Last month, the Rhode Island General Assembly proposed a series of bills to extend a state pilot program to open overdose prevention centers. If passed, the program’s current March 1, 2024 expiration date would be extended to March 2026, giving organizers more time to open prevention centers.
Legislation to extend the pilot program failed to pass in the State Senate last year. Still, State Sen. Joshua Miller (D-28), the extension bill’s sponsor on the Senate side, said that with a “solid” proposal and “respected” organizations managing the center, this year may be different.
“We’re very optimistic,” he said. “We feel that everybody would understand that this is appropriate legislation.”
In July 2021, Rhode Island became among the first U.S. states to license harm reduction centers, also commonly referred to as overdose prevention centers or supervised injection sites. At these locations, individuals can consume illicit drugs under the watch of medical professionals, who may also provide other forms of recovery assistance.
Since the pilot program was signed into law by Gov. Daniel McKee over one and a half years ago, no such site has opened in the state. But that might soon change, according to Linda Hurley, president and CEO of CODAC Behavioral Healthcare.
In partnership with CODAC, Project Weber/RENEW, which provides Rhode Islanders with “harm reduction and recovery support” services, recently applied for funding for a proposed center at 349 Huntington Ave., a building CODAC currently owns, Hurley said.
The proposed location will include a medical suite, safe inhalation and injection sites, private consultation rooms and a space for people to “relax safely” after consuming substances, Hurley added.
“It’s actually a lot more than just supervised consumption,” said Brandon Marshall, professor of epidemiology, adding that such centers typically provide sterile drug use equipment, Narcan and other harm reduction services. Supervised consumption “is a critical component of these facilities, but in terms of what they aim to do, it is broader.”
Hurley explained that the site was chosen based on the lack of residences near the proposed location and community needs in the West End, one of the three Providence neighborhoods with overdose hotspots. The building also has availability, as CODAC plans to move out ahead of the site’s implementation, according to Hurley.
CODAC and Project Weber/RENEW hope to have a site up and running far ahead of the year’s end, Hurley added. A request for proposals, which will distribute funding for the program, set Dec. 31, 2023 as the deadline for a center to be fully operational.
“We’re moving (plans) forward as far as we can until we have the funding so that when the funding comes in, we can drop it and go,” Hurley said, adding that CODAC has begun interviewing to fill jobs at the site and brought in an architectural engineer.
Similar centers have already opened in Canada and Australia, where Marshall said the research has shown that such centers have a positive effect. In Nov. 2021, the first U.S. center opened in New York City. But in nearby Philadelphia, plans for a center were blocked due to a legal battle with the U.S. Department of Justice, which said the site would violate federal law.
Rhode Island state law requires that any overdose prevention centers receive municipal approval. While the Providence site has yet to receive such approval, Hurley said there have been “positive … ongoing conversations” with Providence City Council officials. Council President Rachel Miller declined to comment on the issue.
Despite progress, State Rep. John Edwards (D-70) worries that the clock is ticking on the program.
“The original pilot is running out, and they’re just getting to the point where they’re going to get a facility up,” said Edwards, who introduced the legislation to extend the pilot in the state House of Representatives. “I don’t want to have the program end before they actually have a chance to do some good with it.”
Marshall said he is supportive of a pilot extension, highlighting that even if a center is operational before the sunset clause, studying its effects on local neighborhoods and the individuals who use the center will take time.
According to Marshall, the delay in opening the state’s first overdose prevention center is due to a need for funding and regulation. While the law legalizing the centers passed in July 2021, the R.I. Department of Health still needed to develop regulations and a licensing procedure, he said. Those regulations took effect in mid-February last year.
“Do I wish it were faster? Yes. We’re losing more than one Rhode Islander every day to fatal overdose,” Marshall said. “But we’re also right at the forefront of this issue and I think there’s a benefit in going slowly and trying to make sure that this is (a) sustainable intervention.”
The “vast majority” of the initial funding for the center will come from a request for proposals released in Nov. 2022, which will award money from funds obtained in opioid settlements, according to Joshua Miller. That RFP currently lists Project Weber/RENEW as receiving a “Tentative Award.”
“The hurdle has always been funding,” said Joshua Miller, the extension bill’s sponsor on the Senate side. “Once there was an appropriate funding opportunity, that made it move much quicker.”
Edwards believes that the opposition to the bill to extend the pilot program will be similar to those who opposed the original legislation. “This will be like their second bite at the apple I’m sure,” he said. Edwards added that the bill “should be fairly simple to get through,” as the initial pilot legislation passed “overwhelmingly” with 63 votes for and 9 against.
State Senate Minority Leader Jessica de la Cruz (R-23) is among those who opposed the pilot. She opposes the extension but said she believes the bill is likely to pass. “My opposition really was not because of the drug use,” de la Cruz said, adding that she was against the pilot because she does not believe such centers offer a “recovery aspect.”
De la Cruz added that the centers do not address “the root cause” of substance abuse issues and will likely be inaccessible for her northwest Rhode Island constituents if located as proposed in Providence.
The original pilot legislation states that each harm reduction center “shall provide referrals for counseling or other medical treatment that may be appropriate” for those using the centers. The centers will also provide “wrap-around services,” like HIV testing, medications and connections to treatment when ready, according to a website from the governor’s Overdose Prevention and Intervention Task Force.
According to Hurley, substance abuse disorder and mental health treatment will be available on the second floor of the proposed center, but only upon request. The services may be advertised through signage, “but there is absolutely no expectation that utilizing this overdose prevention site implies that you should be accessing (recovery) care,” Hurley said.
For Edwards, the potential impact of an operational center is crucial nonetheless. “It’s going to save lives,” he said. “Very simple.”
Jacob Smollen is a Metro editor covering city and state politics and co-editor of the Bruno Brief. He is a sophomore from Philadelphia studying International and Public Affairs.