Government to Fund Study on Safe Injection Sites For Overdose Prevention

Federal money will fund research into the benefits and costs of safe injection sites

The grant, from the National Institute on Drug Abuse (NIDA), provides $5 million over four years to researchers at New York University and Brown University to study two existing safe injection sites in New York City and one due to open next year in Providence, Rhode Island.^[1]

The funds won’t be used to operate the facilities, where individuals can use drugs under supervision and access medical support if they overdose. Instead, they will fund research into whether the centers can prevent overdoses and measure both their costs and potential savings for the criminal justice and healthcare systems.

Safe injection sites remain controversial

Harm reduction advocates have long argued for the establishment of safe injection sites, also called overdose prevention centers, drug consumption rooms, and supervised consumption services, in the United States.^[2] 

At these facilities, drug users can intravenously inject illicit substances, usually opioids like heroin, with clean needles and with clinicians standing by to administer help, such as the overdose rescue drug naloxone (Narcan), in the event of an overdose.^[3] At legally-sanctioned injection sites, individuals are safe from criminal prosecution for possessing and using illicit drugs. 

The facilities can reduce the risk of overdose deaths, abscesses, and infections like endocarditis, and the transmission of blood-borne illnesses such as HIV and hepatitis, proponents say.

The injection sites can also provide immediate medical care, including HIV and STI testing, wound care, and immunizations, and can connect drug users with addiction treatment, mental health services, detox services, and other community support. At some sites, users can test their substances for the presence of the deadly opioid fentanyl.

However, opponents argue that the sites encourage drug use and degrade the surrounding area.^[4] That was the argument made by Rod Rosenstein, then deputy attorney general for the Trump Administration, in an editorial for the New York Times in 2018.^[5]

He said that injection sites are “very dangerous” and “normalize drug use and facilitate drug addiction by sending a powerful message to teenagers that the government thinks illegal drugs can be used safely.” He also argued that the injection sites would draw drug dealers and users to neighborhoods. The Trump administration sued to block the opening of a proposed injection site in Philadelphia in 2019.^[6]

Gathering more data about the benefits and risks of injection sites could help settle the debate, said Dr. Nora Volkow, director of the National Institute on Drug Abuse. “There is a lot of discussion about overdose prevention centers, but ultimately, we need data to see if they are working or not, and what impact they may have on the community,” she said.^[1]

Related: What to do in the event of an overdose

Biden administration has signaled it might back safe injection sites

The NIDA-funded study will be the first large-scale, government-backed research into sanctioned safe injection sites in the U.S. It's further indication that federal policy could be shifting on consumption sites, steered by a Biden administration that has embraced harm reduction to tackle the opioid crisis. 

In December, the National Institutes of Health (NIH) set up a research network to study a variety of harm reduction programs, including those supplying naloxone and those providing fentanyl test strips. The new study into injection sites will be part of that project.^[1] 

In 2022, the Justice Department told the Associated Press that it was “evaluating” injection sites.^[7]

“Although we cannot comment on pending litigation, the Department is evaluating supervised consumption sites, including discussions with state and local regulators about appropriate guardrails for such sites, as part of an overall approach to harm reduction and public safety,” the agency said in a statement.^[8]

The Biden administration didn’t act when New York City opened the first officially authorized safe injection sites—which it calls “overdose prevention centers”— in the United States in late 2021.^[9] The two New York City sites, located at syringe exchange programs, will be the subject of the NIDA-funded study, alongside one to open in early 2024 in Rhode Island after approval by the state’s General Assembly.^[10]

States including Colorado, Nevada, and New Mexico are all considering permitting safe injection sites. However the governors of California and Vermont last year vetoed safe injection bills passed by state legislatures, and Pennsylvania’s Senate voted last week to prohibit them.^[1]

More than two hundred safe injection sites already exist around the world, primarily in Canada, Australia, and Europe, especially the Netherlands.^[2][11]

Previous studies have found positive impacts, including reduced deaths and increased entry to treatment

More than 100 peer-reviewed studies have probed the effects of existing international overdose prevention centers, as well as those that have operated illicitly in the United States. They have consistently proven the benefits of these sites, the Drug Policy Allowance says.^[2]

Related: Opioid overdose epidemic

The positive impact of safe injection sites includes reducing overdose deaths and safely managing on-site overdoses, reducing the amount and frequency of drug consumption by users, reducing HIV and hepatitis C risk behavior, increasing entry into substance use disorder treatment, and saving society money by reducing overdose deaths, disease, and the use of emergency medical services.^[2]