Lawmakers urged to open a safe consumption site to prevent fatal drug overdoses

Lewiston resident Rosie Boyce said she’s been sober for the last 14 years, but it wasn’t because of some “miraculous treatment program.”

Boyce attributed her survival to using drugs in a dedicated house and with friends who were ready to respond to an overdose. And she said the drugs she used weren’t poisoned with fentanyl.

Wristbands fill a counter last year at The Church of Safe Injection in Lewiston. Russ Dillingham/Sun Journal

“Bottom line: I was able to stay alive long enough to find recovery,” Boyce said Monday while testifying in support of a bill that would authorize a safe consumption site in Maine.

Others weren’t so lucky. Boyce rattled off the first names of people she knew who died of an overdose while alone: Billy was pushed from a vehicle and left to die in a parking lot. Pam overdosed in her vehicle and her husband Mike died alone in their apartment a year later. Pete was left alone in a hotel bathtub. And Tom was found inside his truck, which was still running.

Boyce was one of dozens of people in recovery, advocates and physicians who urged lawmakers on the Health and Human Services Committee to support a bill that would create Maine’s first safe consumption site, where people can use drugs under supervision to prevent overdoses and receive medical care for untreated wounds and referrals to treatment programs.

A bill sponsored by Rep. Laurie Osher, D-Orono, would direct the Department of Health and Human Services to create a two-year pilot project for a harm reduction health center, which is another name for an overdose prevention site or a safe consumption site. It would offer counseling and health service referrals and a place to use previously obtained controlled substances.

The center’s location would need to be approved by the host municipality and the bill seeks to provide immunity to the state, municipality, employees and clients from criminal and civil liability. Rules for the center would be drafted with the help of an advisory board, and DHHS would need to report on the center’s activities to the next Legislature.

Osher said her proposal, L.D. 1159, is modeled after a bill approved in Rhode Island, which is expected to open its first site this year.

“It will save lives,” she said.

The creation of a safe consumption site has been discussed repeatedly in Portland in recent years as a way to reduce fatal overdoses. And state lawmakers voted against a similar proposal in 2019.

The idea is to create a space where people can use previously obtained drugs in a safe and supervised environment, where help and sterile equipment is available. The centers also act as a gateway to medical care and treatment, recovery and other services.

Such sites typically face opposition over fears that they will encourage drug use or compromise community safety. But advocates say the sites reduce street-level drug use and discarded needles, while preventing overdose deaths, halting the spread of diseases and building trusting relationships that can eventually lead to treatment and recovery.

Advocates told members of the HHS committee on Monday that more 120 centers currently exist in 11 countries, though the Drug Policy Alliance puts that number at nearly 200 sites in 14 countries, including Canada, France, Germany, Iceland and Spain. No overdose deaths have been recorded at an overdose prevention site.

Overdose prevention sites have not been endorsed by the federal government, but advocates say the sites are the logical extension of other government-endorsed harm reduction efforts, like syringe exchanges that have been around for decades to stop the spread of HIV and hepatitis C among intravenous drug users.

Those centers are not technically allowed under federal law, however. The U.S. Justice Department took legal action against a group trying to open a safe consumption site in Philadelphia during the Trump administration, but President Biden seems to be taking a hands-off approach.

Biden’s Justice Department told The Associated Press last year that it was evaluating such proposals, and did not respond to a question from the AP about the administration’s position last month.

The lack of federal approval, however, is not stopping some U.S. communities from opening the centers.

The nonprofit OnPoint NYC currently operates two harm reduction service centers in New York City. The group describes itself as the largest harm reduction service provider on the East Coast. Nearly 848 overdoses have been reversed and no deaths have been recorded in Harlem and Washington Heights, which have served about 3,140 people since they opened in November 2021.

A harm reduction center is also in the works in Somerville, Massachusetts. And lawmakers in Colorado, New Mexico and Nevada are also considering opening centers.

The proposals stem from the growing number of lethal overdoses. In 2021, 106,700 people died of a fatal drug overdose in the U.S., up from 91,800 the previous year.

Maine set another record for overdose deaths in 2022 with an estimated 716 fatalities – up from 631 and 502 in each of the two previous years, respectively.

“We are doing something wrong,” Marshall Mercer, the executive director of Hope Brokers, a nonprofit that helps people who use drugs, told lawmakers on Monday. “It’s time for a change.”

Lawmakers voted against a 2019 bill to create two safe consumption sites. The HHS committee voted 8-1 against it, with only Rep. Rachel Talbot Ross, a Portland Democrat who is now house speaker, voting in support of an amended version of the bill.

The committee did not take any action Monday but will discuss the bill in a future meeting.

Rep. Michele Meyer, D-Eliot, who leads the current HHS committee, said federal law would be an important factor for her.

“I need to understand whether this is lawful federally,” Meyer said.

In addition to people in recovery and advocates, Osher’s bill was supported by academics and physicians.

Dr. David Kispert, a board-certified internal medicine and addiction medicine specialist practicing as medical director at two Portland-based opioid treatment programs, said states have legal authority to operate the centers just as many states, including Maine, moved to legalize the use of marijuana despite it being a scheduled drug under federal law.

“States have clear legal authority to authorize harm reduction centers, just as they can legalize the cultivation, distribution and possession of marijuana,” Kispert said.

Nobody testified against the bill on Monday, but in 2019 the Department of Public Safety and the Maine Drug Enforcement Agency raised concerns about the federal prohibition and whether it would encourage drug use.

Gov. Janet Mills acknowledged the 2019 proposal as a “potentially life-saving option,” but one that faced “significant legal hurdles.”

Spokespeople for Mills, a former Maine attorney general, did not respond to a question about Osher’s bill.

Jess Falero, an organizer with the Church of Safe Injection, which advocates for harm reduction policies, urged lawmakers to show courage.

“We are a community that has been beaten down by stigma, shame and institutional oppression and we are a community who’s voices have been silenced and deemed unworthy,” Falero said. “The members of this committee have an incredible opportunity to make history. … We can radically transform the overdose rates and the lives of people who use drugs.”