Rhode Island set to be first state to pilot safe-injection sites for drug users

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Overdose deaths are the leading cause of accidental death in the country

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Rhode Island In a major test of the idea that harm reduction to drug users is more effective than criminalizing, is planning to create supervised spaces for users to inject illicit drugs.

The two-year pilot, a first for a state, will set up sites where users can also test drugs for potentially lethal doses fentanyl, the potent synthetic opioid that drove overdose deaths in 2020 to a nationwide record.

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States including Massachusetts and California are considering similar sites. Some cities have attempted to legalize supervised-injection sites, including Philadelphia, where one was barred from opening under a legal challenge from the Trump administration.

Such injection sites allow people to access drugs that include: Heroin and MethamphetamineUnder the supervision of trained personnel. In the event of an overdose, workers may administer the naloxone antidote. Advocates say the sites prevent overdose deaths and provide access to other services that can help protect users from harm, such as housing, medical care and treatment.

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Critics say there is no evidence that the sites reduce illegal drug use or dependence. Rhode Island State Rep. Arthur Corvis, a Democrat, said it doesn’t make sense to set rules for most people and then make room for some to break them. “There’s almost like a moral oxymoron going on there,” he said.

director of philadelphia The site, called SafeHouse, is asking a federal judge for the Eastern District of Pennsylvania to reconsider arguments in favor of its opening. The Justice Department would not say whether the Biden administration would argue against Safehouse’s request.

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Legal experts say Rhode Island’s planned safe use sites may be more successful in facing a federal challenge because states have more authority than cities to set drug-enforcement policy. Advocates of so-called harm-reduction policies say Rhode Island’s law is the most direct test yet of the idea that legal-consumption sites can reduce deaths and harm to drug users.

“We have historically been a country that addresses health conditions with punishment,” said Suzanne Carlberg-Rasich, associate professor of public health at DePaul University in Chicago.

Rhode Island State Representative Edith Ajello, a democrat, said the overdose death of his best friend’s son during the pandemic helped convince him that safe-access sites would help prevent deaths across the state.

“Supervised consumption sites can help mitigate these losses,” she said.

Overdose deaths are the leading cause of accidental death in the country, killing more people than car accidents. According to federal figures and public-health officials, fatal drug supplies and the destabilizing impact of the Covid-19 pandemic led to a nearly 30% increase in such deaths in 2020.

One user of the planned sites will be in Rhode Island, said Lee McDaniel, 51, who has used the drugs for more than a decade. He said he ended up in dangerous, abusive and potentially fatal situations to hide his drug use.

“We are forced to put ourselves in a position where we have to degrade, malign and take away our human dignity,” he said.

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Countries including Canada and the Netherlands have established similar secure access sites. In Toronto, Sean Hopkins said the site she helps manage has helped users find treatment, housing and medical care. She said that some users visit the site up to four times a day.

Critics, including some Rhode Island lawmakers, say the sites are enabling drug use. Proponents state that eliminating drug dependence does not follow a linear pattern and point to an increase in enrollment in detoxification programs in places that are supervised. Injection sites have been introduced.

Under the Biden administration, the Office of National Drug Control Policy, which focused on drug criminalization under the previous administration, has for the first time designated harm reduction as a priority.

“Language is the first step. But real investment and support is what’s really needed,” said Ellen Glover, campaign director for drug policy, harm reduction and criminal justice at People’s Action, a group of some 40 organizations, including Some are working to reduce overdose deaths. .

The Substance Abuse and Mental Health Services Administration added $30 million in federal support for harm-reduction services this year, and the Drug Enforcement Administration lifted a decade-long moratorium on mobile opioid-treatment programs. The administration has also proposed that Congress remove the mandatory minimum sentence for possession of fentanyl-related substances.

Meanwhile, harm-reduction advocates criticize the Biden administration’s support for the Trump-era policy, which implemented the harshest criminal penalties for drug offenses for fentanyl-related substances. According to the US Sentencing Commission, the number of people convicted of smuggling fentanyl-related drugs has increased by 160% since harsher penalties were implemented in 2018.

The DEA said that about 40% of illicit drugs tested for fentanyl contain a potentially lethal dose of at least 2 milligrams. According to the DEA, the synthetic opioid can produce effects similar to morphine, but can be up to 100 times more potent.

Rhode Island is set to codify rules for the operation of its supervised injection sites in January and aims to be agreed locally by March. Some public-health advocates in Rhode Island are concerned about how safe-access sites will operate without public funding. A Medicaid spokesperson said the program does not pay for the administration of controlled substances that are illegal under federal law.

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Amy Nunn, executive director of the Rhode Island Public Health Institute, the nonprofit working to open a safe-consumption site in Providence, said it’s unclear how the site will receive malpractice insurance or Medicaid costs of treating users there. will cover or not. She said her group would pursue private donations and other sources of funding for the site.

“People will put up a lot of obstacles,” she said. “There’s a lot of stigma attached to drug use.”


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