A New York Senate committee passed a bill authorizing the establishment of a state-sanctioned overdose prevention center (or OPC, also referred to as supervised consumption sites or safer consumption spaces). Safer consumption spaces are supervised places to use illegal drugs under medical supervision. The legislation, Senate Bill S399A (the enactment of the Safer Consumption Services Act, or SCSA), would require the New York State Department of Health to authorize at least one supervised consumption site. While OPCs already exist, this bill will make it easier for harm reduction workers to do their jobs and solidify the work that is already happening.
New York City opened the first city-authorized safe consumption sites in late 2021. The advancing legislation will provide a sterile environment for people to use pre-obtained substances (they won’t provide you with any), giving them a safe alternative to bathrooms or other sites frequented. In addition, the prevention center will also keep medical workers on site to ensure folks are administering the drug more safely. Such sites also offer protection that’s not available when using the drug in a non-monitored establishment, as medical workers will be there to treat any overdoses properly. Naloxone to reverse opioid overdoses will be at the safer consumption site. On-site workers will also educate participants on safer consumption practices and information on treatment. While the site can collect aggregate data on its participants and their experiences, participants and the staff at the safer consumption site will have immunity from prosecution for the sanctioned activities.
For some history, in 2015, IDUHA (the Injection Drug Users Health Alliance) released a memo essentially directing Harm Reduction agencies to act on the assumption that people using their bathrooms would likely be using opioids and therefore be at risk of overdose, a New York City harm reduction worker explains to High Times. However, most agencies have a policy wherein anyone using the bathroom gets a knock on the door every few minutes, and staff can access the bathroom and provide overdose support (including naloxone and rescue breaths and contacting EMS) when the occupant is unresponsive. “On average, my team responds to one overdose a month in our bathroom, with several utilizations a day not resulting in overdose. We have to wait for someone to stop breathing and stop responding to a knock at the door, at which point they may have been not breathing for several minutes,” our source says. “The SCSA is an important bill because it acknowledges work that is already happening—harm reduction workers and people who use drugs and their peers are already on the front lines of the overdose crisis.”
The Senate Health Committee passed the harm reduction legislation from Sen. Gustavo Rivera (D) in a voice vote on Tuesday, and it will now go to the Finance Committee for consideration. The Assembly companion version of SCSA, sponsored by Assemblymember Linda Rosenthal (D), cleared the chamber’s Health Committee in March.
“Harm reduction works. Harm reduction is a modality—a way to approach dealing with an issue which assumes, first, that a person who uses drugs is a person, and that they have to be met where they are,” Rivera said at the hearing. “Fact number two, criminalization has not worked.”
“Over decades of the drug war, it is pretty clear that we have lost said war,” he continues. “The notion that we could arrest our way out of addiction—that we could arrest our way out of overdoses and deaths—has been proven to be a lie based on all of these years of experience. Criminalization does not work.”
It marks a milestone in harm reduction history. “Today, the Senate recognized the dire situation New York is in because of the overdose crisis and failed War on Drugs era policies,” the advocacy group VOCAL-NY said in a press release on Tuesday. “New York is one step closer to seeing Overdose Prevention Centers authorized across the state,” the group’s Users Union leaders elaborated. “The legislature needs to keep the momentum and pass the Safe Consumption Services Act out of both houses by the end of session.”
However, the New York City harm reduction worker High Times spoke with explains that this bill may be simply securing what already exists, thanks to the hard work of passionate harm reduction groups. “Every OPC will be placed in already existing harm reduction agencies. In a very real way, the bill will not change much. Last week I went to Albany with a cohort of workers and participants at VOCAL-NY, Housing Works, and OnPoint to speak to legislators who had not signed on yet. When we met with [New York State Senator] Tim Kennedy’s legislative director, I told her: we are already doing this, but because we can’t acknowledge it, we have to keep the bathroom door closed. Let us leave the door open—that’s all we’re asking.”
The Food and Drug Administration on Monday said that it had given regulatory approval to a nasal spray that has proven effective in reversing overdoses caused by fentanyl and other opioids.
The spray, known as Opvee, is the “the first nalmefene hydrochloride nasal spray for the emergency treatment of known or suspected opioid overdose in adults and pediatric patients 12 years of age and older,” the FDA said in the announcement, adding that it is also the “first FDA approval of nalmefene hydrochloride nasal spray for health care and community use.”
In Monday’s announcement, the FDA said that drug overdose “persists as a major public health issue in the United States, with more than 103,000 reported fatal overdoses occurring in the 12-month period ending in November 2022, primarily driven by synthetic opioids like illicit fentanyl.”
It is also part of the FDA’s “Overdose Prevention Framework,” a program launched last year “to undertake impactful, creative actions to prevent drug overdoses and reduce deaths.” Earlier this year, the FDA approved the first overdose-reversal product that can be obtained without a prescription.
“The agency continues to advance the FDA Overdose Prevention Framework and take actionable steps that encourage harm reduction by supporting the development of novel overdose reversal products,” FDA Commissioner Robert M. Califf said in Monday’s announcement.
“On the heels of the FDA’s recent approval of the first over-the-counter opioid reversal agent, the availability of nalmefene nasal spray places a new prescription opioid reversal option in the hands of communities, harm reduction groups and emergency responders.”
The opioid crisis in the United States has prompted lawmakers throughout the country to improve access to potentially life-saving drugs that can be used in the event of an overdose. The best-known is naloxone, which “has been used for decades to quickly counter overdoses of heroin, fentanyl and prescription painkillers,” according to the Associated Press.
Opvee works similarly to naloxone, the AP said, and it has “achieved similar recovery results to Narcan, the leading brand of naloxone nasal spray.”
“The approval of Opvee was supported by safety and pharmacokinetic studies, as well as a study in people who use opioids recreationally to assess how quickly the drug works. The most common adverse reactions include nasal discomfort, headache, nausea, dizziness, hot flush, vomiting, anxiety, fatigue, nasal congestion and throat irritation, pain in the nose (rhinalgia), decreased appetite, skin redness (erythema) and excessive sweating (hyperhidrosis). The use of nalmefene hydrochloride in patients who are opioid-dependent may result in opioid withdrawal characterized by the following signs and symptoms: body aches, diarrhea, fast heart rate (tachycardia), fever, runny nose, sneezing, goosebumps (piloerection), sweating, yawning, nausea or vomiting, nervousness, restlessness or irritability, shivering or trembling, abdominal cramps, weakness and increased blood pressure.”
“We simply cannot tolerate more needless loss of life. We have to act with urgency and we have to act now,” said Minnesota state Sen. Kelly Morrison, a Democrat, who is sponsoring the bill.
In its report released earlier this month, the CDC found that 69,943 people died of a fentanyl-induced overdose in 2021, which equals to a rate of 21.6 and is up considerably from 2016, when 18,499 died of an overdose from fentanyl at a rate of 5.7.
The future is now: Vending machines in 2023 dispense cannabis, beer, art, cupcakes, and now the life-saving drug Narcan, as we race into an automated world.
Santa Clara University (SCU) in California announced the installation of a free on-campus vending machine that dispenses canisters of the opioid-overdose reversing medication Narcan.
“Naloxone is a miracle drug that can reverse an opioid overdose within minutes,” Santa Clara University Assistant Professor of Public Health Jamie Chang told NBC Bay Area. “To not provide this seemed really counterintuitive to a lot of public health principles.”
One of the goals is to avoid the stigma surrounding opioid overdoses, and instead see Narcan as a life-saving instant solution. The fact is that people die because friends are afraid to dial 911, or are unaware of Good Samaritan laws that protect people from trying to save a life from an overdose. But students need to have the Narcan on-hand in order to act fast in most situations.
“Our goal for this is to get naloxone out into the community because the more naloxone that people have in their hands, the more chances there are to save a life,” student Isabella Bunkers said.
The vending machine concept is likely coming to a university near you. The Mercury Newsreports that Stanford University plans to introduce one in a few weeks. “SCU is a party school, so drug use is something that we know happens on campus, off campus or near campus,” said Setareh Tehrani, who helped launch the project.
The idea was inspired by the death of Charlie Ternan, a former SCU student, who died of fentanyl poisoning while his friends thought he was asleep at an off-campus fraternity in 2020.
This arrives as one in five youth deaths in California are blamed on fentanyl and opioids, according to preliminary data from the California Department of Vital Statistics. Fentanyl killed a record 5,722 Californians in 2021, much more than the estimated 4,258 people who died in auto accidents in the state and more than twice the 2,548 killed in homicides.
You don’t even have to be looking for fentanyl to overdose from it: Two students at Ohio State University died from fentanyl overdoses, according to a May 5 announcement by the Columbus Police Department, and officials say the fentanyl was disguised as Adderall.
While Narcan can cost up to $150 without insurance, most students can’t afford the cost, which is one of the core purposes of the project. Additionally, when someone is overdosing on an opioid, fumbling around for a payment method might take too long to save a life.
“The first thing is that it’s free, and it’s in a place that is widely accessible to students,” said Chang, who helped launch the campus vending machine. “(But even) regardless of whether or not students decide to take the Naloxone, we’re hoping that it at least sends the message that they need to take this seriously and that there are tools out there for them.”
Under California’s Senate Bill 367, public colleges in California, public schools are required to provide access to Narcan on campuses. Some high schools in the state are taking the initiative to provide Narcan for students.
Santa Clara County is considering installing similar vending machines on high school campuses.
“People are more aware of fentanyl. We’ve talked about it everywhere, from Greek life to club sports to varsity sports,” said Olivia Pruett, a senior who studies public health. But Narcan “is only effective if people have it when they need it. This conversation has to keep happening.”
According to local news station WCCO, the proposed Minnesota legislation “would require each school building to keep two doses of the nasal spray version” of Narcan, with the station noting that the “policy and funding to support it are tucked inside two House and Senate spending packages subject to end-of-session budget negotiations.”
“We simply cannot tolerate more needless loss of life. We have to act with urgency and we have to act now,” said Democratic state Sen. Kelly Morrison, as quoted by WCCO. “We are thrilled that finally our bill is close to making it all the way to becoming law in Minnesota.”
The station reported that Morrison was joined at a Thursday news conference in St. Paul by other advocates and Minnesota Congressman Dean Phillips, a Democrat, who touted “a new bill he’s co-authored in Congress designed to incentivize states to make similar moves as Minnesota.”
“At the federal level, not every state is doing that, so this is complementary more than anything else,” Phillips said, as quoted by WCCO. “It… just simply allows schools to apply for dollars that currently exist. And it’s actually quite easy and easily accessible, but right now they are precluded from doing so.”
The last decade has seen an alarming spike in deadly overdoses in the United States from opioids such as fentanyl.
The CDC’s report also found a rise in other drug-related overdoses:
“The age-adjusted rate of drug overdose deaths involving fentanyl more than tripled over the study period, from 5.7 per 100,000 standard population in 2016 to 21.6 in 2021, with a 55.0% increase from 2019 (11.2) to 2020 (17.4), and a 24.1% increase from 2020 to 2021 (21.6). The rate of drug overdose deaths involving methamphetamine more than quadrupled, from 2.1 in 2016 to 9.6 in 2021,” the report said. The rate of drug overdose deaths involving cocaine more than doubled, from 3.5 in 2016 to 7.9 per 100,000 in 2021. The rate of drug overdose deaths involving heroin decreased by 40.8%, from 4.9 in 2016 to 2.9 in 2021, although this decrease was not statistically significant. The rate of drug overdose deaths involving oxycodone decreased 21.0%, from 1.9 in 2016 to 1.5 in 2021.”
The CDC said that, between 2016 and 2021, “age-adjusted drug overdose death rates involving fentanyl, methamphetamine, and cocaine increased, while drug overdose death rates involving oxycodone decreased.”
“In 2021, the age-adjusted death rates for males were higher than the rates for females for all drugs analyzed. Among those aged 25–64, the highest rate of drug overdose deaths involved fentanyl; although a similar pattern was observed among those aged 0–24 years and 65 and over, no significant differences were observed between the rates. Fentanyl was also the most frequent opioid or stimulant drug involved in drug overdose deaths for the race and Hispanic-origin groups analyzed,” the CDC reported.
Those troubling statistics have prompted policymakers to take action. In 2021, New York City opened the first overdose prevention center in the country. The facilities are defined as “safe places where people who use drugs can receive medical care and be connected to treatment and social services.”
“New York City has led the nation’s battle against COVID-19, and the fight to keep our community safe doesn’t stop there. After exhaustive study, we know the right path forward to protect the most vulnerable people in our city. And we will not hesitate to take it,” then-New York City Mayor Bill de Blasio said in the announcement at the time. “Overdose Prevention Centers are a safe and effective way to address the opioid crisis. I’m proud to show cities in this country that after decades of failure, a smarter approach is possible.”
A bill proposed in Colorado would give the go-ahead to local governments to set up so-called “safe injection sites” within their jurisdictions, with advocates saying that the facilities help prevent overdoses and save lives.
The sites, also known as “overdose prevention centers,” have been authorized in other states and cities in the United States –– but rarely without controversy.
The legislation introduced in the Colorado House of Representatives would allow “localities to set up a site where people can use previously obtained controlled substance[s] in a monitored setting,” according to local news station Denver7.
The Associated Press reported that Democratic lawmakers there “pushed the controversial bill forward in committee Wednesday,” but while the party controls the state General Assembly, “the measure faces steep odds amid broad backlash from police, Republicans, and lingering questions about whether the sites are even legal in the United States.”
A year ago, the U.S. Department of Justice told the Associated Press that it was “evaluating” the sites and in discussion with regulators about implementing “appropriate guardrails.”
“It does not supply drugs by any means. And it also doesn’t force any local government in a city to establish one of these sites in their communities,” said Colorado state House Rep. Jenny Willford, a Democrat, as quoted by Denver7.
In late 2021, New York City opened the nation’s first overdose prevention center, which came a year after the city suffered from more than 2,000 drug overdose deaths, the highest number in two decades.
The city, citing a report from its Health Department, estimated that the overdose prevention centers could prevent as many as 130 deaths per year.
“New York City has led the nation’s battle against COVID-19, and the fight to keep our community safe doesn’t stop there. After exhaustive study, we know the right path forward to protect the most vulnerable people in our city. And we will not hesitate to take it,” said Bill de Blasio, then the mayor of New York City. “Overdose Prevention Centers are a safe and effective way to address the opioid crisis. I’m proud to show cities in this country that after decades of failure, a smarter approach is possible.”
“Between November 30, 2021, and January 31, 2022, 613 individuals used OPC services 5975 times across 2 sites,” read the study, which was conducted by the NYC Health Department.
“During the first 2 months of OPC operation, trained staff responded 125 times to mitigate overdose risk. In response to opioid-involved symptoms of overdose, naloxone was administered 19 times and oxygen 35 times, while respiration or blood oxygen levels were monitored 26 times. In response to stimulant-involved symptoms of overdose (also known as overamping), staff intervened 45 times to provide hydration, cooling, and de-escalation as needed. Emergency medical services responded 5 times, and participants were transported to emergency departments 3 times. No fatal overdoses occurred in OPCs or among individuals transported to hospitals,” the study continued. “More than half of individuals using OPC services (52.5%) received additional support during their visit. This included, but was not limited to naloxone distribution, counseling, hepatitis C testing, medical care, and holistic services (eg, auricular acupuncture).”
It remains to be seen whether the facilities get approved in Colorado, where some Republicans have already expressed wariness.
As of Tuesday, certain naloxone products like NARCAN have been evaluated by the U.S. Food and Drug Administration and determined to be safe enough to potentially be sold over the counter in the near future.
“Today, the U.S. Food and Drug Administration issued a Federal Register notice, Safety and Effectiveness of Certain Naloxone Hydrochloride Drug Products for Nonprescription Use, that may help facilitate the development and approval of certain nonprescription naloxone drug products, including through the switch of certain naloxone drug products from prescription status to nonprescription status,” the FDA announcement said.
For those who don’t know, NARCAN is basically a nasal spray that acts as an anti-opiate of sorts. Naloxone is used alongside buprenorphine in the drug Suboxone which is used to treat the symptoms of opiate withdrawal. The key difference in NARCAN is that it’s naloxone by itself at a relatively high dose, which has absolutely no potential for abuse on its own.
“Naloxone is a medicine that rapidly reverses an opioid overdose. It is an opioid antagonist. This means that it attaches to opioid receptors and reverses and blocks the effects of other opioids. Naloxone can quickly restore normal breathing to a person if their breathing has slowed or stopped because of an opioid overdose. But, naloxone has no effect on someone who does not have opioids in their system, and it is not a treatment for opioid use disorder.” – Excerpt from the National Institute of Health website.
At the moment you aren’t necessarily required to have a prescription to obtain NARCAN but in most cases you need to get it directly from a pharmacist and it can be very expensive. I obtained four free doses through this program, but the point is most addicts simply don’t have the regular access to NARCAN that they require.
“Today’s action supports our efforts to combat the opioid overdose crisis by helping expand access to naloxone,” said FDA Commissioner Robert M. Califf, M.D. “The agency will keep overdose prevention and reduction in substance use disorders as a key priority and area of intense strategic focus for action as rapidly as possible.”
The FDA assessment won’t make NARCAN freely available just yet but it is an important first step toward making a dent in the 100,306 deaths of United States citizens from drug overdose in the 12 months leading up to April 2021.
“This preliminary assessment is intended to facilitate development and approval of nonprescription naloxone products; however, it is not a final determination that certain naloxone drug products are safe and effective for nonprescription use, and it does not mandate an immediately effective switch to nonprescription/over-the-counter (OTC) availability for naloxone,” the FDA said.
If you or someone you love uses opiates, carrying NARCAN is an absolute necessity. The following is a list of signs a person might be experiencing an opiate overdose from the official NARCAN website:
Unusual sleepiness or unresponsiveness
Breathing will be slow or absent
Slow heartbeat or low blood pressure
Skin feels cold and clammy
Pupils are tiny
Nails and lips are blue
If someone is exhibiting these symptoms you simply aim the NARCAN nasal plunger into the person’s nose and press the plunger to release the naloxone. They may require two doses especially if more powerful opiates like fentanyl are involved.
I realize people might be cautious to carry NARCAN if they don’t use opiates and don’t know anyone who does but trust me when I say that you absolutely know someone who uses opiates in secret and fentanyl is popping up in drugs that have nothing to do with opiates at all like cocaine or even cannabis in a couple isolated incidents. Carrying NARCAN can save the lives of your loved ones or even strangers and I tell everyone I know to carry it at all times.
Brightly colored fentanyl pressed into pills or in a chalky form—called rainbow fentanyl—was found in 18 states, a press release from the Drug Enforcement Administration (DEA) warns, and drug dealers getting “kids and young adults” hooked early on.
It was only a matter of time until fentanyl and other deadly drugs were marketed the way designer drugs are, as colorfully branded pills and in other forms.
“Rainbow fentanyl—fentanyl pills and powder that come in a variety of bright colors, shapes, and sizes—is a deliberate effort by drug traffickers to drive addiction amongst kids and young adults,” said DEA Administrator Anne Milgram. “The men and women of the DEA are relentlessly working to stop the trafficking of rainbow fentanyl and defeat the Mexican drug cartels that are responsible for the vast majority of the fentanyl that is being trafficked in the United States.”
There’s no other way to look at what’s happening in the United States with opioids as anything other than an epidemic. In fact, according to NIDA’s data, deaths involving synthetic opioids other than methadone—primarily fentanyl—continued their steady death march with 56,516 overdose deaths reported in 2020.
That number, 56,526 deaths, is in the ballpark of total U.S. military casualties during the Vietnam War recorded in the Defense Casualty Analysis System. Similarly, the Centers for Disease Control and Prevention (CDC) recorded 107,622 total drug overdoses in 2021, and say that the majority, or 66% of those deaths, are related to synthetic opioids like fentanyl. (The CDC also says an overdose from cannabis is “unlikely.”)
An overdose from accidentally taking a bit too much fentanyl, however, is likely. The DEA’s announcement reminds us that fentanyl is 50 times more potent than heroin and 100 times more potent than morphine. In other words, 2 mg of fentanyl, equal to 10-15 grains of table salt, can kill you. Obviously, street drugs don’t provide lab testing results—and the margin for error is as slim as 2 mg.
The DEA announcement blames cartels for the rise in rainbow fentanyl, explaining that the fentanyl available in the United States is primarily supplied by two criminal drug networks: the Sinaloa Cartel and the Jalisco New Generation Cartel (CJNG).
Uttam Dhillon, former acting administrator of the DEA, told Yahoo! News on September 1 that the Sinaloa cartel has ramped up pill production big time, and that DEA agents are now seizing millions of fentanyl pills in places such as Los Angeles.
“Even seeing just one lab in Mexico pressing pills was something unique that we were seeing. And this was only a few years ago,” Dhillon told Yahoo! News. “Now we’re seeing literally a million pills being seized in Los Angeles, for example, just a few months ago. So the growth has been massive.”
The DEA is fighting back with public awareness campaigns and FAQ sheets.
Launched in September 2021, the ”One Pill Can Kill” Public Awareness Campaign was launched by the DEA with a goal to educate Americans about the dangers of fake pills, which can be disguised as a less dangerous pill or in other ways. The DEA also provides more resources for parents that can be found on DEA’s Fentanyl Awareness page.
California Governor Gavin Newsom on Monday vetoed a bill that would have authorized a limited number of safe injection sites, delivering a blow to harm reduction advocates trying to reign in the number of overdose deaths plaguing the state and the nation. Newsom vetoed the measure, Senate Bill 57, saying that the overdose prevention programs authorized by the bill could lead to a “world of unintended consequences.”
SB 57 would have authorized four local jurisdictions to operate overdose prevention programs, also known as safe consumption sites or safe injection sites, as a five-year pilot program. Overdose prevention centers would have been approved for Los Angeles County and the cities of San Francisco, Oakland and Los Angeles, where local leaders had requested to be included in the legislation. The bill was approved by the California State Assembly on June 30 and by the state Senate on August 1.
“Every overdose death is preventable,” Wiener said after the legislation was passed by the state Assembly. “We have the tools to end these deaths, get people healthy, and reduce harm for people who use drugs. Right now, we are letting people die on our streets for no reason other than an arbitrary legal prohibition that we need to remove. SB 57 is long overdue, and will make a huge impact for some of the most vulnerable people in our community.”
Safe injection sites offer places where people can inject or otherwise consume drugs under the supervision of trained healthcare professionals, who can intervene in the event of a drug overdose or other medical emergency. Overdose prevention centers also offer other services including referrals to drug treatment, housing assistance, and HIV prevention services. Safe injection sites have operated successfully in Switzerland, Canada, and at least ten other countries for years, with no overdose deaths among people using the facilities recorded.
The success of other safe injection sites failed to sway the California governor, however. While expressing support for harm reduction measures, he said that they need “well-documented, vetted, and thoughtful operational and sustainability plans.” Newsom also acknowledged that overdose prevention programs could be beneficial, but vetoed SB-57 on Monday, citing potential “unintended consequences” of the legislation.
“It is possible that these sites would help improve the safety and health of our urban areas, but if done without a strong plan, they could work against this purpose,” the governor wrote in his veto message. “These unintended consequences in cities like Los Angeles, San Francisco and Oakland cannot be taken lightly. Worsening drug consumption challenges in these areas is not a risk we can take.”
Instead of approving the legislation, Newsom said that he would direct the secretary of the California Department of Health and Human Services “to convene city and county officials to discuss minimum standards and best practices for safe and sustainable overdose prevention programs.”
“I remain open to this discussion when those local officials come back to the Legislature with recommendations for a truly limited pilot program — with comprehensive plans for siting, operations, community partnerships, and fiscal sustainability that demonstrate how these programs will be run safely and effectively,” Newsom wrote.
Supporters Disappointed By Veto
After Newsom’s veto of the safe injection site bill was announced, Wiener said in a statement that it does not take more research to come to the conclusion that overdose prevention centers save lives.
“Today’s veto is tragic,” said Wiener. “While this veto is a major setback for the effort to save lives and connect people to treatment, we must not — and will not — let it end this movement. We’ll continue to fight for an end to the War on Drugs and a focus on drug use and addiction as the health issues that they are.”
A coalition of healthcare organizations, drug treatment specialists, policy reform advocates and civil rights organizations supported the passage of SB 57, saying the bill would save lives and create opportunities for substance abuse intervention. Jeannette Zanipatin, California state director of the Drug Policy Alliance, criticized Newsom’s reasoning for the veto, noting that local officials in the jurisdictions slated for the safe consumption sites had already signed onto the legislation.
“We are incredibly disappointed and heartbroken that Governor Newsom has put his own political ambitions ahead of saving thousands of lives and vetoed this critical legislation. Despite the Governor’s remarks, LA, San Francisco and Oakland have already designated this a priority by authorizing the programs locally and have been standing ready to implement them quickly,” Zanipatin said in a statement from the group. “We have already engaged local stakeholders in a robust process and they have taken active steps towards implementation in order to be part of the pilot SB 57 would have put in place. We don’t need additional processes. What we need is action. Without action, people are going to die.”
Shane Pennington, counsel at the cannabis law firm Vicente Sederberg LLP, is also disappointed by the veto.
“Gov. Newsom’s decision to veto this bill is very disappointing,” Pennington wrote in an email to High Times. “Research proves that safe consumption sites save lives, plain and simple. I hope the Governor’s call for local leadership to develop thoughtful operational and sustainable plans for the sites bears fruit.”
The idea of a safe drug consumption site is horrible in the first place, there’s no getting around that. By the time we start talking about these things, it means there’s already a pretty big problem that has proliferated out to massive degrees. Right now, California is waiting for a safe drug consumption site bill to get signed by the governor, to combat the ongoing and growing opioid issue. But he’s been holding back… Will he do it?
California looks to be the second state to institute legislation for safe drug consumption sites, so long as the governor doesn’t veto the bill. Welcome to this wholly independent publication focusing on the cannabis and psychedelics spaces of today. We offer theCannadelics Weekly Newsletter so readers can keep updated on important events, as well as get themselves some great deals on tons of products from vapes and smoking equipment, to cannabinoid compounds like the super-popular Delta 8 & HHC. Find deals in our ‘best of’ lists, and please only buy products you’re totally comfortable using.
What’s a safe use site?
A safe use site – also called a ‘safe drug consumption’ site in California’s SB 57 bill, a ‘harm reduction site’, or a ‘safe injection site’ is a place where drug users can use drugs without threat of legal intervention. This isn’t meant to encourage the use of hard drugs, but instead to offer a safe place for those battling addiction, who are required to take their drug because of their addictions. These sites make it legal to use drugs that are either uniformly illegal, or not meant to support an addiction.
Safe use sites generally offer other services, as well. Like testing kits for fentanyl to ensure a person is using what they think they are; giving out clean needles, and a place to dispose of used ones; and resuscitative services in case of overdose. They are also sites where users can gain information for different programs related to drug addiction or other social services like housing. In general, the sites are meant to act as an oasis for those with drug problems, which allows them to go about their habit, while also possibly accessing help to stop it.
California isn’t the first state to entertain the idea of these programs. In July of 2021, Rhode Island became the first US state to approve a safe use site measure when Governor Dan McKee signed a bill instituting these sites as a measure against that state’s growing opioid issue. Prior to Rhode Island, Philadelphia also attempted to institute safe use sites, but so far has been barred from doing so.
Rhode Island was the first to pass official legislation, but not the first state to enact a program. That designation goes to New York City. The first safe use sites in New York opened in November of 2021, and are in East Harlem and Washington Heights. The sites are backed by Mayor Bill de Blasio, who made the decision to open them, as no formal legislation currently exists. There is a bill circulating in New York’s legislature now, that would institute programs like this throughout New York if it passes.
These sites don’t explicitly come with the expectation of reducing drug use, but they do give a safe place to use the drugs – and possibly more importantly, to keep them away from other populations. The American Medical Association published a study recently about those first two sites in New York, which concluded that the sites have decreased overdose risks, kept use out of the public, and have been useful in providing complimentary services to users in need.
California’s safe drug consumption site legislation
At the end of July, the California Senate re-passed a bill to establish safe drug consumption sites in the state. The bill (SB 57) was amended by the General Assembly in June, requiring yet another Senate vote for passage after edits. This happened in a vote of 21-11, sending the piece of legislation to Governor Gavin Newsom’s desk.
This initial pilot program is meant to go until January 1st, 2028, and only approves sites in the cities of Los Angeles, San Francisco, Los Angeles Country, and Oakland. According to Sen. Scott Wiener who introduced the legislation, “We’re seeing an escalation in overdose deaths. These sites are a proven strategy to save lives & get folks into treatment. It’s time.”
Wiener introduced the legislation originally in 2020, and it did pass the Senate in spring of 2021. Prior to that attempt, a similar bill did go through in 2018, which was vetoed by then-governor Jerry Brown. This time around, though Newsom is against the war on drugs, and a proponent of legal cannabis, there seems to be a hold up in getting the bill signed into law.
Newsom has not actually signed the bill. Though Newsom supports liberal measures, and is a beacon for liberal policy, as a main advocate in the fight for same-sex marriage and cannabis legalization, he still hasn’t signed the bill. If he doesn’t by August 22nd, it will automatically pass into law, though he has until then to sign it or veto it himself. What the holdup is, isn’t clear for sure, but some speculate it has to do with Newsom wanting to run for president in the upcoming 2024 election.
Where else do safe use sites exist and why?
California and other parts of the US might be starting to adopt safe drug consumption sites, but this isn’t new to other parts of the world. These sites already exist in Canada, Australia, and different parts of Europe, for which there are about 100 sites operating. The largest number in Europe is in the Netherlands, which has almost 40 sites. The country started operating these centers in 1996, and was able to subsequently lower the amount of overdose deaths in the country. Canada opened its first site as far back as 2003 in Vancouver.
In Canada, between the years 2017-2019, there were two million visits to these safe use sites. As of last year the country had 39 operational safe use sites, which accounted for an expected daily rate of 3,000 people across sites. The busier sites operating in Canada often have up to 500 visits a day, according to Health-Infobase.
These pilot programs were not put in place for drugs like cannabis, but rather to combat the increasing opioid epidemic which is claiming so many lives. However, it technically operates as a place where cannabis can be used freely as well. The real culprit is not illegal drugs like heroin (which started the whole safe-use thing in the first place), but prescription opioid medications like fentanyl, which are still being written in large quantities.
Just how many deaths are we talking about? In May of this year, the CDC released preliminary data, which put the overdose rate for 2021 at 107,622. That’s total overdose deaths, but seeing how 68,000 of 2020’s 93,000 overdose deaths were opioid-related, it gives a pretty good idea of just how impactful opioids were in the 2021 number.
Why is this considered a pharmaceutical issue? Of the close to 71,000 overdose deaths of 2019, heroin overdoses accounted for under 15,000, while synthetic opioid overdoses (the big pharma drugs like fentanyl and oxycodone) accounted for 48,000. Of course, its actually been noted by the CDC that heroin overdose deaths decreased by 7% from 2019-2020, indicating that a raised overdose rate, is related to the pharma-produced synthetic opioids only.
Is this the best option?
This is so much of a pharmaceutically-made problem, that it makes recent moves, like President Biden sending out a memorandum on why Colombia should still be attacked for its illicit drug trade, seem rather odd. If Biden is saying Colombia is that dangerous, when its not where the drugs causing the deadly issue are coming from…then why act like that’s the big problem, while simultaneously allowing pharmaceutical companies to continue selling opioids, and for doctors to continue prescribing them?
If the drug problem is so bad and rising despite a failing war on drugs, then it seems the US should be blocking all pharmaceutical opioids in general, and leaving countries like Colombia out of it. Not only did Biden send that memorandum, but he did it the day new Colombian president Gustavo Petro started talking about ending the war on drugs, and finding better means that won’t result in a bunch of dead Colombians. Sounds like Biden would prefer dead Colombians to other, more useful, and more sense-making, options.
Like ketamine. How ketamine has been so completely left out of the conversation, while memorandums are given to the defense secretary to continue bombing Colombians suspected of having a part in the illicit drug industry, is insane. Yet research is out on ketamine’s ability to help with both acute and chronic pain, comparably to opioids, and that it does so without the same ability for addiction. In fact, it’s been shown to help with the obsessive thoughts that go with addiction, making it an even more useful tool for getting people off of these synthetic opioids. Add onto this that short term infusions have shown to net pain-relief results for up to several weeks at a time, and it makes the idea of safe use sites, or large-scale drug decriminalization measures of hard drugs, the worse options that will keep people hooked, rather then help them end their addictions.
Whether Newsom signs the California bill for safe drug consumption sites, vetoes it, or simply lets it pass into law, the problem doesn’t go away. If America really wants an answer to this growing catastrophe, it will have to think way more logically than making something unwanted, more socially acceptable; and get to the reasonable alternative measures that can actually end this.
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The California Senate took new strides in the effort to control the steep increase in drug overdose deaths this week with the passage of legislation to authorize safe consumption sites in the state. The measure, Senate Bill 57 from Democratic Senator Scott Wiener, was passed by the Senate on Monday after receiving the approval of the California State Assembly a month earlier. The bill now heads to the desk of Democratic Governor Gavin Newsom for consideration.
“Every overdose death is preventable,” Wiener said after the legislation was passed by the state Assembly on June 30. “We have the tools to end these deaths, get people healthy, and reduce harm for people who use drugs. Right now, we are letting people die on our streets for no reason other than an arbitrary legal prohibition that we need to remove. SB 57 is long overdue, and will make a huge impact for some of the most vulnerable people in our community.”
SB-57 authorizes four local jurisdictions to operate overdose prevention programs, also known as safe consumption sites or safe injection sites, as a five-year pilot program. The legislation provides approval for such facilities in Los Angeles County and the cities of San Francisco, Oakland and Los Angeles. A statement from Wiener’s office noted that the city councils or board of supervisors in all four jurisdictions had requested to be included in the legislation.
Overdose Prevention Centers Save Lives
Safe injection sites offer places where people can inject or otherwise consume drugs under the supervision of trained healthcare professionals, who can intervene in the event of a drug overdose or other medical emergency. The facilities also offer other services including referrals to drug treatment, housing assistance, and HIV prevention services. Safe injection sites have operated successfully in Switzerland, Canada, and eight other countries for years, with no overdose deaths among people using the facilities recorded.
The legislation passed this week also includes protections for professionals who work at the authorized safe injection sites, exempting them from professional discipline, civil liability, and existing criminal penalties due to good-faith conduct and actions under the overdose prevention program. The Medical Board of California and the Osteopathic Medical Board of California would still be permitted to take disciplinary action against licensed medical professionals under the bill.
Wiener’s bill was passed as California and the nation continue to suffer the effects of an epidemic of overdose deaths, largely fueled by the opioid crisis and the introduction of fentanyl into the illicit drug supply. In May, the U.S. Centers for Disease Control and Prevention (CDC) estimated that 107,000 people died of a drug overdose last year, setting a grisly new record for drug-related deaths in the country. And in California, overdose deaths spiked by 83% from 2017 to 2020, according to CDC data.
Safe Injection Sites Opened in NYC Last Year
Late last year, civic officials in New York City announced that the city had opened the first publicly recognized overdose prevention centers. Since then, research published by the American Medical Association found that New York’s safe consumption drug sites have decreased overdose risk, encouraged people not to use illicit drugs in public and provided ancillary health services to people who use illicit substances. As in other safe injection sites around the world, no overdose deaths have occurred at New York’s facilities, leading city leaders to call for nationwide support for overdose prevention centers from the Biden administration.
But opening safe injection sites has been a challenge in many communities because of provisions of federal law that prohibit providing a location for the use of illegal drugs. Shane Pennington, an attorney with the law firm Vicente Sederberg LLP, said that action on authorizing safe consumption sites across the country is needed at the federal level.
“The Biden administration promised to bring harm-reduction strategies to the fight against the U.S. overdose epidemic. Safe consumption sites are one such strategy that mountains of evidence proves saves lives,” Pennington wrote in an email to High Times. “The fact that the Federal government is inexplicably dragging its feet in implementing that strategy should not cause the states to do the same. Safe consumption sites save lives. I hope the Governor signs the California bill into law and other states pass similar life-saving measures as soon as possible.”