Advocates of a proposal to open three centers where people can use illegal opioids with medical supervision say the idea could reduce overdoses and decrease crime. But state officials warn that the centers may break federal law.
The proposal, part of a larger bill up for debate in the Public Health Committee, would create three “harm reduction” sites — centers where people could go and use drugs like opioids and fentanyl in the presence of healthcare workers with experience treating substance abuse. The centers would also offer clean syringes and information about treatment options for people looking to get help.
Connecticut would be only the third state — after New York and Rhode Island — to offer either state or local support to these types of sites.
State Sen. Saud Anwar, D-South Windsor, said on Wednesday that he had the opportunity to visit one of the two centers in New York, run by the organization OnPointNYC. Anwar said the sites had supervised 60,000 uses of drugs with zero fatalities.
“We don’t have that here. And we need that here,” said Anwar.
But Nancy Navarretta, the Connecticut Commissioner of Mental Health and Addiction Services, said on Wednesday that she believed having a center that allowed people to use illegal substances would be impossible until federal law was changed.
The federal law, sometimes referred to as the “crack house statute,” makes it illegal to “knowingly open, lease, rent, use, or maintain any place, whether permanently or temporarily, for the purpose of manufacturing, distributing, or using any controlled substance.” In 2021, a court ruled that the law made it illegal for a local organization in Philadelphia to open a safe injection site there.
During the public hearing on Wednesday, Anwar expressed frustration with the federal law.
“Despite a number of interventions, we have still not seen a major dent in the number of deaths,” he said, noting that the number deaths remained steady at around 4 per day. “It’s almost like the federal law is coming in the way of saving lives of our citizens.”
In 2020, the Rhode Island legislature passed a law to create pilot “safe consumption” sites, set to expire in March. But Navarretta said that Rhode Island has not yet been able to open a site due to community opposition, and because they have not been able to find a building where the center could be housed.
But Navarretta said she believed the centers opened in New York City were “doing great work” and that she hoped to learn from them.
“A safe space”
According to data from the state Department of Public Health, the number of deaths from drug overdoses has risen steadily since 2015, peaking in 2021 with over 1,500 deaths. The number dropped slightly to just over 1,400 in 2022. In 2022, Black residents of Connecticut died from overdoses at nearly twice the rate of White residents.
In a forum hosted by Anwar earlier this month, Ryan McNeil, an associate professor of medicine at the Yale School of Public Health, said that studies on existing centers showed that they had the potential to lower “public disorder,” and decrease the spread of diseases like HIV and Hepatitis C.
“We know these sites are incredibly effective at attracting people who are vulnerable,” McNeil said. He added that they offered a “welcoming environment” for people and could bring in people who didn’t have stable housing.
McNeil, who formerly worked at the University of British Columbia, said that studies on a site in Vancouver found a 35 percent reduction in overdose deaths in the area around the site. He said that more recent work found that scaling up the sites in British Columbia prevented more than 200 deaths. He said that British Columbia was about the same size as Connecticut and had roughly the same overdose rate.
“I think there’s a strong comparison point there,” he said.
Liz Evans, who has worked with these sites in both Vancouver and New York, said the site she worked with in Canada was subject to “voluminous studies” that found that people who used the site were more likely to go into detox, less likely to overdose, and that the sites resulted in a decrease in “public disorder” and savings in healthcare costs.
She said the sites offer primary care and a “therapeutic relationship” in a place that is non-judgemental.
“Most importantly for me, people injecting in a safe space — we have fewer mothers who don’t need to be told the life-changing news that their son and daughter is dead,” said
Evans said she believed the facilities would need state funds to operate. The New York facilities were able to continue operating because they were “seen and supported by the state as a healthcare facility.”
The two centers in New York do not use federal or state funds to operate — they are paid for with philanthropic donations. Megan Kapler, an organizer for the advocacy group Prescription Addiction Intervention Now, said this has left the centers in a precarious position.
“They are at risk of closure right now,” said Kapler, adding that using federal funding would make it possible for these centers to stay open at night and on weekends.
The proposal from Connecticut would charge the Commissioner of the Department of Mental Health and Addiction Services with putting aside funds to be taken out of the settlement that the state of Connecticut and other states will receive from major opioid distributors and opioid manufacturer Johnson and Johnson. Connecticut is expected to receive $300 million of the $26 billion settlement over the next 18 years.
The bill would also establish an advisory committee for the pilot centers.
Querying Connecticut’s Cities
While the commissioner would have the discretion to decide which municipalities would have pilot sites, Anwar said during a press conference on Wednesday that he had already heard interest from community members in Hartford and Bridgeport, and from the municipal officials in New Haven. Opening a site would also require the consent of the municipality where it would be located.
New Haven Mayor Justin Elicker told CT Examiner in a statement that he was in support of having a center in the city, but he said there would need to be a “very thoughtful plan and robust community conversation” about any site that would open.
“In New Haven, we’re committed to expanding access to services and a harm reduction center would save lives, and actually help people break the cycle of addiction by connecting them to substance use treatment and other services and supports,” he said.
The offices of the mayors of Hartford and Bridgeport did not respond to queries from CT Examiner about whether they would be open to hosting a similar site in their cities.
Navarretta said that there are already similar centers in Hartford that her department runs. These centers provide naloxone and connect people with treatment options, but they do not allow people to use drugs on site.
Anwar said he believed there could be a way to create more “harm reduction centers” that would not be against the federal law — similar to the ones in Hartford.
“I think there are legal ways to be able to do this, without breaking a federal law,” said Anwar.