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  • Amanda McMahon, Olivia Reed

Barriers to Overdose Prevention Centers in the U.S.

Introduction

An estimated 108,000 Americans died from fatal overdoses between May 2021 and May 2022. Safe consumption centers, also known as overdose prevention centers (OPC), can play a key role in reducing overdoses by ensuring lifesaving resources are easily accessible. These centers are equipped with trained medical staff to prevent overdoses, provide clean syringes, and fentanyl testing strips among other services for people who inject drugs (PWID) with the overall goal of preventing death and improving the community’s health. Although two states have successfully opened OPCs, U.S. federal law restricts the opening, use, or maintenance of a site for the purpose of using any controlled substances. However OPCs have resulted in reductions in overdoses and the spread of infectious diseases in countries where these centers have been established, including Switzerland and Canada.


Barriers and Impact of Overdose Prevention Centers

Despite evidence from abroad demonstrating overdose prevention centers’ effectiveness, few states in the U.S. have launched facilities. New York was the first state to open an OPC, leading to the intervention of 898 overdoses since launching in November 2021. Rhode Island enacted legislation allowing for the implementation of a two-year pilot program introducing OPCs in the community. Additionally, there are many states, including New Mexico and Illinois, that are actively working on bills to allow the opening of these facilities while protecting the program, employees, and PWID.


While some states have successfully launched OPCs, places such as Philadelphia have faced enforcement discretion from the Department of Justice, preventing them from opening their facility, due to a statute in the Anti-Drug Abuse Act of 1986, restricting the opening, use or maintenance of a site for the purpose of using controlled substances. Many argue that OPCs exist solely for the purpose of providing a place for people to inject drugs. Supporters of OPC’s, however, assert the real purpose is to provide space where trained medical staff are present to intervene should an overdose occur. Furthermore, these centers work to reduce the spread of infectious diseases and connections to treatment services should the patient be ready. A cost-benefit analysis of a supervised consumption site in New York City showed that the city could annually save up to $1.6 million in healthcare costs. This person-centered approach can be key in reducing overdose deaths, infectious diseases, and saving healthcare costs across the country.


Overdose Prevention Centers - A Path Forward

At this time, there is no federal legislation in place that permits the opening of OPCs, however, opinions about these centers could be shifting. The Department of Justice under the Biden administration may be open to allowing them according to recent reports. The benefits of OPCs may outweigh the concerns over the operation of these facilities and present the public with an evidence-based option that has proven successful. These centers allow healthcare professionals to meet PWID in their own space and give them the assistance they need and want at that moment, likely leading to more lives being saved. The National Harm Reduction Coalition and other similar organizations are actively working to break down the stigma around these centers through education and awareness campaigns. Additionally, states and advocacy organizations are working to garner support from the public, political leadership, as well as law enforcement officials.

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