Democratic State Representative Dylan Fernandes of the Barnstable, Dukes and Nantucket district is a presenter of House Bill 2088, which would create a 10-year pilot program for clinically supervised consumption of controlled substances. He addressed the virtual hearing on Monday.
“We can't forget about an epidemic that's raging right here in Massachusetts," said Fernandes. "And after a few years of slight reduction in opioid overdose deaths, we've actually seen in the past year a significant uptick. And even with that slight reduction that we saw previously, we're still spending next to $2 billion as a state for only really marginal gains. And we need to have more creative and thoughtful solutions to address this crisis.”
Since 2000, annual opioid-related overdose deaths among Massachusetts residents have grown from under 400 to over 2,000. 2020 is estimated to be the most lethal year yet, breaking the record set in 2016. Ferandes says there are examples across the world that show safe injection sites work.
“Our friends to the north in Canada have had these facilities open for a number of years, and have shown that there's a 35% reduction in deaths within the community around the site in Vancouver," said the state representative. "These sites provide a pathway for a treatment for drug users. We've seen that at that same site, there was 3,000 individuals who are referred to addiction counseling, so it saves lives, gets people into treatment. It also makes the community a safer place. And communities where safe consumption sites are available, there are a decrease and public usage of drugs and reduction in discarded syringes around the area. And they actually reduce local health care costs, we've seen at sites where these are held that they reduce the number of hospitalizations due to drug overdoses.”
The opioid epidemic has a sharply varied impact from region to region in the commonwealth.
“The most recent annual overdose death numbers in Berkshire County saw a massive 44% increase in the number of deaths while the rest of the state saw a 5% increase. The need to act and implement a harm reduction infrastructure to save lives is urgent," said Berkshire County District Attorney Andrea Harrington. “Berkshire County's overdose rates are 10% higher than the national average. And the Massachusetts Health Policy Forum attributes this to socioeconomic distress, inadequate treatment infrastructure, a lack of housing, rural isolation, stigma, a lack of transportation and trauma. I'm responsible for investigations and all unattended deaths in Berkshire County. In the last four years, the number of unattended death investigations conducted by my office increased by 71%. And this was heavily driven by increased numbers of fatal overdoses. I've reviewed the autopsies from 2017 to 2020, and what I see is that the percentage of overdose victims with at least five different substances detected in toxicology reports grew from 3% to 29%.”
With the number of Massachusetts State Police Troopers assigned to her office dropping from 14 to 10, Harrington said she has fewer resources than ever to assist small police departments with investigatory resources around the epidemic.
“My election was a mandate from our community to end the failed war on drugs and to recognize substance use as a public health matter," continued Harrington. "The criminalization, over-prosecution and stigmatization of people who use drugs has contributed directly to the year after year increase in fatal overdose deaths. We are now changing that we're using our role in the justice system as a pathway to rehabilitation. And it is very clear that voters in my community, they want to see a harm reduction.”
Berkshire County paramedic Stephen Murray, of the group Never Use Alone, also testified at the hearing.
“Here in Western Massachusetts, I've served our community for the last eight years as both a firefighter and an EMS provider," said Murray. "I've had a front row seat to the worsening overdose crisis, responded to more than 100 overdoses in my career. At least 30 of those were fatal. I'm also here before you as an overdose survivor myself. I've been in recovery for more than 10 years. And it's easy for me to imagine that I could have been an overdose statistic myself. It's easy for me to imagine that because almost everybody that I went to rehab with is dead.”
Never Use Alone is a phone line for injection drug users to call while consuming. If the caller stops responding while on the line, the operator notifies emergency services. The group says it’s received almost 4,500 calls and made 28 EMS calls since it was founded in 2019. Murray himself responded to one of those calls as a paramedic.
“The way I started this morning is not unlike how I started my mornings in active use," he said. "The difference was that this morning, I consumed my drug of choice, which is caffeine, at a dose of two cups, or approximately 160 milligrams of caffeine, which gave the desired effect of wakefulness energy, and to get rid of my withdrawal headache. I had the privilege this morning to consume a drug from a safe supply. Imagine waking up in your cup of coffee had 10 or even 100 times the amount of caffeine and compared to the day before. You would be sweating, starting to have palpitations, and you could even have a stroke or a heart attack. We benefit every day from a safe supply when we drink our coffee. People who use drugs are rolling the dice every time they use. The war on drugs has given us the most dangerous supply we've ever had.”
Powerful voices in the state have spoken out against supervised consumption sites. Governor Charlie Baker says they remain illegal under federal law. Then-Massachusetts U.S. Attorney Andrew Lelling issued an official statement condemning the concept in 2018, saying the sites would be illegal, normalize intravenous drug use, and undermine the work of treatment providers and law enforcement.
