Providence safe injection site will be studied by Brown, NYU — what they're looking for

PROVIDENCE — In 2021, Rhode Island became the first state in the nation to authorize centers for people to consume illegal drugs under supervision, and now lessons learned in the Ocean State could help pave the way for similar harm-reduction efforts elsewhere.

Researchers from the Brown University School of Public Health are teaming up with their counterparts from NYU Langone Health to study the efficacy and community impacts of the first overdose-prevention centers in the United States through a four-year, $5.8-million grant from the National Institute on Drug Abuse, an arm of the National Institutes of Health.

The grant will enable researchers to examine the country’s first sanctioned so-called harm-reduction centers, or safe-consumption sites, two of which opened in 2021 in New York City with another to debut early next year in Providence through a partnership between Project Weber/RENEW and CODAC Behavioral Healthcare.

“It’s critical for us to understand how the centers are impacting users and the effect on the community,” said Brandon D.L. Marshall, a professor of epidemiology and founding director of the People, Place and Health Collective at Brown’s School of Public Health. “We are excited to get started and work closely with people in New York City.”

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Study will look at people in Rhode Island and New York

The study is set to launch June 1, but Marshall said the groundwork will be laid in the coming days through a small pilot study that will vet survey questions and help focus the researchers’ approach.

The study will encompass 500 people in Rhode Island and 500 in New York, Marshall said. Half the participants are expected to use the overdose-prevention centers and half will not, allowing a comparison of health, housing and criminal justice outcomes, as well as impacts on the neighboring community.

“It will look very deeply into how health care patterns might change,” Marshall said.

The work will touch on everything from the centers’ influence on overdose numbers, to emergency runs and rescue calls, to access to housing, arrest rates, and neighborhood litter and public drug use.

“We want to understand what are the operational costs … and what are the potential benefits to the community,” Marshall said.

It will study, too, how people are using the space to help inform best practices, said Dr. Alexandra Collins, a co-investigator on the project.

The researchers emphasized the study’s significance in applying for the grant in that it will evaluate the public health, public safety, and community benefits – and potential unintended effects.

Marshall is committed, he said, to publishing the results, no matter what the findings.

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Providence center to open next year, link to social services, health care

Rhode Island will have the benefit of applying lessons learned in New York City to the center set to open in early 2024 on Huntington Avenue in Providence, advocates said.

It is planned as a space for people to consume drugs they own under the oversight of trained staff who can intervene in the event of an overdose and help guide them toward social services and substance-use treatment. The center will also act as an access point for case-management services, HIV and hepatitis C testing, housing support, peer recovery coaching and other health care services.

Essentials will be on hand, such as food, water and hygiene products and fentanyl test strips, naloxone, and other supplies aimed at increasing safe consumption.

The Providence center will be funded through $2.6 million in opioid settlement funds distributed to Project Weber/RENEW and its clinical partner, CODAC, by the state Executive Office of Health and Human Services.

“This is a historic and humane step forward in the fight against the epidemic of overdose deaths,” Project Weber/RENEW Executive Director Colleen Daley Ndoye said in a news release. “With more than 100,000 people dying in this country every year – and hundreds in Rhode Island alone – it is time for us to take action to keep more people from dying. No one can make the decision to ask for support and help, let alone decide to enter treatment or recovery if they are dead.”

Since the New York sites opened in 2021, more than 3,200 people have used the services, with staff intervening in 898 overdoses – with no deaths, according to a story in the Washington Post.

Outreach to city leaders

There is no set opening date, but organizers are hoping for March 2024, according to Mikel Wadewitz, of Project Weber/RENEW.

Representatives of Project Weber/RENEW and CODAC have begun briefing the City Council on plans, Parker Gavigan, spokesman for the council, said.

“I’m told the process will take some more time. A full council vote for approval could come before the summer recess [in August],” Gavigan said.

Municipal approval is required under the law approving centers in a pilot program that now extends through March 2026.

Two-hundred overdose prevention centers worldwide

The researchers noted that there are 200-plus overdose prevention centers in 14 countries, with some studies showing they lead to overdose reversals, decreases in emergency room visits, increased access to addiction treatment and other positive public impacts.

The need for data looking at how the centers function in America, which relies on privatized health insurance, could help to shape social policies and policing practices.

Marshall noted that while centers have typically operated in larger cities such as Vancouver, New York and Paris, the Providence center’s experience will inform centers in the many similarly sized urban centers.

In 2021, more than 106,000 Americans died from drug overdoses. Rhode Island saw a record 435 opioid overdose deaths that year and 376 in 2022, a number likely to increase as statistics are finalized.

The grant signals the federal government’s move toward harm reduction, a strategy geared toward keeping people alive in order to connect them with addiction treatment, mental-health services and medical care.

Critics say the sites could encourage drug use and negatively impact the surrounding neighborhoods.

National focus on harm-reduction

The White House’s drug control policy has focused on expanding access to prevention, harm reduction, treatment and recovery services while reducing the supply of illicit substances. The Justice Department has indicated an openness to safe injection sites.

“We at Project Weber/RENEW are excited about this innovative approach to RI's overdose crisis," Project Weber/RENEW’s Daley Ndoye said.  "We look forward to working with the research team at Brown who will study the impacts this center and our services will have, and to be a model for how other overdose prevention centers can be opened nationwide."

This study will be a part of the NIH Harm Reduction Research Network, established last year to assess harm reduction methods.

This article originally appeared on The Providence Journal: Safe injection site in Providence will be studied using $5.8M grant