MHA Testifies in Support of Safe Injection Facilities

Saying that healthcare providers have “a moral obligation to help patients remain alive and healthy until they can choose recovery,” MHA on Wednesday testified in support of a Massachusetts senate bill that would allow DPH to implement safe injection facilities (SIFs) subject to local approval.

SIFs are spaces for people who use illicit drugs to consume those drugs (brought into the SIF) under the supervision of a healthcare professional or other trained staff. The reasoning is that if users take drugs in monitored spaces, as opposed to unsupervised on the street, there’s less of a chance they’ll overdose and a greater chance that they’ll be directed to treatment.

On average, 5 to 6 people die of opioid overdoses daily in Massachusetts. The state and healthcare community have adopted many strategies to address that shocking trend. For example, an MHA-convened expert panel developed new opioid prescribing guidelines for all hospitals and the state has upgraded its prescription monitoring system. But as the problem persists and more powerful opioids like fentanyl are becoming widely available, providers and policymakers are looking to such seemingly counterintuitive strategies such as SIFs or “safer drug consumption programs”  as the Senate Bill 1081 refers to them.

On Wednesday, MHA’s V.P. of Clinical Integration Steve Defossez, M.D., testified with MHA’s V.P. of Government Advocacy Mike Sroczynski before the Joint Committee on Mental Health, Substance Use & Recovery.  The bill’s lead sponsor is Sen. William Brownsberger (D-Belmont).
They noted that substance use disorder (SUD) is a chronic physical disease of the brain amenable to successful therapy just like other chronic diseases such as diabetes or hypertension. One component of SUD, however, is impaired decision-making. Therefore, not all patients with opioid SUD are ready to choose recovery, treatment and abstinence when it is offered to them. However, such patients may be amenable to pursuing treatment when exposed to cost-effective treatments that reduce harm; initial data shows that supervised injection facilities, as envisioned by SB1081, hold great promise on this front.

“The end result of an opioid substance use disorder may be recovery, incarceration or death,” Defossez said. “Alternative strategies such as SIFs help move SUD patients toward recovery. MHA believes healthcare providers have a moral obligation to help patients remain alive and healthy until they can choose recovery.  SIFs can help accomplish this goal by reducing or eliminating the risk of overdose death and helping reduce transmission of viral diseases such as HIV and hepatitis.”

Sroczynski noted that in one study, a safe injection facility documented a 30% increase in the rate of patients choosing recovery rather than persistent drug use.  “The reason for this increase is that every time a patient uses a SIF, it’s a touchpoint for a compassionate healthcare worker to make a personal connection with a client and increase that client’s awareness of their treatment options,” he said.