With state statistics indicating that roughly four Massachusetts residents die every day from an overdose, the need for some sort of new approach seems more urgent than ever, Gaeta said. Still, her organization plans only a limited version of the “safe place” other countries offer. In Boston, patients will not be allowed to take drugs in the room.
“It’s not a place where people would be injecting,” Gaeta said. “But it’s a place where people would come if they’re high and they need a safe place to be that’s not a street corner, and not a bathroom by themselves, where they’re at high risk of dying if they do overdose.”
All the funding isn’t yet secured, she said, but the plan is to convert a conference room for this purpose. A nurse and outreach worker would move among 10 or so users to check breathing, other vitals, and general health. If patients in the room need more than nursing care, there’s a hospital across the street.
Gaeta says staff in the room will “try like heck” to get patients coming off a high into treatment.
Ray Tamasi, the CEO at Gosnold, an addiction treatment network on Cape Cod, says his staff tried a similar approach with alcohol addiction about 15 years ago.
It was marginally successful, Tamasi said, “but it was taxing, very labor intensive and difficult. You have to have the resources to be able to do it.”
The Boston organizers say they are desperate to try something new. Overdoses have become the leading cause of death among Boston’s homeless men and women. But will users who inject drugs or take a cocktail of pills find their way to this room?
“I could say, for myself, I would use it just to be safe,” said Nicole, who currently is getting treatment with methadone for her heroin addiction. She asked to be identified by only her first name because some family members don’t know about her heroin use.
“A lot of addicts are homeless or by themselves,” Nicole said. “So, to have somebody—especially a nurse—keep an eye on you, and have a place to go when you’re under the influence or high … and somebody monitors you … that’s an awesome idea.”
A review in 2014 of 75 research articles found that supervised injection facilities—the type of “safe room” offered outside the United States—reduced the rate of overdose. And a 2008 study found that patients in Vancouver, British Columbia, and Sydney, Australia, who were monitored by a nurse while they used heroin were more likely to end up in treatment than patients who were not monitored.
The use—or lack of use—of these safe rooms in various countries highlights a divide in addiction treatment, said Barbara Herbert, the president of the Massachusetts chapter of the American Society of Addiction Medicine.
“The controversy,” Herbert said, “is, does it encourage people to keep using if we make their lives less dangerous and less miserable, or can we scare people into care?”