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Supervised injection sites for drug users urged for Worcester; officials call for data

Telegram & Gazette - 10/12/2021

WORCESTER - Drug users are dying at alarming rates in Worcester, and some believe there's an additional strategy the city can employ to help stem the tide.

It's a so-called supervised injection site.

"I support them," said Michael Earielo, program director at Everyday Miracles Peer Recovery Support Center. "Too many people are dying alone, overdosing alone.

"A (supervised injection) site will stop that."

A supervised injection site is a place where drug users inject themselves with their own illicit drugs under the supervision of medical professionals. Injection occurs in a safe place to prevent fatal overdoses.

A vital point, according to supporters of the sites, is drug users can be connected with counseling and treatment services to help turn their lives around.

More than 100 countries outside the U.S. have these sites. There are none in the U.S. after a federal circuit court judge in Pennsylvania ruled them illegal.

There is momentum to potentially bring them to Massachusetts.

Last month, a joint committee at the State House discussed several pending bills. One calls for a 10-year pilot program to establish at least two supervised injection sites in Massachusetts.

Local social service organizations appear to support them, while some in city government said they need to see the data from pilot sites before making a potential commitment.

"If the data is successful, (a supervised injection site) would be a consideration for us," said Dr. Matilde Castiel, Worcester health and human services commissioner.

City Manager Edward M. Augustus Jr. said the city's existing clean needle exchange programs, plus established partnerships with local organizations, help tackle the substance-abuse problem.

As for bringing a supervised injection site to Worcester, Augustus said, "Now, there is not much support on the City Council and the community to have one of these sites."

Like Castiel, Augustus needs to see the data.

"We would see what happens with the two pilot sites. At some point we would revisit the idea. Now, I would not recommend we volunteer to be one of the pilot sites," Augustus said.

How a site is professionally managed and paid for are considerations the City Council needs to discuss, said District 4 City Councilor Sarai Rivera.

"We want to make sure that if something is done, there is research behind it and it's properly funded to have the safety of individuals and minimal community impact," Rivera said.

As Earielo sees it, the main advantage of supervised injection sites is to start dialogue with drug users so they can get the support and treatment services they need.

"Too many are dying and dying alone. We have to stop some of the deaths," Earielo said.

Like Earielo, the Rev. Richie Gonzalez, backs the sites. Gonzalez is executive director at Net of Compassion, a social service organization formed nearly 11 years ago to serve some of the city's most needy residents.

Formerly homeless and a drug user, Gonzalez said he received services that saved him from a fatal overdose. It's that kind of support from a supervised injection site that Gonzalez believes will save more lives. Especially, drug users who inject in isolation.

"I am 100% in support (of a supervised injection site)," Gonzalez said.

There were 24 fatal overdoses in Worcester related to heroin/opiates from October 2020 through September 2021, according to the Worcester Police Department. Plus, 725 nonfatal overdoses occurred over the same time period.

Within the city of Worcester, according to the state Department of Public Health, opioid- related overdose deaths dropped 7% from 144 in 2019 to 125 in 2020.

However, the number of opioid-related overdose deaths involving Worcester residents jumped 17% from 81 in 2019 to 98 in 2020.

Racial and ethnic disparities persist statewide for opioid-related overdose death rates, according to the state Department of Public Health.

The death rate jumped 69% for Black men per 100,000 people from 2019 to 2020. That compares to a 1% increase for Latino men and a 6% decline for white men.

For women, the death rate per 100,000 people increased across the board: 68% Latina, 32% Black, 6% white.

Worcester's health and human services department doesn't have a demographic breakdown of the statewide numbers, Castiel said.

"It's hard to get local data," Castiel said, and explained that it comes from a variety of sources, including the state DPH and coroner's office. Additionally, the data isn't an exact science, because someone can suffer a fatal overdose and not call 911. Or someone who suffers an overdose could be driven to the hospital, and it's not reported to police.

The police report did supply demographic data for its report that spanned October 2020 through September 2021: 74% of overdoses were male, 26% female. Also, 78% of overdoses involved city residents, 22% were nonresidents.

The racial breakdown of overdoses, according to police: 47% white, 28% unknown, 19% Hispanic, 5% Black, 1% Asian or Pacific Islander.

Castiel noted supervised injection sites are just one piece of the puzzle to help residents dealing with substance use.

Some services are in place, including through the city's Opioid Task Force and Reentry Task Force. The latter helps those released from prison get addiction counseling, housing and employment assistance.

Other needed services are lacking or inadequate, not just in Worcester but in the overall drug treatment sphere, Castiel said.

They include on-demand, medical-assisted treatment in shelters and doctors' offices; mental health counseling to supplement addiction counseling; recovery coaches who can work with patients in their homes; and doctors of color and those who are fluent in Spanish to help non-English speaking patients.

"All are important that need to happen. We, as a city, are working on them," Castiel said.

Nicole Bell knows the damage substance abuse can inflict on a community.

Approximately 40 clients at Bell's nonprofit in Worcester, Living in Freedom Together, suffered a drug overdose in the past two years. Bell founded the organization, which provides resources to women who are victims of prostitution and sex trafficking.

She thinks it's time that Worcester had a supervised injection site to stop fatal overdoses and help those living with the ill effects of substance abuse.

"I am all for that," Bell said.

Bell shared her personal story of drug abuse to highlight the need for an injection site in Worcester.

"I was so chained by my drug use. Every dollar was going to feed my addiction. My biggest fear was I would die behind a dumpster," Bell said.

That fear can play out in the lives of many drug abusers, Bell said, because they often inject themselves in unsafe places where no one will find them - a dangerous scenario that could be alleviated if there was a supervised injection site.

One reason is a fear that drug users will flock to any community that opens any kind of shelter or support service, Bell said.

The flock won't happen, according to Bell, citing her experience as a drug abuser in Boston, when she didn't have the resources to move around.

"People are not going to move here because it's a mecca for injecting drugs," Bell said. "A lot of folks believe that if you open shelters and put in more services for people, then conditions are better to use drugs.

"A mass exodus to Worcester is not real."

The stigma of drug abuse is another factor.

"People not familiar think a supervised injection site will enable people to keep getting high," Earielo said. "The supervised injection site has professionals on staff to stop the spread of disease, and stop people from dying alone."

"A lot of lobbying," Earielo said. "The data shows they're successful. Data is key."

Overcoming public hesitancy is another hurdle, said Bell.

"I wish people would listen to the medical professionals when it comes to this issue, instead of the policymakers. They are not experts on substance use. The medical professionals and the public health professionals are," Bell said.

Bell wished she had a nonjudgmental place to turn to, like a supervised injection site, when she was in the throes of drug abuse.

"When I was overdosing, if I was taken somewhere where I was not treated like s---, then maybe my life could have been different than it was," Bell said.

"Supervised injection sites are more than a safe place to use drugs," Bell added. "They reduce overdose deaths, and it's also about vital connections to community. We need to do it. The amount of deaths is unreal."

"Mind-blowing" is how Earielo compared the United States to other countries that treat substance use.

"Our country is more about locking people up and throwing away the key. Dehumanizing them," Eariello said. "We're so far behind in care and programming for substance-use disorder, compared to other countries.

"It's a no-brainer. Supervised injection sites save lives. That's the most important thing right now."

Contact Henry Schwan at henry.schwan@telegram.com. Follow him on Twitter @henrytelegram

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