Spokespeople and public officials remain at conflict.
The Somerville safe injection site opening has been delayed to 2021, as the city shifts resources to COVID-19.
The site would be a place where IV drug users can come and inject themselves with their own drugs around medical supervision—a bold stroke in Massachusetts’s fight against the opioid epidemic.
Dr Mark Eisenberg, a primary care doctor in Charlestown, has experienced the carnage of the opioid crisis firsthand. He is a strong advocate and organizer for this safe injection site.
“Right around … 2003, Suboxone (a drug prescribed to ease withdrawal symptoms) became available, so I started prescribing Suboxone. And we developed this great team of providers, so we had a full-time recovery coach, an addiction nurse, social workers, psychiatrists, interns. We had this great team put around our patients, we were prescribing medication, but despite that, for some patients, that doesn’t work,” Eisenberg told DigBoston.
“Sometimes they have a period of sobriety and something bad happens, their parent dies or they lose their job, or something, and they go back to the pattern from before and use drugs,” explained Eisenberg. “And if they aren’t doing it in safe conditions then they are likely to overdose and die or catch some bad infections.”
Damage done by the opioid epidemic in America is often defined by the rate of overdose deaths. But the taboo surrounding drug abuse fuels the carnage, pushing addicts to use in dark alleys and parked cars with no access to sanitized spaces or tools. Unsanitary injection practices can leave drug users ravaged by diseases like HIV, hepatitis C, or endocarditis (infection in the interior lining of the heart).
“I have probably lost at least two dozen of my patients to overdose deaths, and many more have had other horrible things like endocarditis and massive strokes,” said Eisenberg.
The mayor of Somerville, Joseph Curtatone, originally promised the safe injection site in 2019, with an opening set for 2020. But the delay to next year highlights the threats to the injection site.
“Gov. Baker doesn’t believe in the science and disputes the data, even though there are hundreds of peer-reviewed articles that support it. And then we have the attorney general and our federal prosecutor that also don’t believe in the science.” Eisenberg said.
One of the most outspoken figures against the safe injection site has been Andrew Lelling, US attorney for the district of Massachusetts. Lelling declined to comment for this story, but released a public statement last year opposing the site:
“Opioid overdose deaths are down 11% over this last year, a substantial drop and the continuation of a multi-year trend. Now would not be the time to open a site for the purpose of making it easier to take heroin and fentanyl.
“Despite the constant repetition by proponents of these sites, there are no reliable studies showing that they reduce overall numbers of overdose deaths or, more importantly, help addicts get clean,” Lelling argued. “Meanwhile, these sites are harmful to the communities that host them, as they attract high concentrations of drug users, followed by drug dealers, and so an increase in crime.”
While sanctioned supervised injection sites are rare, data from existing sites challenges Lelling’s assertions. A report on an unsanctioned drug injection site operating in the US since September 2014 showed that in its first two years 2,574 injections were made and only two overdoses occurred, both of which were reversed by staff.
Data gathered at a sanctioned site established in Vancouver in 2003 to combat the spread of HIV and a wave of overdose deaths in Canada calls into question the negative neighborhood effects purportedly linked to safe injection initiatives.
Authors of a 2006 study published by BioMed Central examined data from the Vancouver Police Department and found no increase in drug trafficking or drug-related crimes around the safe injection site and no violent incidents at the site.
Lelling’s contention that there is no need for a supervised injection site because Massachusetts’s drug overdose rate went down from 2018 to 2019 is also questionable.
Massachusetts Department of Public Health data on yearly overdose-related deaths amongst Massachusetts residents shows that the death rate went up 187% from 2012 to 2016 and has plateaued since. Thus, the 11% decrease in deaths Lelling points to does not indicate a positive trend downwards.
Lynn Wencus is a member of Team Sharing, a national network of parents who have lost children to opioid addiction. Team Sharing provides support for people who have lost relatives and advocates for awareness about substance use disorder (SUD). Wencus and the organization have been very active in advocating for the Somerville safe injection site.
Wencus, who lost her son Jeff to an opioid overdose in 2017, was willing to talk to the Dig about her experience. She feels very strongly that the safe consumption site will save lives. “The biggest thing I think about now with safe consumption sites is: Would he still be alive today if they existed back in 2017?”
She also emphasized the economic benefits of the safe injection site. Many addicts in Massachusetts are subsidized, their health care and addiction therapy covered by state programs. A lot of state money is spent when drug users contract diseases from unclean needles.
“My son is a prime example of that. He had not worked for five years prior to his death. He was subsidized by the commonwealth of Massachusetts with food stamps and transitional assistance. His health insurance was totally paid for by the state, which was great for him; however, as an IV drug user he was in the doctor and hospitalized so many times with complications to his health,” Wencus said. “He had sepsis, he was in Mass General for two weeks and we didn’t pay a nickel.
“People don’t understand that it’s not just about injecting drugs, it’s more than that. There is a benefit to not just keeping people alive until they want treatment and that is the most important thing. But there is an economic benefit too [to safe injection sites] that I want to make sure people are aware of.”
Despite the potential economic and public health benefits, the COVID-19 pandemic and firm opposition by state officials are threats to the site’s opening.
Moreover, in a separate statement, Lelling made a veiled threat that users of the site may be at risk of arrest, stating that he “cannot envision any scenario in which sites that normalize intravenous use of heroin and fentanyl would be off limits to federal law enforcement efforts.”
Lelling is well within his rights to file a lawsuit disputing the legality of the injection site.
A safe injection site was actually recently sanctioned by a judge in Philadelphia. Before it could open, Safehouse, the primary organizer for the site, was hit by a lawsuit from the Department of Justice. This year, a US district judge announced a hold on the opening of the Philadelphia site until the lawsuit was resolved.
Despite being delayed because of COVID-19, the Somerville site is not safe from lawsuits that could stop it from even opening.
The last thing Lynn Wencus said to me in our interview was: “If my son were alive today, and they opened one up in Somerville, I’d be driving him if he wanted to go there and use.”