Somerville maps fastest path to state's first supervised consumption clinic — starting in a parking lot

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A report commissioned by Somerville spells out location and design options for a supervised consumption, or overdose prevention center. It’s the latest step in Somerville’s pledge to open the first such clinic in Massachusetts, where people who inject, smoke or snort drugs would be monitored and given oxygen or naloxone to prevent a fatal overdose.

The 81-page document, prepared by Fenway Health, recommends the city begin with a large trailer, outfitted as a clinic, stationed in a city-owned parking lot. It would be open between 10 and 24 hours a day, depending on what the city could afford and would cost between $1.4 and $2.9 million a year. Somerville would partner with area providers for services the trailer doesn’t have room to offer: primary care, help with housing and initiating treatment.

Advocates acknowledge a portable unit is not ideal. But they say it would be the fastest way to get a supervised consumption clinic up and running while the city reviews more expensive options, like renovating buildings.

“With more than 2,000 people a year in Massachusetts dying, the imperative to move as quickly as possible is that we need to start saving lives,” said Carl Sciortino, executive vice president of external relations at Fenway Health and project leader of the report. “A modular unit will meet the critical needs of the clients that we're aiming to serve.”

The report includes two possible floor plans for the trailer, one that would occupy three parking spaces, another four. Seven or eight small cubicles for people who inject or sniff drugs line one wall. There’s a room for people who smoke, a clinic, a bathroom, space to check in and out and one or two meeting rooms.

The layout of the trailer across three parking spots. (Screenshot from Somerville's report)
The layout of a trailer that spans three parking spots. (Screenshot from Somerville's report)
The layout of a trailer that spans four parking spots. (Screenshot from Somerville's report)
The layout of a trailer that spans four parking spots. (Screenshot from Somerville's report)

There would be at least seven staffers, the report says, including a nurse, a behavioral health clinician, the program director, a site manager, a safety specialist and two peer support specialists.

The report came out the same week the Massachusetts Legislature tabled bills that would have created a pilot program for supervised consumption clinics in Massachusetts and lifted some state licensing and liability concerns for clients and staff.

Somerville Mayor Katjana Ballantyne says she’s not deterred.

“I’m committed to moving forward,” Ballantyne said. “This is a tool for harm reduction. And, why not use it, because 15 to 20 people are dying every year in our community?”

Two overdose prevention centers that opened in New York City last year, the first in the U.S., did so without explicit state or federal approval. A study released this July showed they are saving lives. The program’s director said in a tweet that as of July 22, staffers have intervened in 329 overdoses with zero deaths.

A holistic health services room is seen at an overdose prevention center in New York, N.Y., on Feb. 18. (Seth Wenig/AP)
A holistic health services room is seen at an overdose prevention center in New York, N.Y., on Feb. 18. (Seth Wenig/AP)

Leaders at the Department of Justice and President Biden’s drug czar have said they are evaluating supervised consumption as a harm reduction tool. Massachusetts Attorney General Maura Healey, a Democrat who is running for governor, said she’s already decided.

“Harm reduction strategies are an important part of mitigating the opioid crisis,” Healey said in a statement. “I support allowing communities to decide what’s best for their residents, including the option of setting up safe consumption sites, given the urgent need to help connect people with treatment services, address stigma, and save lives.”

Supervised consumption has some formidable opponents. Republican Gov. Charlie Baker has said he wants to focus on legal approaches to tackling overdose deaths, and that there is more evidence needed to support the use of such sites. Some members of the Massachusetts Chiefs of Police Association say assisting with illegal drug use could be seen as immoral. And top State House leaders have said the idea needs more study.

During a virtual community forum this spring, 55% of Somerville residents who participated listed themselves as supportive of supervised consumption, 18% said they were curious and 13% were opposed. But support for the idea may not translate to welcoming a center into a neighborhood.

Community opposition and a legal challenge from the Trump administration derailed plans for a supervised consumption site in Philadelphia. The Justice Department, under President Biden, is in settlement talks with the group proposing to open that clinic. A spokesperson for Rachael Rollins, U.S. Attorney for Massachusetts, said her office declined to comment for this story, citing the Philadelphia case.

Protesters demonstrate in support of supervised injection sites in Philadelphia in 2019. (Matt Rourke/AP)
Protesters demonstrate in support of supervised injection sites in Philadelphia in 2019. (Matt Rourke/AP)

Ballantyne says Somerville residents will have many more opportunities to ask questions and weigh in before the city selects the parking lot that would host an overdose prevention center.

“It might mean we go out door-knocking,” Ballantyne said with a laugh. “Somerville residents like to be engaged.”

Ballantyne says her next steps are hiring a program director and forming a new advisory committee to help the city choose a location. The report suggests lots in East Somerville, Davis Square and Union Square, based on access to public transportation, the location of overdoses and deaths and the distance from parks, schools and libraries.

The report says the city has the tools to open this fiscal year, but Ballantyne isn’t committing to that timeline. She says it will take time to hire and train staff, buy and build out the modular unit, choose a site and outfit it with water lines and electricity.

Somerville Mayor Katjana Ballantyne in Davis Square. (Jesse Costa/WBUR)
Somerville Mayor Katjana Ballantyne in Davis Square. (Jesse Costa/WBUR)

Ballantyne says Somerville has about $1.5 million that could be used to open a supervised consumption site. That might cover start-up costs, but not much else. Ballantyne says she and members of her administration are talking to leaders of other municipalities and private foundations about additional funds.

Sciortino, the report leader, says Somerville deserves a lot of credit for its commitment to opening a supervised consumption site, “a step that, frankly, every community should be taking to save lives.”

The value of these clinics struck Sciortino during a tour of one of New York’s sites, where he saw people who are often shunned on the streets treated with care and respect.

“The affirmation of the dignity and wholeness of the clients was inspiring,” Sciortino said. “We need to give people a chance to live for the ability to someday get treatment.”

This segment aired on July 29, 2022.


Martha Bebinger Reporter
Martha Bebinger covers health care and other general assignments for WBUR.



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