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City social services director Mehul Dalal, Yale epidemiologist Robert Heimer, and DESK leader Steve Werlin: All in support of harm reduction center pilot.
City public health experts and homelessness-services advocates traveled to Hartford — online and in person — to support a proposal to counter a fatally rising tide of local opioid overdoses by providing a safe area to consume drugs under medical supervision.
New Haveners spoke up and wrote in on that overdose-prevention matter Wednesday during a public hearing held by the state legislature’s Public Health Committee. The hybrid meeting took place online via videoconference and in-person in the state Capitol.
The New Haveners’ goal: To permit a three-city pilot program for a first-in-Connecticut version of an idea at the cutting, and controversial, edge of how to address the opioid epidemic: medically supervised injection and drug consumption sites. (Click here to read an in-depth New York Times account of how a similar site has worked out in the Big Apple.)
That would happen under a bill that provoked the most local feedback at Wednesday’s hearing: Senate Bill No. 9: An Act Concerning Health and Wellness for Connecticut Residents.
Among other provisions, the 56-page bill would establish by October a “harm reduction center” pilot program in three municipalities across Connecticut.
Each participating town or city would have a “medical facility where a person may safely consume controlled substances under the observation of licensed health care providers who are present to provide necessary medical treatment in the event of an overdose of a controlled substance,” to quote directly from the bill itself.
Each center would have to employ licensed health care providers with experience treating people with substance use disorders. Each would also have to provide referrals for “substance use disorder counseling or other mental health or medical treatment services that may be appropriate for persons utilizing the harm reduction center.”
Supporters of the proposal described these sites — also dubbed “overdose prevention centers” — as life-saving interventions that recognize the reality of drug abuse and treat it like a medical problem that does not need to kill over 1,000 Connecticut residents every year. Critics worried that such centers would represent a de facto legalization of all drugs.
If the state legislature approves the bill and the governor signs it into law, the state Department of Mental Health and Addiction Services (DMHAS) commissioner would get to pick the three municipalities to participate in the pilot program. The three statewide harm reduction sites would also have to be approved by the “chief elected officials of each municipality selected by said commissioner.”
The bill also states that the DMHAS commissioner may request money from the state’s Opioid Settlement Fund to pay in part or in full for the harm reduction center pilot program.
"Time For This Life-Saving Strategy To Come To CT"
In a two-page writeup supporting this provision of the bill, city Community Services Administrator Mehul Dalal detailed just how severe New Haven’s opioid epidemic has gotten in recent years — and why he thinks this harm reduction center pilot would help.
“The City of New Haven has been hit hard with the opioid overdose epidemic,” he wrote. “The proportions of this tragedy are difficult to [overstate]. In 2015 there were 26 deaths due to overdose in New Haven. By 2021 and 2022 there have been 118 and 130 deaths respectively, far surpassing the death toll of COVID19 in our city in those years. We are seeing a larger share of our illicit drug supply contain fentanyl, fentanyl analogs, and xylazine. Stimulants such as crack and cocaine are often adulterated with fentanyl and users may not be aware that they are ingesting opioids. Every week two or three residents of our city lose their life to a suspected overdose – we have a front row seat to this unfolding public health crisis. We are called to do more and to do so urgently.”
Dalal wrote that harm reduction centers can play an important role in preventing overdoses and saving lives. He said that New York City opened the country’s first official “overdose prevention center” in November 2021, and have intervened in over 700 overdoses “without a single fatality” in that time.
Harm reduction centers save lives and increase uptake of substance use treatment, he said. They can also reduce “public drug use, syringe litter, and emergency calls without increasing drug-related crime locally.”
In addition to supporting the bill’s proposal to establish a harm reduction center pilot program in Connecticut, Dalal called on the legislative committee to add “liability protection provisions related to the establishment and operation of harm reduction centers” similar to those in place in Rhode Island, and to allow more than just licensed health care providers to work at these sites.
In addition to Dalal, several Yale School of Public Health faculty and affiliates wrote in with their own testimony supporting the proposed bill.
Yale School of Public Health epidemiologist Gregg Gonsalves described the proposal as “a groundbreaking move for our state.” He wrote that over 30 countries already have such sites in place. Nearby states like New York and Rhode Island also already have programs open or in the works. He said they don’t increase drug use or crime “but do encourage people to seek treatment for their opioid use disorder — the data are clear on this and I ask you to follow the science, which supports these kinds of approaches.”
Fellow Yale epidemiologist and pioneering local harm-reduction advocate Robert Heimer agreed.
“While harm reduction centers remain controversial in the United States, there is a 20-plus year history of their effectiveness in other countries throughout western Europe (Denmark, France, Germany, Luxembourg, the Netherlands, Norway, Spain, Switzerland), in Australia, and in multiple locations in Canada,” he wrote. “After thousands of doses of illicit drugs taken in harm reduction centers, no fatalities have been reported.”
He wrote that existing centers in New York and California “have attended to the medical needs of people using drugs, reduced community nuisance by affording people clean and sheltered places to use their drugs, and assisted in reducing or eliminating people’s use of the more dangerous illicit drugs. In sum, the health benefits far outweigh the detriments and there are potential cost savings if the number of overdoses that require EMS response are decreased.”
Heimer said this current proposal is reminiscent of a vote that the state legislature took in 1990 to allow a “pilot syringe exchange program to open in New Haven. I was part of the evaluation of that program, which became a bellwether leading other US jurisdiction to begin reducing HIV transmission among people who inject drug.” When that program started, there were 650 new infections diagnosed each year in the state. In the last five years, there have been 16 per year. “That is a 97.5% reduction, better prevention than achieved by almost all vaccines. Syringe access was big part of the decrease, and the first of several interventions that reduced transmission. I hope that history will repeat itself and harm reduction centers will become the first of several synergistic strategies that reduce opioid overdose deaths.”
“The overdose crisis has had a devastating impact on communities across Connecticut, with over 1,400 overdose deaths in Connecticut in 2022 alone,” added Yale public health graduate student and New Haven resident David Oliveros. “As an advocate for evidence-based solutions to this crisis, I believe that overdose prevention sites have the potential to save lives and reduce the harms associated with drug use… These sites provide a safe and supervised environment for individuals to use drugs, reducing the risk of overdose and the spread of infectious diseases like HIV and Hepatitis C.”
Public-health experts weren’t the only New Haveners to write in and speak up in support of the harm reduction center pilot program.
Steve Werlin, who leads the Downtown Evening Soup Kitchen, wrote that “frontline workers” at his homelessness services nonprofit have reversed eight overdoses in and around its Ninth Square building and neighborhood since December. “Our clients need to be alive for us to help them,” Werlin wrote, and overdose prevention centers help accomplish exactly that: saving lives from thoroughly preventable overdose-induced deaths. “It is time for this life-saving strategy to come to Connecticut.”
"Would You Say That Drugs Should Be Legal?"
State Sen. Martin Looney on Wednesday: "We need to be more creative and more assertive in taking actions against this chronic problem that gets worse every year."
New Haven State Sen. and President Pro Tem Martin Looney also wrote and spoke up in support of the harm reduction center pilot program and the three such centers it would create across the state. “Connecticut has the chance to be a leader in implementing this groundbreaking pilot program, along with Rhode Island and New York City who have centers like these,” he wrote. “OnPoint NYC, started in November of 2021, to date has had 65,945 utilizations of its overdose prevention centers, 819 overdose interventions, and ZERO deaths. This is the right step forward in helping the most vulnerable of our state and making sure there are steps to recovery and support for them in the state.”
Looney described the bill to his legislative colleagues as one of the state Senate’s comprehensive bills this session. “We need to be more creative and more assertive in taking actions against this chronic problem that gets worse every year,” he said in support of the harm reduction center pilot.
Committee Chair Anwar: Make sure funding works.
South Windsor State Sen. and Public Health Committee Co-Chair Saud Anwar referred to a previous testifier in the day who pointed out that the Opioid Settlement Fund can’t be used for the purpose of setting up harm reduction centers. He urged Looney to “brainstorm how we can work on this” and find the right funding to make this pilot a reality if it’s approved.
Looney agreed. “If one source is not available, we should examine whether or not another unencumbered funding source may be available.”
How much might these overdose prevention centers cost? asked Derby State Rep. Nicole Klarides-Ditria.
Looney said he isn’t sure. “It’s a brand new proposal.” Presumably these centers would rent physical space or “potentially be a mobile facility. Those are all things that need to be investigated.”
Overdose prevention center pro Liz Evans: "Deflecting away from the criminal justice system is ultimately the way to go."
Later in Wednesday’s hearing, Killingly State Rep. Anne Dauphinais pressed Liz Evans, who has spent the past two decades working at and advising overdose prevention centers across North America, on one such concern she has about the pilot program.
“Would you say that drugs should be legal?” Dauphinais asked. “Do you think we as a society should be making drugs legal?”
Evans replied that “the reality on the ground is that enfocement plays a key role in managing the drug problem,” but arrests and jails and prison time can’t solve it. People who care and are adequately trained to address substance use disorders are the most effective as addressing these issues instead. “Deflecting away from the criminal justice system is ultimately the way to go,” Evans said.
Mayoral Challenger: "Drug-Free Zones" Should Apply To Methadone Clinics
Tom Goldenberg on Wednesday.
While no New Haveners appeared to write in or speak up during Wednesday’s hearing in explicit opposition to this bill, Democratic mayoral challenger Tom Goldenberg did Zoom in to urge the legislators to impose stricter limits on where certain opioid addiction treatment centers can be located.
Goldenberg’s testimony built off of a call he made during a recent press conference on Congress Avenue for the APT Foundation methadone clinic to immediately close its doors and relocate to an industrial area such as Long Wharf.
On Wednesday, Goldenberg called on the state legislators to amend current laws defining “drug-free zones” to include methadone clinics and safe-use injection sites. “We have laws about the proximity schools in terms of advertising alcohol, advertising cigarettes,” he said. “Here is a school that is 350 feet away from a clinic where there is frequent drug dealing, which I have witnessed myself,” as well as occasional bouts of violence. He also called for a mandatory public hearing before a safe-use injection site can be opened in any municipality.
“We desperately need an open conversation on best practices when dealing with the opioid epidemic,” Goldenberg wrote in his submitted testimony to the committee. “This is even more pressing as cities across the U.S. (and from what I have heard, New Haven city government) plan safe-use injection sites, where cities establish a penalty-free zone for injecting opioids. That is why I am calling for more community discussion before these decisions are made, and I am calling for common sense laws that protect the safety of schools and children.”
Click here for a previous Independent story detailing Goldenberg’s and Mayor Justin Elicker’s stances on the current APT clinic on Congress, as well as on methadone clinics in the city more broadly.
OMG. This is a rotten idea. It's about time somebody started paying attention to all the deaths but setting up legal drug dens - supervised or not, gives direct permission to say it's ok to consume these drugs. Using NYC as an example? They haven't had an overdose in their drug dens but there are plenty on the street. What's the connection to the supervised drug centers and the overall overdose rate? Is it significantly less? Are there fewer drug users? Look at the APT opposition - where in the world would you put this facility and can you imagine the zombies coming and going?