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Rhode Island is the first state to legalize supervised drug injection sites. The two-year pilot program calls for establishing safe places where people can use heroin and other illicit drugs. But even with a green light from state government, Lynn Arditi of The Public's Radio says it may be months before the first supervised injection site can open.
LYNN ARDITI, BYLINE: Representative Stephen Casey is an unlikely crusader for supervised injection sites. A Democrat, he's also a Catholic and self-described conservative. He's against abortion rights, and he supports the Second Amendment right to own a gun.
STEPHEN CASEY: So my first reaction was, no way. As a rescue guy, I'm like, we can't give them a shoot-up center.
ARDITI: Casey is also a firefighter and licensed emergency medical technician in Woonsocket, R.I.
CASEY: Guy comes home from work and goes into the bathroom. His wife doesn't even know he's doing it. And he ODs in the bathroom.
ARDITI: EMTs try to revive people with naloxone, a medication that reverses an opioid overdose. But sometimes they don't get there in time. Last year, 430 people in Rhode Island died of drug overdoses, the highest on record. Studies of supervised injection sites in Canada and Australia show they reduced fatal overdoses and lowered the number of overdose-related 911 emergency calls. The sites also were associated with less use of drugs in public outdoor spaces, and there was no apparent increase in crime.
JOHN EDWARDS: Yeah, we're going to let them come in and use their drugs because that's when they have overdoses, and we want to be there to save them.
ARDITI: That's Representative John Edwards. A Democrat from Tiverton, Edwards sponsored the bill to create the new harm-reduction centers. Clients would bring their own drugs and be given clean needles and a safe space to use them. Clients also would be allowed to smoke their drugs. Staff would be trained to administer naloxone when someone overdoses. Representative Casey says they'd also offer information about drug treatment and other health services.
CASEY: This is something that - it just might work. And if it wasn't going to cost the state any money, we'd be crazy not to try it.
ARDITI: At least 100 supervised injection sites operate around the world, mainly in Canada, Europe and Australia. Last November, New York City opened the nation's first supervised injection site. Similar sites have been proposed in other cities. A plan to open one in Philadelphia is currently blocked in court, and the Biden administration hasn't taken a position on it yet. Scott Burris of the Center for Public Health Law and Research at Temple University says that while supporters of supervised injection sites are keeping their eye on what happens in Philadelphia, Rhode Island has a distinct advantage - supervised injection sites are already legal in the state. The next hurdle - finding a place to open the sites. The law requires anyone who wants to open a supervised injection site to first get approval from the local city or town council. The city council in Woonsocket, where Representative Casey is an EMT, recently proposed a resolution to prohibit the sites in their city.
Lisa Peterson is chief operating officer at VICTA, a private substance abuse and mental health treatment program that's looking to partner with other groups to open a supervised injection site in Providence. Peterson says that even some elected officials who support the program are reluctant to say so publicly. That's because for much of the public...
LISA PETERSON: This does seem really radical, and an elected official who supports it in theory might worry about what their constituents think.
ARDITI: So while Rhode Island was the first to legalize supervised injection sites, it's going to take work to persuade public officials to allow a site in their backyard.
For NPR News, I'm Lynn Arditi in Providence.
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