State lawmakers are considering a proposal to let cities and towns create areas where narcotic users can consume the illegal drugs without fearing arrest.
A bill under consideration in the Maine State Legislature, LD 1364, would authorize municipalities to open so-called “safe consumption sites,” also known as safe injection sites.
The bill outlines a number of requirements which must be met in order for a safe injection site to be approved, including the provision of “a hygienic location supervised by a health care professional and other trained staff where a client may self-administer previously obtained drugs” and “sterile drug use supplies.”
Sites would also be required to have staff “monitor clients for potential overdose” and to administer naloxone hydrochloride, the overdose reversal drug known as Narcan, as well as other medical interventions, as necessary.
It is further required that sites would “provide referrals to services, including substance use disorder counseling and treatment, primary medical care, mental health services and social services,” in addition to “overdose prevention education.”
Proponents of the bill suggest that safe consumption sites are essential to addressing the epidemic of drug overdose deaths.
Opponents, on the other hand, argue that there is little evidence concerning the efficacy of safe consumption sites when it comes to reducing drug abuse. They argue that such sites actually have the potential to exacerbate the problem.
Rep. Grayson Lookner (D-Portland), one of the sponsors of LD 1364, testified to the Committee on Criminal Justice and Public Safety that the purpose of the bill is to “begin to create real solutions to this crisis that has for far too-long evaded our best efforts at saving lives in our great state.”
Representatives of several addiction recovery organizations, as well as Meagan Sway of the American Civil Liberties Union Maine, testified in support of the legislation.
Sway testified that addressing the drug overdose death epidemic in the state requires a comprehensive strategy, part of which, in her opinion, ought to include safe consumption sites.
“The evidence shows that overdose prevention sites work,” Sway said.
To support this, she cites overdose prevention programs in Australia, Canada, and Europe that “have successfully prevented overdose deaths and the transmission of blood borne disease, and have connected people to treatment.”
Sway also pointed to two safe consumption sites in New York City that have, she claimed, prevented more than 600 overdose deaths.
Jeanne Marquis, Selectman for China, Maine and an organizer for Maine Recovery Advocacy Project, also testified in support of the bill.
“When you have a family member with substance-use disorder, you can‘t wish their addiction away. Your loved one needs to choose the path to recovery on their own,” she said. “Until they make this choice, we need to keep them alive. Safe Consumption Sites will keep our sons and daughters alive.”
Marquis argued that safe consumption sites will not lead to an increase in drug use.
“What these Harm Reduction Health Centers will do is enable people to not have to use alone, enable people access to related health services, enable people to have access to recovery services, and, most importantly, enable people to live,” she said.
Not everyone, however, agrees that LD 1364 is an appropriate or effective approach to achieving these goals.
Several individuals representing law enforcement interests testified in opposition to the bill.
Jason Trundy, Waldo County Sheriff, testifying on behalf of the Maine Sheriffs Association, raised concerns about the untested nature of safe consumption sites in areas that are “comparable to Maine communities.”
“While Representative Lookner is carefully looking to save the lives of Mainers, what are
the unintended consequences?” he asked. “Will drug users from rural communities make their way to the cities for these services?”
Trundy also points out that under LD 1364 there is no limit to how many communities can open these sites, how many can be set up within one municipality, nor what sanctions might be put in place should violations occur.
Charles Rumsey, Chief of the Cumberland Police Department and President of the Maine Chiefs of Police Association, also testified in opposition to the bill.
“The Maine Chiefs are in opposition to this bill and others like it this session because
we are sworn to protect lives, and we have not seen enough data to show that harm
reduction centers protect lives,” Rumsey said. “We do have concern, however, that establishment of these sites would lead to an increase in drug dealing and other criminal activity associated with addiction to illicit drugs near the sites.”
Rumsey summed up his testimony by arguing that safe consumption sites are simply not the answer to the illicit substance crisis Maine is currently facing:
We are in support of legislation that help people to stop using drugs that can wreak havoc on their own lives, their family’s lives and the community. We wholeheartedly support efforts to establish detox centers, including centers that will accept patients who present while under the influence of drugs. But we have not seen enough evidence that harm reduction centers assist people to stop using illicit drugs. Rather, we are concerned that these centers enable continued use, and potentially even ‘normalize’ the use of these substances.
Deputy Chief Christopher M. Martin of the Brewer Police Department also testified in opposition to LD 1364.
“Supervised injection sites do little to reduce the overall demand for illicit drugs,” Martin said.
Martin also raised concerns about the need to, by default, decriminalize the possession of illicit drugs in the area surrounding a safe consumption site, allowing consumers to safely transport their drugs to and from the site without interdiction by law enforcement.
In his testimony, Martin contextualized LD 1364 within the broader conversation in Maine regarding drug decriminalization and safe consumption sites.
“The Maine Center for Sensible Drug Control Policy released a report outlining legislative priorities in 2019, and since that time nearly all of the social justice reform measures have been introduced as legislation,” he said. “Safe injection sites were one of those priorities in an effort to move towards the broader objective of the decriminalization of drug possession.”
Martin proposed an alternative path forward in his testimony, suggesting that lawmakers consider the illicit drug economy and then employ models to influence behaviors regarding supply and demand. He recommended that investments be made in the areas of enforcement, education, access to treatment, and sustainable recovery.
“It is through a balanced pragmatic approach that we can have a functional drug control strategy,” he said.
On behalf of Gov. Janet Mills, Gordon Smith also testified in opposition to LD 1364.
Among the reasons listed for Gov. Mills’ stance on the bill are the existence of a federal prohibition on the establishment of safe consumption sites, as well as the lack of data on their operation in primarily rural states.
Smith’s testimony also notes that the other services outlined in the bill, specifically those related to health referrals, are already provided by Maine’s community recovery centers and Syringe Service Programs.
Mills also opposes the LD 1364 on the grounds that “there is insufficient evidence to date that safe use sites encourage individuals to find a pathway to recovery.”
Given the lethality of the current drug supply, we should be doing all we can to encourage individuals to find a pathway to recovery, as continuing to use in this environment all too frequently results in a fatal overdose. Eighty percent of Maine’s fatal overdoses last year involved fentanyl, which acts quickly and is 50 to 100 times more lethal than morphine. Only two milligrams of fentanyl is considered a potentially lethal dose. Given that an individual would be unlikely to – and may not be able to – use the facility in every instance (the NYC facilities are open only 12 to 14 hours per day and only 5 days per week), the establishment of such a site may actually increase the risk to users by creating a false sense of security in ongoing use.
The Committee on Criminal Justice and Public Safety issued a divided report on LD 1364, and it remains to be seen how the Maine House and Senate will ultimately handle this legislation.