RENEE MONTAGNE, HOST:
America's war on drugs has long focused on stopping people from getting drugs and punishing them if they do. Now a Boston nonprofit is trying to different approach. Instead of prison cells and wardens, it's turning to nurses, medical equipment, some soft chairs and a room where heroin users can ride out a high. From member station WBUR, reporter Martha Bebinger takes us to a stretch of the city's Massachusetts Avenue known as Methadone Mile.
MARTHA BEBINGER, BYLINE: Jessie Gaeta, chief medical officer at the Boston Health Care for the Homeless Program, walks Mass. Ave. several times a day - past the city's needle exchange program, one of Boston's methadone clinics and one of the city's busiest emergency rooms at Boston Medical Center.
JESSIE GAETA: There's people just literally in the few blocks around our building and the hospital that we are watching overdose on our way from the parking lot and who at the moment are outside and being, you know, sort of stepped over.
BEBINGER: There have been hushed conversations for many months about creating a safe place where heroin users could get high. Now there's a growing urgency, as the latest numbers show roughly four residents in the state dying after an overdose every day. In at least eight countries around the world, there are rooms monitored by nurses, where patients can both use drugs and rest or sleep off the effects. Boston Health Care for the Homeless plans to offer just rest and monitoring.
GAETA: It's not a place where people would be injecting. But it's a place where people would come if they're high and they need a safe place to be that's not a street corner or not a bathroom by themselves, where they're really at high risk of dying if they do overdose.
BEBINGER: If patients in Gaeta's converted conference room need more than nursing care, there's a hospital right across the street. Gaeta says staff in the room will "try like heck," her words, to get patients coming off a high into treatment. Organizers are desperate to try something new. Overdoses have become the leading cause of death among Boston's homeless men and women. But will users shoot up or take a cocktail of pills and find their way to this room?
NICOLE: I could say for myself that I would use it just to be safe.
BEBINGER: Nicole, who asked that we only use her first name because some family members do not know about her heroin use, is treating her addiction with methadone.
NICOLE: A lot of addicts are homeless or by themselves. So to have somebody, especially a nurse, keep an eye on you and have a place to go when you're under the influence or when you're high, and somebody monitors you, I think that that's an awesome idea.
BEBINGER: A review of 75 research articles found that supervised injection facilities reduced the rate of overdose. Patients checked by a nurse while using heroine in Vancouver, British Columbia, and Sydney, Australia, were more likely to end up in treatment than patients who were not monitored. These safe rooms, though, highlight a divide in addiction treatment, says Dr. Barbara Herbert, president of the Massachusetts chapter of the American Society of Addiction Medicine.
BARBARA HERBERT: The controversy is, does it encourage people to keep using if we make their lives less dangerous and less miserable? Or can we scare people into care?
BEBINGER: Herbert says many addiction medicine providers have moved away from the tough love, abstinence or nothing approach and support safe injection or safe use rooms.
HERBERT: It's not that we don't want people to be drug-free. But dead people don't recover.
BEBINGER: The idea is still widely controversial among both public health and elected leaders. But Republican Governor Charlie Baker says he's open to hearing what Boston Health Care for the Homeless has planned. And Boston Mayor Marty Walsh, who speaks openly about his own alcohol addiction and recovery, is supportive.
MARTY WALSH: I'm up for trying anything when it comes to addiction and active using out there. And I think if we can help some folks, homeless folks in particular, with their addiction, we should try anything.
BEBINGER: In just the past month, EMT has revived six people after an overdose in the neighborhood where Boston Health Care for the Homeless plans to open a heroin safe-use space in a few weeks. For NPR News, I'm Martha Bebinger in Boston.
MONTAGNE: And that story is part of a partnership, NPR, WBUR and Kaiser Health News.
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