the areas around such facilities, like has occurred with the methadone treatment clinic in Boston.

    Second, will there be any requirement for such facilities to provide education and/or addiction treatment options for those who use the facilities?

    Finally, will there be measures in place to ensure that anyone going to these facilities can do so without fear of prosecution, since such prosecutions do little to deal with the problems of addiction and would lead to fewer people going to SIFs, thus defeating the purpose of the bill?

    1. Yes. The core SIF idea is to provide treatment options at the facilities. And yes, we need to make sure prosecution is not a risk. That means collaboration with police in the development of the concept.

      As to drug dealers in the area. Yes, a real challenge to be considered in the context of a particular facility.

  9. I can’t help but think these facilities would serve as feeding stations for profit driven treatment centers. Is “medically-assisted treatment” code for lifelong treatment with toxic psychotropics? An uncomfortable truth: in our very own backyard, McLean Hospital prescribes them long-term, without informed consent, to people in its detox programs.

  10. Thank you for this, I think it is a good idea. A key thing you said is that people will do this even if we punish them for it, which is why punitive measurements for addiction behaviors don’t work. I mean short of them committing actual crimes of course. I hope Massachusetts can start a trend of treating addiction like the medical disorder it is. It is hard to feel compassion for addicts, but we have to act compassionately.

  11. I was very pleased to see you take the recent proposal of the Massachusetts Medical Society and turn it into a bill so that it can be vetted through the legislative process. We need to explore all means in dealing with the opioid addiction crisis and this may prove to be a highly effective tool in that effort.

  12. Inevitably, facilities like this will find their way to Central Square, Cambridge and further solidify its unwanted role as the place where junkies go for everything. I am generally supportive of the concept, but I hope at least some effort is expended to ensure that Central Square doesn’t have to continue bearing the burden of every problem relating to substance abuse.

    Perhaps a Belmont location could be considered.

    1. The location is the challenge: I understand that people typically won’t bother to travel more than a few blocks to a facility. So, it needs to be in a place where there are lot of people who might need it.

  13. I question how many intravenous drug users would use such a center.

    And if they expressed an interest in using one, how close would the center need to be for them to actually use it?

    And then there is the liability. I doubt a private organization would consider opening a business were people could come and inject drugs they bought on the street, and if the drugs were bad, the workers will try and save your life. Because the first time someone dies at your facility, you have a wrongful death lawsuit.

    1. >I question how many intravenous drug users would use such a center.

      We don’t have to wonder. We have data from jurisdictions that have already done this. And the data say that the facilities are well-used.

      >And if they expressed an interest in using one, how close would the center need to be for them to actually use it?

      That seems like an argument to build enough facilities to meet the need, or at the very least to prioritize building facilities in areas with more of a drug problem.

      If you think there aren’t any locations where such a facility could be built in Massachusetts that would not be within easy distance of many addicts, then you are greatly underestimating the scope of the addiction epidemic.

      Also, being unable to build such facilities in close proximity to all addicts is not an argument against building such facilities. This is not an all-or-nothing situation. Helping some addicts is better than helping none of them.

      >And then there is the liability.

      It seems clear that if/when a law authorizing such facilities is passed, it can and will address the liability question.

      In short, these are not substantive arguments against building safe injection facilities.

      1. I am not arguing against building them, I am asking if it is feasible and useful to build them.

        Despite popular belief, there is a limit to our resources. I just question whether the people who might use the facility would actually do so. The teen user might not think he needs to, the business professional might be afraid to because of job loss and the user on the other side of town might not go because of how far it is and I’m not sure for public safety reasons whether we want some guy driving across town after injecting anyway.

        If you build it, they may not come?

    2. They are most likely to use a facility when they have a new product and they aren’t sure about it’s potency and when the facility is not too far away. The liability is something that does need to be addressed in the legal framework.

  14. MGL Chapter 94C Sec 35 needs to be revisited in light of this effort:

    Section 35: Unlawful presence at a place where heroin is kept or being in company of person in possession thereof

    Section 35. Any person who is knowingly present at a place where heroin is kept or deposited in violation of the provisions of this chapter, or any person who is in the company of a person, knowing that said person is in possession of heroin in violation of the provisions of this chapter, shall be punished by imprisonment for not more than one year or by a fine of not more than one thousand dollars, or both; provided, however, that the provisions of the third paragraph of section thirty-four relative to probation sealing of the records and repeated violations shall apply to him.

  15. Thank you for taking the lead on this — it’s a complex problem, and having safe spaces like what you are proposing is an important step in the process of dealing with it. I definitely recommend finding accessible locations, and I hope you won’t encounter too much of a NIMBY attitude, because it’s becoming increasingly obvious that addiction is spreading across socioeconomic lines rapidly and needs to be dealt with in a diverse variety of communities.

  16. Hi Will,

    I’m all for anything that improves safety. My question is: do we ever have enough Treatment beds–e.g. Long term residential tx beds beyond a month’s stay that help users not only get off the drugs, but help them with jobs and housing?

  17. I totally support this concept as well as the legalization of all drugs and for more treatment centers. I also support the legalization of prostitution which ties in to this.

    The best way to save people, to keep young kids out of drugs and prostitution is to legalize drugs, have safe places for them to do it and provide treatment.

    Legalize all, regulate all and tax all and provide treatment for all. Stop jailing non violent individuals and lets just put those who are violent in jails.

  18. A welcome development from my perspective Will. Treats the issue as the public health epidemic that it has become. I have no issues with harm reduction as an organizing principle. I believe they have had such an approach in one or more of the Scandinavian countries as well, and have far fewer overdose deaths. Good friend lost his 23 year old son to this plague a year ago, and I see the devastation in my work as well. Appreciatre your courage to endorse this dialogue, as many will object.

  19. No. Totally inappropriate normalization of abuse.

    I am very disappointed in you for this and am removing my support for you.

    My tax dollars should not go to support people who wish to waste their lives. You are a fool.

    1. Your tax dollars pay for the epidemic of addiction in this country in countless ways.

      All the data we have suggests that treating addiction as a disease, rather than blaming addicts as “people who wish to waste their lives,” leads to a reduction in addiction and public expense.

      In other words, centers like this save taxpayers money in the long run rather than costing them more money.

      Regardless of whatever problems you may have with the morality of drug use, and regardless of whether you are able to find within yourself the compassion to understand that drug addicts are not making a free choice to waste their lives, criminalizing drugs and blaming addicts has unquestionably proven to be failed policy.

      1. I totally agree with you, Jonathan. Natalie’s point of view is actually detrimental to her own cause. By stigmatizing and punishing addicts, all you’re doing is increasing the negative effects that addicts and addiction have on the community. Forcing these people into the shadows leads to increases in crime, increases in the existence of “shooting galleries” (which ultimately drive down property values) and increase usage of emergency services (making them less available to the general public).

        Even if you have zero compassion for anyone else, it’s STILL the pragmatic thing to do to try and bring these people out into the light where they might actually get help, rather than forcing them underground where they will ultimately do greater harm.

  20. Will,

    After visiting the Insite Injection Site in Vancouver I was convinced. It was opened in a high drug use area, across the street from police HQ, with support of both the Chief and Mayor. Insite is open 24/7 and has never had a fatality from an overdose.
    Those using the facility provide their own drugs, Insite provides only a safe place. Drug counselors are always on duty.

    Tom Neel

  21. I would support this, maybe. I’m concerned about an increase in drug dealing and crime in the neighborhood where it’s situated. I’m concerned that you see the “state” as being the main player for, as you put it, “the huge ongoing support to have a shot at recovery”.

    Where do 12 Step support groups fit in here? Like AA, NA? Addicts who see long term recovery are able to get support through these peer support organizations. And it’s free! I suggest that your proposed facilities have, at the very least, an onsite meeting space dedicated to AA and NA meetings. You could easily get outside 12Step groups to come in and put on meetings. I also suggest, in particular, one of the 12Step groups that does meditation meetings. ( Familiarize yourself, for instance, on the 12Step Meditation group meeting at Boston Medical )

    I think it’s very important from the “get go” to incorporate elements of personal resposibility for the addict. Because all of the good will and help from the state can in fact be enfeebling in the long run. An addict gets better in the long term when they realize they can flex their own personal responsibility and take the steps to get’s an issue of healthy pride and spiritual growth. The state can’t supply that to addicts. However, 12Step groups often can.

    1. Perhaps I am confused, but I see inherent contradiction and even danger in 12-step groups like AA and NA being co-located in a safe injection facility.

      Thank God, I’ve never been addicted to anything and don’t have any first-hand experience with 12-step groups, but my understanding is that their philosophy does not accept that there is any “safe” usage of addictive substances.

      Safe injection facilities therefore occupy a markedly different role than 12-step programs in terms of how institutions help addicts.

      Furthermore, it seems to me that if I’m a recovering addict struggling to stay clean, a safe injection facility is the worst possible thing for me to go anywhere near. Putting NA meetings in such a facility would be like putting AA meetings in the back room of a bar.

      1. You bring up some good points. My main concern is that this clinic will in fact be “enablers” to the addict’s drug use. I see it as a moral hazard. I wish there were a strong counterpoint to that, hence, 12Step groups.

        Although, it is well known that active users often attend 12Step groups, sometimes for long periods of time. Some of them eventually get sober. To my knowledge, none are shunned at meetings. Because every addict in the room knows the hell that that active user is living in.

        I simply want to float the idea of having a treatment aspect at the same clinic. Because I’m uncomfortable with normalizing what will basically be a safe shooting gallery.

        As an example, I know folks who achieved long term sobriety through a program housed in a trailer on the grounds of Cambridge Hospital about thirty years ago. It was an acupuncture detox service. Wonderful, wonderful place. Run by MAPS ( Mass Association of Portuguese Speakers). It served many needs- from helping the addict to detox, to helping through early sobriety which included sleep problems, etc. By it’s welcoming, warm presence it created a place for isolated addicts to converge and get not only acupuncture treatment but also very important ongoing social support.

  22. This is a rational and sensible — and courageous — measure. Kudos to you!!

  23. I think this is a great idea, but I’d actually like to see it taken further. It’s clear that we need to stop treating drug addiction like a crime and start treating it like a disease. I’d love to see harm reduction clinics that offer a wide variety of resources to help reduce harm to addicts. Safe injection facilities, needle exchanges, NARCAN, anything that might help an addict survive until they are ready to pursue and receive treatment.

    These clinics could also offer voluntary education services to help addicts understand the tools at their disposal to get clean if they want to. The war on drugs has failed. We lost. It’s time to take a different approach. We need to remove the stigma associated with being an addict to allow them to come out of the shadows and into places where they can receive the support they need to stay alive long enough to turn things around.

  24. Hi Will,

    Thanks for standing on the side of compassion (and data!) against the deadly danger of stigma and shame.

    I’m curious – is there a pragmatic reason to limit a facility like this to those who specifically use fentanyl and other opioids, or would it be possible to offer safe injection to users of (e.g.) injectable amphetamines, cocaine, steroids, etc.? While the opioid crisis is at the forefront of a lot of minds (and for good reason!), I think there’s an opportunity to do even greater good here, unless there’s a logistical consideration that I’ve overlooked.

    1. From reading what Will wrote above and also the text of the bill he introduced, I didn’t get the impression that there was any intent to limit the facility to only certain drugs.

      Can you point out what Will wrote that gave you that impression? I.e., please help me see what I’m missing. 😉

    2. I don’t know of a reason that one would limit a SIF to a particular drug. One caveat though: They work best for injectables that are fast acting. If someone has ingested pills, they may not fully enter the blood stream until later and the person may have left the facility.

      1. Will – that makes sense, thanks.

        Jonathan – sorry, didn’t mean to imply that Will’s proposal was inherently restricted to opioids. But since it was very much framed in terms of fentanyl and a response to the opioid crisis, I wanted to make sure I understood whether that was just because it was the most salient example, or because there actually was an intent to restrict the SIF to one particular substance. (And if the latter, why.)

        Curiosity satisfied. 😉

  25. I was very pleased to see your name in the newsline mentioning this bill. (I’ve been disappointed by the unthinking opposition from police chiefs (mentioned in previous stories); they need to look at what actually reduces problems rather than assuming they can do everything with force.) Obviously there is a lot to work out — particularly including whether anything can be done to reduce drug sales in the immediate area — but this is a necessary step, not just a humane one.

    I’d also like to thank Jonathan Kamens for temperate, fact-filled responses to comments I would have snapped at; this is an issue for thought, not reaction. With specific reference to NA, I would like to see the injection centers develop their own program towards getting people out of addiction without requiring any acknowledgment of a higher power; I see this requirement as a great weakness in NA.

  26. Thanks for taking leadership role on this issue. New approaches are needed in the space. I want to see MA lead and innovate in taking on the narcotic epidemic rather than double-down on failed ideas.

  27. Will,

    I certainly understand that your injection facility proposal comes from the very best of motives (and from frustration over how intractable this problem is.) However I cannot see how removing disincentives to drug use can serve the goals of reducing addiction in the long run. This proposal lends the state’s imprimatur to shooting up, provides cover for drug dealers and their worst practices. Overall, it makes drug use more acceptable, helps people rationalize their drug use and makes the state an enabler of addiction.

    I know your heart is in the right place, but please reconsider. This is about as perverse a proposal as can be imagined! Let’s put our resources into treatment and not into making addiction kinder, gentler, more attractive and even more widespread.

    1. Thanks, Kiril.

      The argument you make has a compelling logic to it — if you make drug use safer, more people will do it. But the reality is that drug use is incredibly unsafe and people do it anyway. So, we might as well try to reduce the carnage. And, while doing it, we’ll get near enough to help.

  28. This will be a life-saving measure and is much needed. Thanks for introducing this bill. Yesterday on WGBH, Senate President Stan Rosenberg said he is open to learning more, but he didn’t sound convinced quite yet. I trust you will be working to educate him and the rest of the senate. Time to take shame out of our public policy and treat the opioid crisis as a healthcare emergency, not as a criminal matter.

  29. I fully support the establishment of safe injection sites. As an LICSW who treats addiction, I’m intimately aware of how difficult the process is for getting an addiction under control. The primary benefits of safe injection sites are:
    1. Keeping a person alive until they are ready to begin treatment
    2. Shortening the period of time between relapse by keeping the person connected to care givers
    3. Connecting people struggling with addiction to health care workers and addiction treatment specialists, thus increasing the opportunities for support and access to treatment
    4. Effective PH intervention based on evidence based practice

    I’ve been feeling angry and frustrated by the apparent renewed commitment to the simplistic, ignorant notion of “solving the opioid crisis by locking up the drug dealers” – It’s as if our communities and leaders are in a perpetual state of amnesia and are willing to completely disregard the lessons learned from the previous decade. Thank you for taking this step, Senator. We will only make progress together by using logic and factual data to solve the problem of addiction. We are doomed to failure and more loss of life if emotions and ignorance are allowed to determine public health policy.

    1. As a professional, you are focused on the addict. But the addict population is not the only one our policies must address. We must also think about the people who are not currently users but are at risk. Anything we do to normalize drug use, make it seem safer and more acceptable and remove its disincentives will encourage more people to try drugs and become addicted. In the end this proposal is self-defeating and muddles where the state and the medical establishment stand on drugs.

      1. >Anything we do to normalize drug use, make it seem safer and more acceptable and remove its disincentives will encourage more people to try drugs and become addicted.

        That assertion is not borne out by the available data or the experiences by jurisdictions which have already done what Will is proposing.

        The data show that initiatives like safe injection facilities reduce addiction in the long term rather than increasing it.

        The data show that treating drug addiction like a disease rather than a choice reduces addiction in the long term rather than increasing it.

        Stigmatizing drug addiction does not reduce drug addiction. Stigmatizing drug addiction does not prevent people from becoming addicted to drugs. Rather, what it does is prevent them from getting help to end their addiction. What it does, ultimately, is kill many of them.

        If you would like to advance the opposite argument, please present data supporting the point of view you are espousing.

        Here, I’ll start:

        1. Jonathan,

          The paper you cite has NO information on the effect of the drug injection facility beyond a short statement “that [there was] no observed increase in new initiates into drug use.” Otherwise the paper deals exclusively with the benefits of the facility for addicts. And maybe in the short term there will be such benefits. However I am very concerned about the harm that official sanctioning and even facilitating of drug use will do to the community overall, including the community of those that are at risk but not yet users. If you can offer any material addressing this issue, I would be interested.

          1. Nope, sorry, not going to fall for your sealioning (

            The paper cited supports my argument. It may not support every piece of my argument, or support my argument exactly the way you unreasonably demand that it do so, but it supports my argument.

            You have provided no data or evidence whatsoever to support your argument.

            Furthermore, it is reasonable assume, based on Senator Brownsberger’s long track record consistent with this assumption — that he has done extensive research before deciding to take the position he has on this issue, and that all of the assertions he has made above about the efficacy of safe injection facilities are supported by evidence, or he would have taken the position he has taken.

            So no, I’m not going to waste my time discussing this issue with someone who thinks they can advance arguments without any obligation to support them, when said arguments contradict the recommendation of someone who is without a doubt more knowledgeable about the issue under discussion then they are.

            If/when you provide some evidence to support your argument, then I will be happy to discuss it with you. Until then, no thank you.

  30. These people desperately need to be in hospitals and rehabilitation facilities, not in some neighborhood drug house. It is frightening how radically far left your viewpoints have become. Your proposal will do nothing to help chronic drug users recover, or give them a chance to someday be clean. It will only further enable the progressive course of an eventually fatal disease. Do you realize what you are proposing and how it could put many of your constituents in potential danger? Do you think we are naïve enough to believe these facilities will not eventually be providing shelter, beds, food,and drugs for those desperate users who have none? Where do you think the drug dealers will focus their presence? Right near their constant source of customers!How could you do this to one of our neighborhoods? You are talking about permitting HARD CORE DRUG use in our communities!! This is dangerous, immoral, irresponsible, and illegal. You will be providing a means for helping people to continue destroying themselves. Maybe we would not have such a growing narcotic drug problem in this country if we did not let every drug dealing criminal walk across the border and then protect them after they arrive, or release convicted dealers back on the street because they are “non-violent criminal” offenders. You support all that feeds this epidemic. Why don’t you stand with law enforcement and work to cut this growing drug supply at its sources before it poisons and addicts our fellow people and the youth? Where are your proposed bills to support getting these fiends and their lethal drugs off our streets for good? Your compassion has clouded your common sense and rational thinking. I think you are really losing touch with many you have been elected to serve.

    1. You couldn’t be more wrong. Harm reduction programs keep addicts alive long enough for them to actually get help. These facilities do not provide drugs to anyone (unless you count NARCAN, which saves the lives of those who might otherwise overdose). In states where these programs are most effective, the centers have a good working relationship with the Police to prevent drug dealers from stalking the facilities.

      If you’re so worried about morality, maybe you should look at yourself. The immoral thing would be to keep sending these people to prison (where they unfortunately have access to the same drugs) or worse, allowing these people to keep dying rather than offering them the kind of help that has been PROVEN in states like Washington to be extremely effective.

      1. Maybe you should read before you write. Nowhere in my statement do I advocate imprisoning drug addicts.

        1. Maybe YOU should read before you write. I never said you did advocate for it. What I DID do is point out the truly immoral course of action, since you seem to think that trying to save lives is somehow immoral.

          The world isn’t perfect and unfortunately there are people who become addicted to serious drugs for whatever reason. We can ignore that reality and pretend that they are not already using hardcore drugs in our community or we can accept the reality that these drugs and drugs users are here and try to help them stay alive while also giving them regular access to people who can ultimately help them get off drugs.

  31. Go for it!! Being a heath care provider, I know the effects of fentanyl. I know that it can stop respirations in large enough doses but it only lasts for 10″or so. Long enough to kill someone but not to have long lasting relief from withdrawal.
    Naloxyn completely reverses all of the narcotic in the system so the drug abuser must feel that she/he is in a very scary place.

  32. ARE YOU SERIOUS? sounds like you are trying to corner theorganized drug user vote.

    1. ARE YOU SERIOUS, MR HOOVER? Do some research. These programs work. They save lives and actually lead to a reduction in usage over time.

  33. As usual, Will, a strong, well-reasoned, compassionate and courageous approach. Much appreciation for your taking the lead on this.

    Lee Humphrey

  34. Senator,

    I fully support the idea of creating a safe injection facility, as long this site sits directly across the street from your home. After your car is broken into and your home is burglarized, then you will change your tune.

    Most drug addicts I know are cunning con artists who will do or say anything to get access to more drugs.

    The first step to recovery is to put down the substance. This is not a good idea.

  35. People (like me) who worked in drug treatment programs have wanted this for years. It should have been passed when needle exchange was done. Better late (for some) than never (for many already).

  36. Dear Senator Will: Harm reduction activities are not sickening. They are the only thing that works. Addicts have to be exposed to sobriety in a positive context (for them) and offered a reason to quit and help to do it. They are labor intensive and need all kinds of help, but they can be saved. My husband, who was a street addict for 35 years, homeless a good part of the time, is now clean and sober for about 14 years on subuxone, therapy, meetings and support at home.. He used to work as a drug counselor and in the Cambridge Needle Exchange and now is writes for subject for Spare Change News. He will send you an article he just wrote on the topic under separate cover. If you ever need a speaker on harm reduction or some aspect of it, or a success story of a man who spent 35 years in hell and who now has more than he ever dreamed, he would be happy to speak for/to you. As would I. Thank you so much for your fine work. It needs doing and it isn’t easy. Kudos.

  37. This is the most compassionate approach to the epidemic, but it will be hard for some people not to judge.
    My son has been on the streets more than once, and with medical treatment font clean, sober and employed. Bless the people that help him and others.

  38. I have friends, in Belmont, who’ve lost children/friends/other relatives, to synthetic fentanyl. There are ore much more lethal drugs, killing many, everywhere. Addiction and mental illness are diseases and should never be judged.

    Many choose to be ostriches and live in a nescient bubble. The Belmont police are more than aware of what’s going on, and do their best. There should be no challenge in terms of creating an SIF, in many towns and cities across the U.S.

  39. Thank you Will for this forward thinking approach. I know it’s not practical right now, but I think we should aim for emulating the Swiss, who have been dispensing heroin to registered addicts, who without the burden of cost, can then live regular lives. By dispensing heroin, the Swiss make it much less appealing to young people.
    “In 1994, 77.5% of heroin recipients were under 35. In 2011 only 17.4% were under 35. In 2012 the average age was 42.2. ”
    here is one article:

  40. Thanks Will.

    On target and well put.

    Legalize substances and treat disease and no harm.

  41. I am so happy that you are proposing this legislation. It is so important.

  42. A couple facts:

    Fact 1: this WILL NOT lead to an increase in illicit drug use. Period. That’s just not debatable (see Portugal).
    Fact 2: everything you think you know about substance addiction is wrong.

    Here’s a 15 min TED talk anyone who thinks they know anything about addiction should watch; and if you’re just making assumptions and have never studied anything about addiction but you’re commenting here and you vote on these issues NEEDS to watch.

  43. It’s good to see so many people excited (pro & con) about your proposal. Such conversation almost always helps a good cause, which a safe injection site certainly is.

  44. Where will people get the drugs to inject at these “SAFE”injection sites?
    Maybe we should have safe rehab facilities where addicts can go to get clean

    1. >Where will people get the drugs to inject at these “SAFE”injection sites?

      Where do people get the drugs to inject now?

      >Maybe we should have safe rehab facilities where addicts can go to get clean

      It’s not either/or.

  45. I am pleased with your proposed initiative and forward thinking. State injection facilities would be an excellent initiative to begin the process of providing a safe environment for those addicted and the first step in initiating a process of recovery.

  46. Looks like you have given this a lot of thought. This need has been neglected for too long.

  47. Sen. Brownsberger,

    Have you spoken with the leadership of our hospitals and clinics about their role in providing similar resources? If places like MGH, BWH, and local health centers can be properly trained and set aside some space for safe injection, this could greatly help with infrastructure costs. Further, health care facilities are equipped to deal with the more serious sequelae of overdoses.

    1. The time is now for such facilities. Waiting for a facility to be constructed means more lives lost while waiting. We have hospitals available now that could and should provide such services so that these services are presented throughout the Commonwealth as this opiod epidemic rages, it knows no limits to geography, it doesn’t discriminate in any one neighborhood – it is rampant in every city/town throughout Massachusetts. I support this measure!

  48. Drug Injection Clinics: Why We Need Them Now
    By Marc D. Goldfinger

    There are some people who are I.V. drug users who are not ready to stop using. Others are. But abstinence aside, a medically monitored, safe place to shoot up is a great idea that can save lives. Opiates are difficult to quit and there is more than one way that people get clean. I know because I was a heroin addict for over 30 years. Even when I wanted to stop, I did not have the wherewithal to make such a major life change. I would stay abstinent for a few years, and then relapse again. This happened a number of times between my first recovery and 2004, when I started on a Suboxone regimen that enabled me to stay clean and sober for 13 years now.

    There are many ways shooting drugs can kill you; many of my friends have died of overdose or because of improper injection techniques. Getting high seems simple, but there are many complex factors to consider, all of them of a medical nature. This is why Injection Sites monitored by health workers are a necessity in today’s world.

    I remember once when I was at a poetry reading in a church, and I went into the bathroom and injected my heroin. Suddenly, darkness closed in all around me and I dropped to the floor.

    I was lucky because I realized I had overdosed and struggled to maintain consciousness. I stumbled out of the bathroom, unlocked my bicycle, but I was too twisted to ride. I staggered down the street with my bicycle, fell over, got up, and staggered some more.

    I knew that if I stopped moving and just lay on the ground, I would die. I was one of the lucky ones who made it through the crisis. If I had had an access to a Monitored Injection Site, I could have gone there to shoot up safely.

    It sounds like an oxymoron —“shoot up safely”—but that is what I used to teach people when I worked at the Cambridge Needle Exchange. Shooting up is dangerous. Never shoot alone. Always use a clean needle. Use alcohol where you shoot. Whenever possible, know your dealer and ask how the dope is.

    Of course, most dealers will say “this stuff is a smoker”, which means that it is powerful dope because they are selling a product and nine times out of ten, they are addicts themselves and want to keep their customers because their customers keep them in dope too.

    Then there’s the other side of the picture. Because we’ve made heroin illegal, people who have never had any medical training put the bags together in dingy apartment buildings. What this means is that when you dump the bag in the cooker, you have no idea what you’ve got. You mix it with water and assume there is something there that will get you high.

    Maybe you’ve used that cotton in the spoon to filter the dope and water mixture more than once, and so bacteria that are not supposed be there get into your body. Alternatively, when you stick a needle in without swabbing your skin with an alcohol pad, skin bacteria can enter your body.

    When you push the needle into your vein, you may push the bacteria into your bloodstream, which is your lifeline. That’s why people who shoot dope without proper sterilization techniques can get a heart disease called endocarditis. This is why Injection Sites monitored by health workers is a necessity in today’s world.

    People are not going to just stop shooting dope folks, regardless of how many wars we start. But they are going to need to be taught the proper way to do it, if we want them to live. This is called Harm Reduction. Harm Reduction keeps people from dying. If you die, you can never recover from the illness of addiction.

    I’m not saying that everyone who goes to an Injection Site will stop shooting dope eventually. But, at an Injection Site, people can be exposed to the principles of recovery. And they will live long enough to consider all their options.

    Recovery is the disease of addiction going into remission. If you die, your chance of going into remission is over. We can save the people who use dope by injection if we want to. Every user is someone’s son or daughter; maybe someone’s wife, husband, mother or father. Do we have the courage to keep them alive?

    We don’t want these people to die. That is why the time for safe medically monitored Injection Sites has come. Recovery won’t happen the first or second time. It takes a while. I’ve been in recovery full time since 2004 with the help of support groups, Suboxone, my wife Mary Esther, and a therapist. But the first time I entered recovery was in March of 1994.

    A safe, medically modeled Injection Site could save many lives—maybe your son or daughter, or your own. People who really understand the illness of addiction support Harm Reduction. The time is now.

  49. Asking for clarification, I may have missed this in the different articles, so if I did please forgive me and point me in the right direction and I’ll take a look! Are there any studies on the utilization rates for SIF’s? How will these center’s be identified in the community to be able to be utilized? Are there specific communities in Massachusetts that are being focused on for a pilot program?

  50. If you are skeptical about “safe injection sites” you are in good company. And you should read what Wikipedia has to say about Insite, the safe injection site in Vancouver BC in operation since 2000. The research citations about the work done there, accomplishments, and success will blow you away. Just read it, and be a skeptic.

    NOW: Insite is not the kind of place you would want to hang around too long, it is depressing, and it is in a sketchy neighborhood like where drugs are sold on the street in Boston. BUT, Insite is definitely the kind of play you would want a family to be who was using and wanted to be safe. That is the word … S A F E … , not just secure from threats, but with medical supervision. Worth giving a try, don’t you think,?

    My sister and I visited Insite after a family member who had been an addict, and we thought recovering, died just 4 years ago. If he had access to a place like Insite he’d still be with us.
    Insite opened and, at first, treated addicts who had been unresponsive to methadone treatement. Insite does NOT provide heroin, the clients arrived at the door with what they planned to use. Bad drugs were rate in the city because now attention is being paid, and the police watch too.
    Insite is located two blocks from police HQ in downtown East Vancouver, and it had their full support at the beginning because it solved a problem the police could not solve!!
    Addicts were not dying, stealing, or causing their usual social mess. Some of them are working, smiling, have jobs.

    There is a treatment center on the second floor of the building, and a short-term residential center on the third floor upstairs. Everyone on the staff we met had been an addict.
    You need to give credit for success.

    Be informed before deciding.

  51. Gabor Mater is the Medical Resident at the Insite Supervised Injection Facility in Vancouver BC.
    Listen to his TED talk, what he says … about the power of addiction.
    He admits he is an addict ~ to classical music, collects CDs, he spent $8,000 on them in one week and … , well listen and find out for yourself!!

    If you want to read more … get his book ~

  52. Provide a safe environment for people affected (voluntarily or involuntarily ) to use drugs seems to be a good idea. It provides a better chance of saving lives. But I strongly dis-agree on being soft on drug dealers. Those people who sell drugs for a profit should be considered the worst criminals to our society and they should be jailed and severely punished.

  53. The Criminal Justice Policy Coalition’s position on safe injection sites

    The Criminal Justice Policy Coalition is in favor of establishing safe injection sites across the state. Safe injection sites save lives. According to the Massachusetts Department of Public Health’s latest overdose numbers, the projected deaths from opioid overdoses are on average six users a day. Six unnecessary deaths every day.

    A safe injection site with a trained medical professional, equipped with Narcan and Fentanyl test strips, is our best hands-on defense against these unnecessary deaths. For definitive measurements, more research is underway in Canada, Europe, and Australia and the Commonwealth should study the results. In the meantime, it follows that the return on investment for these sites pays in lives saved.

    For more information, see the following sources:

  54. Has anyone suggested providing fentanyl test kits to SIF users? Could be a way to further reduce overdose onsite.

  55. The time is now for such facilities. Waiting for a facility to be constructed means more lives lost while waiting. We have hospitals available now that could and should provide such services so that these services are presented throughout the Commonwealth as this opiod epidemic rages, it knows no limits to geography, it doesn’t discriminate in any one neighborhood – it is rampant in every city/town throughout Massachusetts. I support this measure!

  56. Is there any evidence that these facilities ever result in a cure? Otherwise, we are spending more resources on normalizing criminal behavior.

    Also, what is the success rate in rescuing someone who has injected fentanyl?

    How many people have been “saved” by these facilities who would not have been saved by the EMT’s?

    Will you start giving them bus passes so they can get there? Why not just set them up in massive housing facilities so they aren’t in the street at all?

    Where does it end?

    1. The thing is that they really are a way to get people into treatment. They create an opportunity for positive engagement.

      But you make a good point when you ask whether people will go there. The evidence as I understand suggests that people will not travel far for this, so you have to locate them where there is already a large population of active users. That limits the options substantially.

  57. Wouldn’t a better solution be to assist drug users in testing the drug they plan to administer first…instead of having a team or facility created to encourage the actual administration of the poison and THEN save them after they inject it? Forgive me but this bill seems counterintuitive to me. While there would be opportunity to educate and potentially capture a few lost souls if we were to provide a safe place to inject…a more prudent solution would be to offer a safe way to test the drug…give them some encouragement and immediate solution for prompt initiation of a withdrawal free and comfortable detox process with a plan to graduate to a recovery program instead? Wouldn’t a drug testing system be more efficient and far less costly?

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