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How Overdose Prevention Sites Work

A vision for Rhode Island’s future harm reduction policy

Please email

smeans@ricares.org

to schedule a viewing/tour

How Overdose Prevention Sites Work presents an accurate model of a potential overdose prevention site (OPS).  Our goal is to debunk myths about these spaces and show how they save lives. The exhibition is created in partnership with the People, Place, and Health Collective (PPHC) at the School of Public Health at Brown University. How Overdose Prevention Sites Work broadens discussions about harm reduction and recovery in Rhode Island.

133 Mathewson Street, Providence RI, 02903

“I will never understand how we have allowed so many people to die when we know of a practical medical intervention where not one person has ever died.”

– Ashley Perry, Project Weber/RENEW

We can bring an OPS to Rhode Island!

We brought OPS to Rhode Island!

Legislation has been passed to make Rhode Island the first state to authorize overdose prevention sites!

We thank the legislators, research partners, community partner organizations and you! for making this possible.

Our stories have been heard and this is only the start to revolutionize the harm reduction and recovery world in Rhode Island and the nation.

Download the Bill

Advocates rally at statehouse in support of overdose prevention legislation | Uprise RI June 24, 2021

With McKee approving harm reduction center pilot, advocates showcase how one would operate | WPRI 12 July 16, 2021

Here’s what a safe injection site would look like | Boston Globe July 14, 2021

Rhode Island to open the country’s 1st safe injection site | ABC News Prime September, 2021

Frequently Asked Questions about Overdose Prevention Sites

What are overdose prevention sites?
What does the evidence say?
How do they affect the neighborhoods where they are located?
What do medical professionals say?
Why provide overdose prevention sites?
Do we need a site like this in Rhode Island?
What neighborhoods have been proposed?
What will an overdose prevention site (or sites) look like in Rhode Island?

A proven way to say lives

Overdose prevention sites (OPS), sometimes called supervised consumption sites, are regulated facilities which allow people to use pre-obtained substances under the supervision of nurses and other professionals who provide non-judgmental care and lifesaving services. Staff, who may include trained peers, do not directly assist in consumption or handle any drugs, but are present to answer questions on safer injection practices, monitor for signs of overdose, provide basic medical care, and refer people to drug treatment and social services.

The size and scope of OPS vary, but most include “wrap-around” services such as: testing for sexually transmitted infections and HIV; providing housing and job search support; and basic hygienic services. Sterile equipment and immediate responses are proven to reduce the risks from overdose and infectious diseases.

More than 120 OPS are currently saving lives and connecting people with treatment in 10 countries, including Canada and Australia. These life-saving facilities complement – but do not replace – existing prevention, harm reduction, and treatment interventions.

The evidence is clear

OPS are among the most well-studied public health interventions concerning the health and safety of people who use drugs. Over 100 peer-reviewed studies have consistently demonstrated positive public health and social benefits.

OPS save lives. Thousands of overdoses have been successfully managed in OPS around the world.In fact, there has not been a single overdose fatality in any OPS worldwide. Studies show that OPS increase entry into treatment for substance use disorders and help sustain long-term treatment engagement and recovery.

OPS also increase utilization of health and social services, including counseling, seeking medical care, and harm reduction programs. Because they offer sterilized equipment and hygienic services, OPS prevent the spread of infectious diseases such as HIV and hepatitis C.

Finally, OPS have the potential to save money due to reduced deaths, the decreased need for emergency medical services, and their ability to prevent diseases.

OPS have a positive effect

These centers have been proven to reduce public drug use, minimize drug paraphernalia litter, and decrease public disturbances. They do not to increase crime in the surrounding neighborhoods.

OPS do not attract new drug users or more drug use; they simply provide a less chaotic, non-isolating environment for vulnerable people. They minimize personal and neighborhood chaos.

OPS save lives inside and outside their doors; one key study showed that after the opening of an OPS in Vancouver, Canada,overdose deaths decreased by 35% in the surrounding neighborhood.Of course OPS do not solve a city’s housing or unemployment problems, but they do connect people with housing and other social services. They function as a vital component of an effective approach to addiction.

OPS do not increase drug selling in the neighborhoods in which they are located. Many OPSs around the world have a low profile in the neighborhoods where they are sited. In Canada, most local businesses support OPSs because they improve neighborhoods by reducing public drug use and decreasing drug-related litter. They are also supported by local police as OPS reduce public disorder where they are sited.

Publicly supported

Major US organizations of medical professionals support OPS, including the American Medical Association.

OPS have also garnered widespread support from nurse’s associations across Canada and Europe, and that care provided in OPS is viewed as falling within the scope of registered nurses’ practice.

More public health access

Decades of research and experience in dozens of countries have shown that overdose prevention sites are a highly effective way to prevent overdoses and save lives.They also help connect people to treatment and other social services, and improve the conditions in the neighborhood in which they are located.

Prevent more loss

Rhode Island has been one of the states most impacted by fatal overdoses.

Between 2015 and 2020,more than 1,700 Rhode Islanders lost their life to an accidental overdose, according to Rhode Island Department of Health statistics, and overdose deaths have increased during the COVID-19 pandemic.

These people were our friends, family members, and loved ones. We have an obligation to do more to address the overdose crisis, and overdose prevention sites are one critical tool in our toolbox.

You can learn more about the overdose crisis in Rhode Island and the resources available in our state from https://preventoverdoseri.org/

Location matters

Overdose prevention sites are most effective in neighborhoods that are highly affected by the overdose crisis (i.e. they experience a significant number of overdoses, have a high density of people using drugs in public, etc.). However, a specific neighborhood or neighborhoods have yet to be selected in Rhode Island.

We can have a say

There are multiple types of overdose prevention site models. While these vary slightly, they all seek to prevent fatal overdoses and connect people to health and social services. No specific model(s) has been chosen for Rhode Island.

No site has been selected or proposed in Rhode Island. An organization has not yet been chosen to manage or implement an overdose prevention site in Rhode Island.

Virtual Gallery

 

How Overdose Prevention Sites Work is designed to show what an OPS could look like. The design is based on existing OPS found around the world. Specific services and protocols vary from site to site. Service models, potential locations, and operational logistics have not been established for a potential OPS in Rhode Island.

This exhibition provides an overview of what is typically available at these sites.

Exhibition Overview

1
1

Registration Desk

2
2

Waiting Area

3
3

Consumption Room

4
4

Observation Area + Support Services

Registration Desk

When a person enters an OPS, the first stop is the registration desk where they connect with one of the site’s staff. If this is a person’s first time accessing the OPS, they will register and be given a client ID number. If they have been there before, they will check-in with the staff using their client ID number or name. Staff will ask the person what substances they brought with them to use, the method they plan on using to consume it, and about how much of it they plan on using.
Information collected by the staff is not shared with other individuals accessing the site. Data collected by the staff is used to track the number of clients the site serves, types of drugs used, services accessed at the site, and overdoses that occur for evaluation and programming purposes.
The registration area has educational information about safer drug use practices, medications for opioid use disorder, naloxone training, HIV and hepatitis C prevention, site rules, and other community resources available. A person can also access harm reduction supplies — like syringes, pipes, and condoms — to take home and can drop off used syringes for safe disposal at the check-in area.

Waiting Area

A person will take a seat in the waiting area until a spot opens up in the consumption room. While they wait for their turn, they can choose to test their drugs using a mass spectrometer — which provides a detailed breakdown of each substance — or fentanyl testing strips. When a spot is available, a person will head to their assigned booth.

“An overdose prevention site is a vital component in a holistic approach to preventing overdoses. An OPS gives people the option of safety and compassion – something that’s not guaranteed when using on the streets or at home alone.”

– Sarah Edwards, Parent Support Network of Rhode Island

Consumption Room

A range of sterile injecting and smoking supplies are available from the supply counter in the consumption room, including sterile syringes, alcohol swabs, and tourniquets. Once a person has what they need, they will take a seat at an open booth or inhalation stall, depending on their method of use.
At the booth, a person will test their drugs using fentanyl test strips and prepare everything themselves. Each booth has a mirror to help the staff monitor potential signs of an overdose. Staff are in the room at all times to answer questions anyone may have and to monitor all use. The OPS is equipped with naloxone, oxygen, and other supplies in case there is a medical emergency.
Once a person is done using, they will safely dispose of their materials in biohazard containers located at their booth. Next, a staff member will clean and disinfect the area and the space will be ready for the next person.

“We know that the main reason people die of a drug overdose in Rhode Island is that they were using alone. As a person in recovery and a peer recovery specialist, I know that overdose prevention sites will help keep people alive and—this is the bottom line—you cannot recover if you are dead.”

– Jon Soske, RICARES

A clinic room is also available. A person can meet with a healthcare practitioner for basic medical care, like voluntary sexually transmitted infection (STI) or HIV testing or general first aid. A healthcare practitioner can also provide referrals for drug treatment and other health services a person may need.
When a person has accessed their needed services and is ready to leave, they exit the site through a door located in the observation area.

Observation Area + Support Services

After using, a person heads to the observation area where they are monitored for signs of an overdose or other medical emergencies. In this area, a person can help themselves to snacks and can connect with nurses, peer recovery coaches, and case workers who provide overall support. These staff help connect a person to health and social services like housing supports, medication for opioid use disorder, or counseling they may need.

“For 7 years, Rhode Island has been implementing various strategies to address the opioid epidemic, yet children, parents, husbands, wives, and loved ones continue to die. It’s time for a new strategy! Overdose prevention sites are a scientifically supported intervention that save lives. It’s time for a change. Support overdose prevention sites.”

– Roxxanne Newman,
People, Place & Health Collective

Download the OPS Exhibition Brochure
Located at 133 Mathewson Street in Downtown Providence, The Benz Gallery expands RICARES educational programming. The gallery offers a space for artists, academics, and community members to present recovery related issues and ideas using art and topic-based installations.  The gallery serves as an entry point for people who want to learn more about the intersection of recovery, trauma, and social justice. The gallery honors our dear friend, Mark Benz, who we miss everyday.
How Overdose Prevention Sites Work would not be possible without Dr. Alexandra Collins, who dedicated her expertise over many hours.
Dr. Alexandra Collins is a Postdoctoral Research Associate in the Department of Epidemiology at Brown University’s School of Public Health and a member of the People, Place, and Health Collective. She received her PhD in Health Sciences with a focus on medical social sciences and applied anthropology from Simon Fraser University in Vancouver, Canada. Her community-engaged research focuses broadly on social, structural, and built environmental drivers of overdose risk among unstably housed persons, drug use risk environments, gender and drug use outcomes, and evaluations of harm reduction interventions.
RICARES would like to thank the following people for their help in creating this exhibition: Dr. Jon Soske, Roxxanne Newman, Dennis Bailer, Ashley Perry, Sarah Edwards, and Gayle Fraser.

How Overdose Preventions Sites Work is generously funded by: