Aug.
31 was International Overdose Awareness Day. On a day dedicated to
recognizing the tragedy of every overdose death, five Chicagoans will
die from unintentional overdoses. In total, close to 2,000 Chicagoans
died from overdoses last year, with the vast majority of these deaths
linked to opioids.
The
frequency of these deaths cannot make us numb. Rather, it must motivate
us to explore all evidence-based options that will prevent these
losses, in particular those options grounded in harm reduction.
The
scientific community has accepted the effectiveness of harm reduction
for decades. At its core, harm reduction promotes and protects health by
recognizing and centering the dignity of all people. It acknowledges
that behavior change regularly is incremental and inconsistent. More
than simply individual, compartmentalized choices, health behaviors are
influenced by social, political and economic systems in which people
find themselves. When it comes to reducing the harms of substance use,
evidence-based approaches focus on empowering and validating safer and
achievable choices, while refraining from chastising less healthy ones.
Nonjudgmental, approachable harm reduction services provide an
opportunity for people to receive needed care without the restrictive
caveats of abstinence and other barriers.
Chicago
has long been at the forefront of many of these harm reduction
approaches. Amid the initial years of the HIV/AIDS epidemic, Chicago
Recovery Alliance and others pushed for “any positive change” and opened
some of the first domestic syringe service sites. Today, Chicago
continues to invest in evidence-based approaches, such as the recent
initiatives to expand access to naloxone, a reversal agent for opioid
overdoses, and medication for opioid use disorder and campaigns to
increase testing of substances for potentially unexpected drugs. While
these efforts have mitigated the damage caused by the overdose epidemic,
the severity of the crisis warrants exploration of all options.
For
more than 30 years, overdose prevention centers (OPC), also called
supervised consumption sites, have saved thousands of lives by providing
people a space to use illicit substances while under the care of
trained staff. Due to the high stigmatization of drug use, many
overdoses occur when people use drugs alone, outside of the presence of
someone with naloxone, so OPCs offer a safe setting for using drugs that
come from an often unstable, unpredictable supply. In addition to using
in the presence of qualified staff, participants can access services
such as HIV and hepatitis C virus testing, wound and injury care, mental
health support and social services. Across the hundreds of OPCs that
have operated throughout the world, thousands of overdoses have been
reversed, and no fatal overdoses have occurred. In addition to reducing
behaviors associated with HIV and hepatitis C virus infection, OPCs also
decrease public drug use and the litter associated with use.
While
most sites are international, OnPoint NYC opened two locations in New
York City near the end of 2021, becoming the first sanctioned OPC in the
United States. Since its start, the program has reversed more than
1,000 potentially fatal overdoses and linked thousands with critical
services in a nonjudgmental and compassionate manner. The success of
these enduring international examples, along with OnPoint’s model, have
prompted many to call for Chicago to follow that lead.
A bill pending before the Illinois General Assembly,
House Bill 2, would create the first state-sanctioned OPC in Illinois.
The bill outlines a pilot OPC program that would provide first aid
services, encourage and enable drug checking, provide referrals to
social and other services, and allow participants to use drugs under the
supervision of trained staff. The OPC would also conduct outreach to
local communities to determine the best location for the site.
This
bill represents a promising step toward embracing the full scope of
evidence-based approaches for addressing the overdose crisis. Even if
the General Assembly fails to approve the legislation, Chicago must
continue as a leader in harm reduction and move forward with
establishing an OPC. Every day that we fail to fully capitalize on
evidence-based approaches, we needlessly allow Chicagoans to die from
fatal overdoses.