Brittney La Shier and Lizzy Handschy, co-directors of the Portland Overdose Prevention Site, provided a presentation on the need for such facilities in order to provide care for people with substance use disorder in order to reduce drug overdoses and reduce the transmission of HIV and hepatitis. They are working to create an overdose center in Portland. The City Council Health & Human Services & Public Safety committees will discuss this idea at their May 14 meeting at 5:30 in City Hall.
The two reviewed some of the causes and contributing factors to the current opioid crisis and the emerging trend to focus on harm reduction and substance use disorder, rather than the punitive approaches of the past. “Incarceration doesn’t work,” Ms. Handschy said, “Accidental overdoses are now more of a risk than auto accidents.”
The two described an overdose prevention center as a safe place for people to inject where the environment is nonjudgmental, and there is access to health care. Centers are designed to provide clinical staff trained in the use of naloxone (Narcan) along with access to sterilized needles that can be safely disposed. Users also have the opportunity for counseling. Ms. La Shier stated that there are currently no such sites in the U.S., but there are over 100 around the globe in 66 cities in 9 countries, including Australia, Portugal, Spain, Switzerland, Germany, and Canada.
(Photo L-R: Brittney La Shier, Lizzy Handschy and President John Curran.)
Barriers to creating these centers include costs, professional licensing, liability, stigmatization, and community acceptance. The biggest obstacle, however, is the law. Currently, the U.S. Department of Justice is pursuing a declaratory judgment against the Safehouse clinic in Philadelphia, which is attempting to be the first overdose prevention site. The case, U.S. v. Safehouse, points to the Controlled Substances Act which prevents anyone from providing a place for the use or distribution of a controlled drug. The suit is not seeking action against the creators of the Philadelphia site, it only asks the court to declare such facilities as illegal. Until this case is settled, the likelihood of municipalities engaging in the creation of overdose prevention sites is unlikely.