By Seth Daniel
Having watched too many of his patients die at the hands of opiate overdoses, Charlestown-based Dr. Mark Eisenberg is one of a growing number of medical providers in Boston calling for the city and state to institute a safe injection site in the city.
“I’ve been a primary care doctor for 32 years here,” he said in a recent interview at MGH Charlestown on High Street. “I’ve lost dozens of patients due to heroin overdoses. I’ve lost five patients here in the last six months. The common denominator is these patients are using alone in fast food restaurants, in cars, under bridges and in bathrooms. If they are to inject drugs in a safe environment with medical supervision, it would prevent these overdoses, and they wouldn’t be dying.”
The movement for a Safe Injection Site in Boston began in earnest this year when the Massachusetts Medical Society (MMS) voted 193-21 to endorse the idea. Since that time, a bill in the legislature on Beacon Hill sponsored by Sen. William Brownsberger (D-Back Bay, Belmont) has gained ground among state leaders.
However, city officials held a hearing at the council in June, and the idea wasn’t as well received before a committee led by Councilors Annissa Essaibi George and Frank Baker.
“I think this idea is asinine, absolutely asinine,” said Councilor Michael Flaherty at the June hearing, saying he prefers recovery and treatment on demand services. “If we think someone is going to score heroin and take a trip over there to inject heroin, that’s not reality. They will inject it or sniff it minutes after purchase…This vision we have of people scoring heroin and taking a bus or tax ride to the facility…that’s not going to happen…The buyers and sellers are going to be wrapped around this facility.”
MMS President Dr. Henry Dorkin testified at the hearing that the vote among physicians was a statement that a task force should be put together to identify the need and placement of a Safe Injection Facility (SIF).
“That vote said this was something we should approach and put together a Task Force to look at the issue…and determine what the appropriate plan would be from a patient perspective,” he said.
He prefaced that by giving statistics that more than 2,000 people in Massachusetts were lost to opiate overdose in 2016, and a SIF is part of a harm-reduction strategy where users would bring their own drugs in that they’ve procured. Drugs would not be provided, but the trained medical staff at the SIF would oversee the user injecting the drugs and make sure they didn’t overdose, and would also be able to provide a quick analysis of what is in the drugs – a precaution that is critical nowadays with the deadly Fentanyl and Carfentanyl substances that have shown up in street opiates.
“This is a harm reduction facility to reduce overdoses and fatalities from overdoses,” he said at the hearing.
Meanwhile, in Charlestown, Dr. Eisenberg’s voice is one of the leading advocates for many years for a SIF in Boston, being part of the ground known as SIFMA Now (Safe Injection Facility Massachusetts Now).
He has travelled to Vancouver where SIFs have been in place for many years – one of the only places in North America due to the facilities being illegal according to U.S. federal law.
“People who use (the SIF in Vancouver) are 35 percent more likely to get help for addiction than people who don’t use it,” he said, something he learned on a first-hand visit. “It wouldn’t be just a Safe Injection site, but counselors are available if they want to go to a detox program. They are more likely to access that if they are with doctors who help. There was a 30-percent decrease in overdoses compared to people who didn’t use it.”
He also said that many of the business and community members where the SIF was located had changed their opinions, having at first been vehemently opposed. Ten years later, he said that is no longer the case in Vancouver.
“I understand the reluctance of the business community here, but I think it also makes things a safer and better for the business community also,” he said. “Our hope now is to get law enforcement and the business community to buy into the idea.”
Like many physicians entering into the SIF debate, Dr. Eisenberg focuses on the human toll, and the patients he knows that died alone of an overdose.
But convincing everyone – even with that narrative – might be an uphill battle. In fact, at the June Council hearing, not many legislators were buying into the idea.
“I’ve been looking at the numbers from Vancouver that were presented and it says that there were 263,000 visits by 6,500 individuals and only 464 entered recovery,” said Councilor Baker in June. “That doesn’t seem like great numbers. I think I have a very difficult time with this if there’s not an end date…I’m not sold on the idea.”