In the battle against the opiate epidemic, the Charlestown MGH Health Center is taking a big step in creating a mock Safe Injection Facility (SIFs) at the High Street facility next week – putting together what a real SIF might look like and talking about the benefits of this controversial tool in the opioid fight.
SIFs are currently illegal in the United States, but are a popular treatment in several Canadian cities. They operate as a supervised area inside where intravenous drug users can come in with their drugs. Once there, they can inject in booths with clean supplies and medical supervision. They are allowed to stay there under supervision until they desire to leave.
“The idea is to show the public what it would look like,” said Dr. Mark Eisenberg, a long-time primary care physician in Charlestown and supporter of SIFs. “It’s to destigmatize and show the public what we’re supplying is a safer place for people to use drugs rather than on a street corner or in an alleyway on Mass and Cass…We’re trying to familiarize the Charlestown community with the concept because obviously this epidemic has effected the community really hard.”
The mock SIF will be in a second-floor conference room and will be within a small tent. There will be an example of a booth that is used in Canada where there will be a mirror, supplies, clean water and staff that would supervise. The mock SIF has been toured to other places over three years, including Harvard Medical School, Northeastern University and Boston University Medical School – though this would be the first time it is open to the public.
The three-day open house will also include a panel discussion on Thursday, Oct. 19, about SIFs. That discussion will include Dr. Eisenberg, a student from the MGH Institute, DJ Michael ‘Smokey’ Cain, and Drug Users Union Secretary Aubrey Esters.
Cain, who lost his son to a drug overdose some years ago, is one example of many parents who are supporting such a new concept.
Eisenberg said on Tuesday of this week, he and several supporters testified before a Committee in the State Legislature that is studying SIFs. Within that testimony – which included several medical professionals – were a number of parents of children who died of drug overdoses. Many grieving parents, Eisenberg said, are turning towards supporting SIFs due to the safety aspect.
“Those are the most powerful voices,” he said. “It’s obvious to them that the last time their son or daughter or sister or brother used drugs, they did it in an unsafe place – whether their own bathroom or a parked car. If they’d have been somewhere safe with supervision they may still be alive today. For parents and everyone, the whole concept takes a step of getting used to and thinking about the whole enabling thing. I think when people process it and think about what happened to their child (or loved one), they realize this is a better alternative.”
The event at MGH is a bit groundbreaking because it is within a long-established health center. Many examples of such a facility are stand-alones or located far from the population in desolate places. A recent train of thought is that if such things were to come to Boston, they should be in existing health facilities – such as a health center.
Eisenberg said his vision is that there would be many such SIFs all over the city that are convenient.
“Ultimately, my vision of the future is that people who plan to inject drugs don’t really want to take two subways and travel 40 minutes because they are usually desperate,” he said. “So, having them available locally in multiple sites throughout the city makes the most sense. We have to start with one and show the feasibility, demonstrate to the public it doesn’t increase crime, and doesn’t honeypot. Once we have one or two on the ground, I think we can have them at multiple locations spread out across the city.”
He said that model has worked in Canada, where such facilities are “spreading like wildfire,” he said. There, they have brick and mortar SIFs and mobile vans as well. Such a combination, he said, might work well in Boston.
That said, Eisenberg was clear that the goal is to get people off of drugs, and that SIFs were one small tool in that overall fight. While they gather headlines and controversial opinions, they are not the overall solution.
“This is just a small little piece,” he said. “I don’t want anyone to think this is going to be the answer. My goal is to keep people safe and alive until such time they are ready to stop using drugs…We can prevent all of the major complications so people are well, and then when they’re ready to stop using, it will be a place people naturally flock to when they need help.
“In general, drug users have had such negative experiences with doctors and hospitals, that is not the place they typically go to get help,” he continued. “They go to a place like the AHOPE (needle exchange) and SPOT (at Boston Health Care for the Homeless) where they have peers that work there…It’s partly a gateway to treatment when they’re ready as well as a safe place to use when they are not.”
The mock consumption sites will be open to the public 9 a.m. to noon, and 1 p.m. to 5 p.m. Oct. 16, 17, and 18. The panel discussion will take place from 5-7 p.m. on Oct. 17. All of the events will be at the Charlestown MGH Health Center on High Street.
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