The city of Somerville partnered with Fenway Health in March to prepare for the opening of a supervised consumption site where people who use drugs can consume drugs in a safe environment under medical supervision to prevent overdoses. Somerville signed a $40,000 contract with the healthcare and research organization — which caters specifically to people in the LGBT community, people of color and other underserved communities — to determine optimal locations for the supervised consumption site, establish a community advisory board and study existing models of drug use monitoring to determine how the site should operate.
Carl Sciortino, executive vice president of external relations at Fenway Health, explained the need for supervised consumption sites.
“We have roughly 2,000 people that die of overdoses in Massachusetts annually, and the covid-19 pandemic has only made things worse for people who use drugs,” Sciortino wrote in an email to the Daily. “Supervised consumption sites provide a place for people to bring pre-obtained drugs and use in the presence of trained staff who can intervene and keep them alive in the event of an overdose.”
Dr. Mark Eisenberg, a primary care physician who specializes in infectious diseases and addiction medicine at MGH Charlestown HealthCare Center, noted the importance of supervised consumption sites in mitigating the risk of needle-transmitted diseases.
“The idea is to have people who are injecting drugs and not ready to stop … be able to do it under supervised conditions with sterile equipment so that they don’t overdose and die or acquire HIV, Hepatitis C or other bacterial infections that are complications of unsafe drug use,” Eisenberg told the Daily.
While the main purpose of a supervised consumption site is to provide supervision of drug use, Sciortino explained that such sites can also provide access to medical care and treatment options.
Joseph Curtatone, former mayor of Somerville, was an avid supporter of opening a supervised consumption site due to the high occurrence of overdoses in Somerville, but his plans to do so were delayed by the pandemic.
“Somerville has many years of experience dealing with the loss of community members to overdoses, and each year first responders are called out for over one hundred overdose calls here,” Sciortino wrote.
According to Sciortino, Fenway Health already offers other drug-related health services, including syringe exchange, disease testing and on-the-ground outreach.
“Fenway Health currently runs a comprehensive drug user health program called ACCESS. We have … an array of services offered out of our Cambridge location, including syringe exchange, Narcan and overdose prevention, HIV/HepC/STI testing and treatment and other core clinical and harm reduction services,” Sciortino wrote. “We also operate a mobile van that does street outreach in the region, including in Somerville.”
The supervised consumption site in Somerville would be the first of its kind in the state.
Supervised consumption sites worldwide have an exceptional track record of harm reduction, Sciortino wrote.
“There are more than 120 supervised consumption sites in existence around the world. … Across all of these programs, not a single person has died of an overdose in a supervised consumption site, while thousands die on our streets when they don’t have access to an SCS,” he wrote. “We are looking at a range of models that have been developed to ensure what is created in Somerville is based on best practices and address the needs of people here in our community.”
In a needs assessment and feasibility study conducted in June 2021 by the city and researchers from Brown University, Davis Square and East Somerville were identified as the two neighborhoods that would benefit most from a supervised consumption site.
“We are exploring options in those areas, and doing community forums and one-on-one conversations to help engage the community in this conversation before a site is determined,” Sciortino wrote.
Of community members surveyed in the study, 56% said they would not be concerned if the supervised consumption site were in their neighborhood.
Eisenberg explained that one barrier to opening a supervised consumption site is the federal illegality of doing so under the “Crack House” statute codified in 21 U.S.C § 856.
“[Under] the Crack House statute, … you can’t knowingly operate a residence or facility in which people are using illegal drugs,” Eisenberg said. “There’s been some fear that if you were to open a building, the federal government would come in and seize it and arrest everyone present, including providers.”
Eisenberg noted that the statute is up for interpretation in the case of supervised consumption sites because they are medical facilities, and that federal law enforcement often will not act upon the statute unless the attorney general or district attorney authorizes it.
“Our local U.S. Attorney Rachael Rollins has been on record saying that she supports opening [supervised consumption sites],” Eisenberg said. “[Massachusetts Attorney General] Maura Healey, who is running for governor, also said that she supports opening it.”
Eisenberg added that the federal government has not yet intervened in New York City, where the country’s first two supervised injection sites opened in November.
Margie Skeer, Weiner Hailey family professor and associate professor in public health and community medicine at the Tufts University School of Medicine, spoke about the stigmatization of people who inject drugs as another significant barrier to the establishment of a supervised consumption site in Somerville.
“We talk about the population of people who inject drugs as a quote-unquote ‘throw-away’ population,” Skeer said. “Often, they feel like society has discarded them, [that] they’re not worth it. … If they need medical care in a supervised consumption site, they have somebody there that actually cares about them as human being and wants them to live.”
Both Skeer and Eisenberg mentioned NIMBYism as a barrier to establishing a supervised consumption site. NIMBY, or “not in my backyard,” refers to the concept that, while individuals may agree with the purpose of supervised consumption sites, they may oppose living near one.
“What we know from decades of experience is that opening an SCS actually improves the quality of life in a neighborhood by reduces public drug use, reduces the discarding of syringes in public places, and preventing overdose deaths in our community,” Sciortino wrote. “This often seems counterintuitive, so it’s important to actively engage the community to develop a full understanding of the fears and address them respectfully.”
For testimony from Somerville residents and city officials regarding safe consumption sites, click here. To hear testimony from a Somerville mother about her son’s struggle with drug addiction, click here.
