BOSTON (SHNS) – Elected, municipal, and faith leaders spent Tuesday commemorating those who lost their lives due to an overdose as part of International Overdose Awareness Day and discussing policy initiatives that could help prevent future deaths.
The day comes after nearly 18 months into a pandemic that has strained public health services and forced more people to stay at home in often isolating situations. Much of the day was marked by events across the state including one at Boston City Hall where city and faith leaders prayed for those affected by substance use.
A provision in the fiscal 2022 budget directs state officials to recognize the day each year with a proclamation from the governor and this year, state bridges, transit hubs, and local buildings plan to light up purple to remember those lost to overdoses. Boston Acting Mayor Kim Janey said City Hall will also light up purple Tuesday evening in honor of the day.
“The convergence of the opioid epidemic with the COVID-19 pandemic has heightened the urgency for preventing overdoses and promoting recovery in Boston,” Janey said at an event inside City Hall. “The pandemic heightened overdose risk by disrupting public health and social services and increasing social isolation.”
Between 1999 and 2019, the opioid overdose crisis claimed nearly 500,000 lives in the U.S., according to the state, and each day an average of 136 Americans die from an overdose on prescription pain medication, heroin, or fentanyl.
Opioid-related deaths rose by five percent in Massachusetts in 2020 compared to 2019, with Black non-Hispanic males making up the largest increase, according to data released in May by the Department of Public Health. The increase in deaths came during the COVID-19 outbreak when health care workers and social services faced challenges in providing care.
State health officials reported 2,104 confirmed and estimated opioid deaths in 2020, 102 more than the previous year and just over the previous high of 2,102 in 2016. The confirmed opioid-related overdose death rate for Black non-Hispanic males increased from 32 to 55 percent per 100,000 people, the largest increase of any ethnic or racial group for that year.
Preliminary Department of Public Health data found that 1,038 people died of opioid overdoses in the first half of 2021, a roughly 5 percent decrease from this time last year.
Mental Health, Substance Use, and Recovery Committee House Chair Adrian Madaro said he would like the Legislature to “do something” to help prevent overdose deaths, adding that it has been a few years since “we’ve tackled this issue and I think it’s due time.”
“We’ve only seen that these issues have actually been exacerbated by the pandemic,” the East Boston Democrat told the News Service. “This is not an issue that is going away. It may have been kind of outshined by the pandemic, which kind of took all the headlines, right, but this is very much still an epidemic raging within the pandemic that needs to be tackled.”
Addressing Overdoses Through Consumption Sites
On the policy side, a handful of bills addressing harm reduction and supervised drug consumption sites are slated for a Sept. 27 hearing before the Mental Health, Substance Use, and Recovery Committee.
One bill (H 2088), filed by Reps. Dylan Fernandes and Marjorie Decker, would create a 10-year pilot program of two or more safe drug consumption sites across the state that municipalities could opt-in to. The bill was filed earlier this year but has yet to emerge for an introductory public hearing, which is scheduled for Sept. 27.
The goal, advocates of the sites say, is to create a safe environment where people can use pre-obtained drugs under the supervision of trained individuals, create relationships with health care workers, and reduce the risk of infection or potentially fatal situations.
“The consumption sites have proven elsewhere to save lives, and help people get into the treatment that they desperately need,” Fernandes told the News Service. “I think it is unconscionable that Massachusetts, a state that claims to be without stigma, is forbidding municipalities that want these sites to have them in their community.”
Supporters of the legislation point to a 2019 report from the Massachusetts Harm Reduction Commission that recommended state officials, in partnership with municipalities, “foster a culture of harm reduction throughout the state and expand the array of harm reduction resources.”
Part of that, the report says, is creating supervised drug consumption sites.
“These sites keep people who use drugs alive and help reduce the public health risks of disease transmission,” the report said. “These sites can also provide a safe space where people may receive harm reduction materials and linkages to other services. A pilot program of one or more supervised consumption sites should be part of the commonwealth’s efforts to combat the opioid crisis.”
Sen. John Keenan, a member of the Mental Health, Substance Abuse and Recovery Committee, took two trips in 2019 to Canada where he visited safe consumption sites in Montreal and Vancouver and met with local providers and health officials.
He said he visited one site in Montreal that was several doors down from a family restaurant.
“People were waiting to go into the restaurant, the kids were running up and down the street. People were walking up and down the street,” he said. “Some of them looked into the storefront where the safe consumption site was and didn’t even realize what it was. So it seemed to have a fairly minimal impact.”
But there are a number of challenges and concerns around utilizing consumption sites, Keenan said, including deciding where to place them.
“My concern would be that they are put where they can do the most good and that generally tends to be where people are already actively and openly using drugs,” he said. “I am concerned about kind of the congregation of a whole lot of different programs in one area and what that may do to a neighborhood.”
Rhode Island Gov. Daniel McKee signed a bill in early July approving a safe consumption site program where municipalities can authorize the sites to operate during a two-year pilot program. The state became the first in the country to legalize the measure and advocates in Massachusetts are hoping lawmakers take a cue from their colleagues to the south.
“There are 2,000 people dying a year in the state from preventable death and municipalities want to be able to use evidence-based solutions to stop their community members from dying,” Fernandes said. “We as a state right now are forbidding them from doing that and that’s wrong and that has to change. And this bill goes a long way and in reversing that policy.”
Madaro said legalizing safe consumption sites is “something that we’re giving a hard look at.”
“There’s a number of safe consumption site pieces of legislation floating in front of the committee,” he said. “There was one that received a favorable report last session so I think that there’s an opportunity to build off of that work.”