By Seth Daniel
Calling it everything from ‘asinine’ to ‘absolutely necessary,’ the City Council’s Committee on Homelessness and Addiction Services held a hearing Monday on the recently touted plan by the state and the Massachusetts Medical Society (MMS) on Safe Injection Facilities (SIFs) – sites that have been floated as being most effective if located in the South End’s Mass/Cass corridor.
The committee hearing was chaired by Councilors Annissa Essaibi George and Frank Baker, but several other councilors attended the hearing, with virtually none of them lending support even after more than an hour of testimony from the MMS, Boston Healthcare for the Homeless and even a current addict.
“I think this idea is asinine, absolutely asinine,” said Councilor Michael Flaherty, saying he prefers recovery and treatment on demand services. “If we think someone is going to score heroin and take a trip over there to inject heroin, that’s not reality. They will inject it or sniff it minutes after purchase…This vision we have of people scoring heroin and taking a bus or tax ride to the facility…that’s not going to happen…The buyers and sellers are going to be wrapped around this facility.”
That promoted the liveliest exchange in an exciting discussion by City Council standards, where Flaherty and MMS President Dr. Henry Dorkin went back and forth talking about where the MMS facility should be located.
“Why don’t we just go out to Newton and we’ll talk with your Mayor Setti Warren about locating this next to your house there in Newton?” asked Flaherty.
“If that’s what the Task Force would find is most appropriate, then yes I will go with you,” said Dorkin, who noted many times that the MMS isn’t interested in making decisions about siting the facility.
The SIF debate was heightened earlier this year when the MMS voted 193-21 for a Task Force to be formed to look into locating a pilot SIF in Massachusetts – with some members suggesting that the South End would be the right location given the Ground Zero status of the Mass/Cass corridor for the opioid epidemic.
“That vote said this was something we should approach and put together a Task Force to look at the issue…and determine what the appropriate plan would be from a patient perspective,” he said.
He prefaced that by giving statistics that more than 2,000 people in Massachusetts were lost to opiate overdose in 2016, and a SIF is part of a harm-reduction strategy where users would bring their own drugs in that they’ve procured. Drugs would not be provided, but the trained medical staff at the SIF would oversee the user injecting the drugs and make sure they didn’t overdose, and would also be able to provide a quick analysis of what is in the drugs – a precaution that is critical nowadays with the deadly Fentanyl and Carfentanyl substances that have shown up in street opiates.
“This is a harm reduction facility to reduce overdoses and fatalities from overdoses,” he said.
His testimony was at the behest of Baker and Essaibi George, who filed for the hearing after the MMS began engaging in talks with the state government about a SIF and did not include anyone from Boston – with many believing that Boston would likely be the location of any SIF.
Right now, SIFs are actually illegal in the United States, though there have been some soft pilots in Seattle. The only legal SIF in North America is in Vancouver, and there seems to be statistics from that long-time SIF location in that city to back up just about any argument for or against SIFs. How the legal hurdles would be overcome with the federal and state government wasn’t even really breached at the hearing, except briefly by Councilor Josh Zakim.
Essaibi George and Baker were concerned by the testimony, and said that even after the long testimony, they didn’t see the overall “end game” of recovery for addicts.
“I’ve been looking at the numbers from Vancouver that were presented and it says that there were 263,000 visits by 6,500 individuals and only 464 entered recovery,” he said. “That doesn’t seem like great numbers. I think I have a very difficult time with this if there’s not an end date…I’m not sold on the idea.”
Others who testified in favor were members of the Boston Public Health Commission (BPHC) and Boston Healthcare for the Homeless (BHCH), both located in the South End.
“Drug overdose is now the leading cause of death among our population,” said Dr. Gabriel Wishik. “We have come to believe we need to introduce SIFs in order to stem the tide of this epidemic.”
BHCH has started a facility inside its waiting room called the SPOT, where people are not allowed to inject drugs, but they are allowed to come in and sit in the room and be observed for an overdose. That has been in effect for one year and gained approval from the neighborhood after a robust debate.
Wishik said he lives in the South End on Concord Street, and he sees people near his house injecting drugs.
“I see people injecting in my alleyway,” he said. “I call the Mayor’s hotline. It’s frustrating to see that when I know there’s a better way…There is a problem in our community. A SIF takes that concern off the street and engages people. We’re not engaging people right now.”
One person that testified is an addict currently using heroin that frequents the Mass/Cass corridor, Aubri Esters of SIFMA Now.
“Right now I have to do a slow shot, testing for Fentanyl before and after and then texting back and forth for a few minutes to a friend to ensure someone knows if I’ve overdosed and can get help,” she said. “I overdosed a week ago and nearly died. I didn’t want to bother my friend with texts, so I didn’t text. It resulted in a near-fatal overdose where I lost my hearing and still haven’t fully recovered. I’ve lost so many friends to accidental overdose over the years. Their names are etched on my mind and the faces I’ll never forget – faces of people shaking and turning blue and they are sitting alone dying in some alley or a bathroom because there is no safe place for them…In my opinion, personal morals don’t belong in public health policy.”
Several South End and Newmarket folks also attended the hearing and testified.
Chief among them was Steve Fox, moderator of the South End Forum, who said the Forum membership does not support the measure at all. He said they, instead, propose that a full Rehabilitation Campus be located elsewhere in Boston.
“The key issue I think for most Bostonians is that any decision-making on this issue needs to be based on solid, reliable evidence-based data that makes sense to neighbors and neighborhoods,” said Fox. “We should not still be debating whether a harm reduction strategy works in the real world while we rush to embrace it.”
Fox also said that the South End shouldn’t even be on the table as a site.
“On behalf of the South End Forum and our neighborhood associations, we stand in firm opposition to locating any pilot SIF program within or adjacent to the South End,” he said. “We are dying by a thousand cuts and no one has addressed the influx of new clients coining in the SIF.”
He suggested that a Rehabilitation Campus be founded on the Shattuck site in Franklin Park, one that is cutting edge and maybe could host some sort of pilot like a SIF.
“That could offer a supportive and self-contained campus setting without impact on any residential neighborhood,” he said. “It is time for Boston to live up to its reputation as the provider of cutting edge solutions. We can no longer ignore the fact that the crisis deepened when we lost Long Island where so many services and programs were co-located, cooperated together and shared resources.”
Numerous businesses from the Newmarket Business Association also testified against the idea, including Executive Director Sue Sullivan.