PROVIDENCE, R.I. (WPRI) — Rhode Island is preparing to open one of the only safe injection sites in the country, embracing a highly controversial program designed to cut down on the state’s deadly opioid overdose crisis that’s killed more than 800 people over the past two years.
State health officials reported 434 Rhode Islanders died from an accidental drug overdose last year, which was one fewer than the highest year on record in 2021.
The onslaught of overdose deaths spurred state leaders to approve the new safe injection site, dubbed an “overdose prevention center,” which is scheduled to open next spring on Huntington Avenue in Providence. The site — located inside the CODAC building — would become one of only three places in the country where people who use drugs can come and inject narcotics such as heroin under medical supervision.
Rhode Island was the first to legalize safe injection sites in the United States in 2021, but two locations have since opened in New York City. Safe injection sites have been around elsewhere for decades in countries including Canada and Switzerland.
Some reports out of those countries have helped convince supporters the model could work effectively in Rhode Island. For example, the Canadian Government reported that while they had roughly 47,000 overdoses and drug-related medical emergencies at injection sites since 2017, no one has died as a result.
The Institute for Clinical and Economic Review reported in 2021 that no one has died at any facilities that it has reviewed across the globe.
CODAC Healthcare president and CEO Linda Hurley brought Target 12 on-site for a tour of the the facility, which is preparing for renovations later this year. Navigating a winding set of windowless hallways, Hurley said many of the existing offices will be removed and be replaced with four or five glass booths for people who choose to use the facility.
“People can self-administer, whether they’re smoking, whether they’re using needles,” Hurley said.
Dennis Bailer, the overdose prevention program director for Project Weber/RENEW, which is collaborating with CODAC, said a medical professional will be ready to step in if a person overdoses.
“People will be right there with life-saving oxygen and Narcan if necessary, although it’s not always necessary,” he said, referencing the name brand of a life-saving nasal spray called naloxone. “We find if you intervene with an overdose immediately, you don’t even need Narcan.”
He said people will also have the ability to test their drugs to make sure there are not any additional contaminants, such as the highly deadly narcotic fentanyl.
People will also be surrounded by peers who can understand their experience, and while they are there, they can also do their laundry, take a shower and access social services.
Bailer said it’s important to offer a safe place for people to use drugs and understand that addiction is a mental health disorder, and that drug use happens whether or not someone is in a safe place.
“People are using in alleyways. They’re behind dumpsters and bathrooms,” Bailer said. “The people who are using will use. We’re not changing that, they’re going to be using. But I don’t want to see anymore of our citizens dying in these horrible places.”
In addition to providing people with a safe place that can prevent them from dying, Hurley said the safe injection site is also a tool to keep them away from crime.
“Especially with xylazine so prevalent right now, it’s like being in a really deep coma for a few hours. They’re being assaulted, they’re being robbed, they’re being raped,” she said. (Xylazine is a horse tranquilizer that’s become more prevalent on the street in recent months.)
Huntington Avenue is also at the epicenter of overdose deaths in Providence, as overdose data shows the highest density of overdose deaths in that area of the city. The data is a key reason why organizers picked the CODAC building to become the state’s first safe injection site.
“This area is what we call, in Rhode Island, a ‘hotspot.’ And every week we identify a different hotspot, it’s consistent here, particularly not just with overdose, but death,” Hurley said.
Research shows location is a crucial tool to lower overdose deaths.
A 2021 review in the National Library of Medicine determined that whenever a safe injection site was placed in an area, it would decrease the risk of people dying from overdoses. The review cited a 2011 study out of Vancouver that showed a 26% reduction in overdose deaths in the immediate area surrounding safe injection sites, compared to the rest of the city.
Hurley said being in the right place at the right time is also important when it comes to getting people on the path to recovery.
“There’s a much higher level of people engaging in care for these alternatives if that care is right at the spot — the physical spot and time they request it,” she said.
But not everyone thinks safe injection sites as designed are the best way to address the opioid epidemic, including R.I. Senate Minority Leader Jessica de la Cruz, who opposed the legislation that made the facilities legal.
“I would be able to support it only if it were part of a recovery plan,” she said. “If someone is on the path to sobriety to get them clean, then I could support it, but if we’re just offering free injection sites so people can use drugs, I don’t support that.”
Bailer, who is in recovery, pushed back on the criticism, saying Rhode Island needs to try this new approach because too many lives are on the line.
“We’re losing too many lives,” he said. “The things that we’ve been doing in terms of substance use disorder and overdose just have not been working for many, many years.”