2023-10-23 00:00:00 - Joint Committee on Mental Health, Substance Use and Recovery
2023-10-23 00:00:00 - Joint Committee on Mental Health, Substance Use and Recovery
SHOW NON-ESSENTIAL DIALOGUE
SPEAKER1 - Good morning, everyone, and welcome to the joint committee on mental health, substance use, and recovery's 5th public hearing of the 2023, 24 legislative session. My name is John Vilas, and I'm the senate chair of the committee. And119 I'm joined by my friend, representative Adrianne the house chair of this committee. We are now calling this hearing to order. Today's hearing focusing on legislation128 related to harm reduction, and I wanna thank all those who are present both in person and virtually for being here today. I'd like to now recognize the other senate members of this committee, the vice chair, Senator Cyr, senator Collins, who's with us in person, senator Creighton, senator Keenan, senator Robin147 Kennedy, and senator O'Connor.
SEN VELIS - As our Commonwealth and the legislature continues to combat the substance use epidemic and support individuals throughout our communities who are struggling with substance use disorders, we know that harm reduction is a critically important part of that conversation. As many of you know, 2021, Massachusetts set a new record for overdose deaths, 2,357 lives tragically lost, and thousands of families who are continuing to grieve. We also know that in those fatal overdoses, Fentanyl was present at the rate of 93%. More than ever before, we have a contaminated drug supply here in Massachusetts. In my mind, at the most basic level, harm reduction is about keeping people alive so that they're able to get the care and treatment that they need.
We can't help someone who's no longer with us. We recognize that harm reduction can take many different forms, and the Commonwealth is not alone in looking at ways to expand the resources and services available in our communities. Legislation similar to these bills are being heard today, has been proposed and being considered in states throughout this entire country,219 and we know that our federal partners are looking at these issues closely as well, evidenced by the National Institute on Drug Abuse's recent funding for a four-year study on the impact231 over of overdose prevention centers. I think it's important for us to keep in mind and to look closely at where237 strategies like this have been implemented already. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER1 - So I'm grateful for this hearing today where we'll be able to have this important conversation and hear from elected officials, medical experts, and researchers, social service, harm reduction specialists, and importantly, individuals with lived experience. These are important conversations and important pieces of legislation that deserve this opportunity for a hearing and that this deserve this critical consideration. I'd now like to turn it over to my friend, the house cochair of the committee,268 Rep. Medaro, for some opening remarks and to recognize the house members.
SPEAKER3 - Thank you, senator. Good morning, everyone. Again, my name's Adrian Madro, proud to serve as the host chair of this committee. I want to thank senator Vilas, for bringing us281 together and cochairing and leading, today's283 hearing. Also grateful to be joined by members of the committee from the house. We have representative Zaros, Karens, Donahue, and, vice chair Dubois, with us today.
REP MADARO - Today's hearing, as296 the senator mentioned, is on harm reduction, and298 it comes at a really critical time in the Commonwealth. I think everyone here recognizes how meaningful harm reduction measures are to public health and how impactful nonjudgmental evidence based care and support is to people in active use. According to the Boston Public Health Commission, accidents, primarily drug overdoses, are the leading cause of premature death in my district, my hometown of318 East Boston. As my co-chair mentioned, nationally, overdose deaths increased by 2.5% with nearly a 110,000 overdose deaths in the past326 year, disproportionately affecting black, indigenous, and other people of color. And in the Commonwealth, opioid related deaths increased also by 2.5% with over 2,300 people dying from an opioid related overdose in the past year.
In addition to the opioid crisis, we're341 hearing of rising stimulant use on top of increases in polysubstance use. That's why it's critical that the Commonwealth continues to build upon its work, to increase access, bolster the workforce, reduce stigma and address the social determinants of health that are barriers to long term recovery. We also must prioritize the often thankless work done by the incredible health care professionals and other workers providing harm reduction, health care, and other services to people who use substances. I'm so grateful to the advocates here today, who are going to share their personal experiences, their expertise, and their thinking about the legislative proposals before us. We could not do our job as a legislature without these perspectives. SHOW NON-ESSENTIAL DIALOGUE
I want to thank LIS and the assistant381 sergeant at arms for facilitating this hybrid hearing as well as our committee staff for their diligent work in preparing for today's hearing. And, again, I388 want to thank all of those testifying virtually and in person for your time, your attention, and your perspective on these critical issues. We look forward to hearing from all of you. Just want to make note. We have a custom here in the joint committee on mental health, substance use, and recovery to take a short mental health break. We might need to404 take two today if the hearing, runs a long Time. So, we will, share more information about that as it gets closer to probably about one o'clock. Without further ado, take it away, senator.
SPEAKER1 - Thank you very much, Mr. chairman. And just a few other housekeeping details before we get started. This is a hybrid hearing With participation both in person and virtually, testimony will be limited to three minutes per person. We have over 70 individuals signed up to testify today, And we do ask that people really try to keep it within that three minute time limit. Written testimony, of course, will also continue to be accepted by the committee and can be442 submitted via email. And as444 is customary, the committee may take elected officials out of turn to testify as they arrive. If you are here today in person and have not yet registered to testify and would like so like to do so, you may do so by filling out the sign in sheet with committee staff outside the hearing room and for members of the committee participating virtually. If you have a question, please use the raise hand feature on Teams or communicate via the chat to committee staff. And lastly, as the the good chairman said, we'll be taking, at some point, a mental health break to stretch out, Go get something to quickly eat and then come back around. So without further ado, I know we have several legislative colleagues here with us today to testify in legislation, And now we would like to recognize the summer Somerville mayor, Katjana Balentine, and rep Christine Barber. Welcome.
Oh, just before we get going, throughout today, I'm going to mess up a lot of pronunciations of people's names. I apologize in advance, and certainly no disrespect was intended by any of us. Thank you.
REP BARBER - HB 1981 - SB 1242 - Thank you, chair Velis. I think you got ours right, so appreciate that. Chair Velis, Chair Madaro, thank you so much time, for thank you for taking us out of turn. I know you have a lot of folks here with really critical testimony before you. I will be exceedingly brief. I'm here with mayor Katjana Ballantyne of Somerville in strong support of house 1981, an act relative preventing overdose death. As you'll hear534 about, Somerville has been working hard for years536 to try to open, an overdose prevention center, and we've gone through, a lot of work to actually make this happen. We continue to see members of our community die, from overdoses. And, of course, as you mentioned and know Very well, the use of Fentanyl makes us even more critical. So this is a public health554 tool that can save lives. And with that, I will turn it over558 to and mayor Ballantyne to talk about that work.
KATJANA BALLANTYNE - CITY OF SOMERVILLE - HB 1981 - SB 1242 - Good morning. Thank you, chair Velis, chair Madaro, for the opportunity to testify567 in support of house bill 1981 and senate bill 1242 to prevent overdose deaths and expand access to treatment. Today, I'm here to call the Commonwealth to join in the fight against the state opioid crisis. We need this legislation to enable local communities and boards of health to establish lifesaving interventions for our residents. So our background in Somerville. As many of you know, Somerville has been working towards opening an overdose prevention center. Our city typically loses at least 15 people annually to overdoses. And year after year, this Heartbreaking loss grows larger.
Year after year, we have more families throughout Summerville mourning loved ones, but our community has decided that enough is enough. We're not content to sit idly by. When there are Tools available to save lives, we need to use them. Overdose prevention centers are proven evidence based public health solutions. We have ample research and real world examples to draw from that show they638 prevent overdose deaths and lead640 to more people into treatment. So legislation can alleviate legal risk. Despite that there are clear benefits right now, there are serious legal risks to opening an overdose prevention center in Massachusetts. Somerville, as a municipality, is willing to take on those risks, but there's more at stake.
Those operating the sites and clients seeking treatment face potential criminal prosecution. Service providers also risk the status of their licensure. We need support from the state to mitigate these risks by677 authorizing the Overdose Prevention Center pilot. This legislation would provide critical legal protections for Somerville's OPC, help our center operate successfully and save lives. So the benefits are beyond just Somerville. I'm here today as the mayor of Somerville because it's my duty to ensure the health and safety of all my constituents, but this legislation is bigger. Municipalities across the commonwealth need every tool possible to address this emergency. We need the state to let us protect our residents. Providers also need to know working at a center.717
Will not jeopardize their professional license, and clients need to know they will not face legal consequences for using a site. So it's time to act. Collectively, we need to mount a response to the opioid epidemic that meets the scale of the crisis. We have an opportunity to lead our region towards life saving solutions. We have an opportunity to meaningfully shift the response to substance use towards an evidence based public health model. We know that supervised consumption sites saves lives and that we urgently need new tools to help prevent overdose. We also know they reduce the open use of substances and benefit the greater community. It's time to act. It's time for Massachusetts to join the other countries around the world that are helping their residents to live safer, healthier lives. Thank you for allowing me to speak in support776 of this critical bill.
VELIS - Mayor, thank you so much, representative so much. Just a just a quick question. one of the things that and you've already referenced it. Some of the legal risks and implications that are out there. Somewhat confounded on my end is, you know, kind of just Thinking about I know about a year and a half ago, you know, the Department of Justice and I'm involving the safe house in Philadelphia had indicated that, you know, we were going to take a look at this and kind of get back to you on some of the legal risk, the new legal landscape, if you will. And so I guess my question to you is, have you had dialogue with the US attorney's office here in Massachusetts or beyond just about where they are currently? We know two US attorneys ago. They were very over820 in their opinion, but do we know where822 in Massachusetts right now?
BALLANTYNE - So I have not Had a conversation with the current attorney, Joe Ngo. I did the previous one.
VELIS - Okay. SHOW NON-ESSENTIAL DIALOGUE
Questions for members of the
BALLANTYNE - And I would like to say that my director of,839 health and human services is here today also who will be testifying later.
VELIS - Yeah. No. I and I appreciate that. For me, it's really just, I I guess I'm just expressing a frustration that I was under the opinion that we were going to have kind of this new legal landscape, this new guidance come out. So really, I was just wondering if you could shed any light on that, mayor.
BALLANTYNE - I don't have any more to share at this this point. So that's why, you know, I'm here. We're trying to use every avenue possible in communicating with everyone, but I don't have anything new to share.
VELIS - Appreciate that, Mayor. SHOW NON-ESSENTIAL DIALOGUE
Questions? Members of the committee, senator Collins.
SEN COLLINS - Thank you. Thank you, ma'am, for your testimony. A lot of Members of the committee have been down to Mass and Cass. I want to thank them. I would ask that anybody who's pushing this legislation get down there because we're essentially asking to legalize massive cash. As it relates to liability question and one that's really important in the last session, we had a similar, bill put forth, and they asked the question about liability because there's something significant, which is, I guess, this bill would remove that liability. In Portugal, for instance, when and people like to say Portugal have been there. Some, members of the911 committee in the legislature were there, including one of the proponents, early this January. And how they operate917 is they have people who are patients.
It's open nine to five, Monday through Friday. They are Nurses who work part time at the facility, full time at a hospital. They're on meth, crack, fentanyl, and we're going to have them sign a and this is what they're doing in Portugal. If you will sign a waiver so the939 people who are operating in the facility don't have liability, That's quite something. I'm hoping that that's not where we're leading here because we're asking people who are in a significantly We950 compromise state to make that sort of a determination. So, as a conversation takes shape, the liability956 question is a significant one for both the city and state folks and wondering if Qualified Immunity protects the public health officials as well from Liabilities in in something like this at the municipal level.
BALLANTYNE - I'm not an attorney. I can't answer the qualified. No. We could get back to you on that piece. It's a good it's an important question. So thank you.
COLLINS - Thank you.
BALLANTYNE - What I would like to say is you mentioned Portugal, but, there's also a facility in New York city, on point, and I actually990 took a trip down there with, our police, Fire, E911, our health and human services, my chief of staff, and myself to, go through the, you know, Take a tour. Ask them, you know, lots of questions. The end result is so the one of their1011 big supporters is, the daycare1014 across the street is because there used to be people sitting in there and sleeping in their doorways, and1022 so the Kids and the families used to have to, crossover people, but now they have this, warming center, everybody on the ground floor with 70, people.
The needles that were distributed or that were found in, in the park across the street have reduced substantially. I will, let my director of HHS remind me of the number, but I think it was, it was something like they're they'd be finding thousands of them, but they've reduced it to, on a monthly basis, they would collect that data, and, they're down to the high hundreds where there used to be, like, maybe 5,000 or so, needles there. So They have, this is an example that we have in the United States, and it's having positive1075 responses that's supported by the New York Police Department and first responders there, and it works.
COLLINS - Yes, thank you very much for that clarification in in the use of New York. I would just caution folks if they're coming up to testify and celebrating Portugal that they get a lot to be desired.
VELIS - And I guess I would1095 and this is more of a comment. It it's remarkable. I went in February to on point as well the East Harlem facility, and it's truly fascinating. It's something that I did not expect. But one of the challenges, and I guess bringing this back to my previous question about kind of a legal landscape that exists, it wasn't it must have been the latter part of the summer where the so that my understanding of what's going on in New York City is it's driven by the city. The state really has kind of been, as far as I understand, hands off. So it's New York City outgoing former mayor the de Blasio kind of giving the okay, if you will, for lack of a better way to describe it.
And then then Rewind1140 or say fast forward to August of this past year where the US attorney in that district1146 in New York kind of raise some concerns about, you know and I think a lot of people I've spoken to a lot of people who said we don't we want to be careful. Maybe those comments were misinterpreted. But, again, raising that question about the legal landscape if we go forward with this, you know, where is the federal government? And it's just if it sounds like I'm frustrated, I am. Certainly not with you folks. It's just really would love some guidance about where the federal government is on this issue. But, yeah, truly, anybody interested in this debate,1177 it's, the on point facilities are fascinating. Thank you very much. SHOW NON-ESSENTIAL DIALOGUE
Any other questions?
Thank you very much for your time.
SPEAKER9 - Thank you.
SPEAKER5 - Thank you.
SPEAKER1 - District attorney David Sullivan.
SPEAKER3 - Like to quickly recognize that representative Chris Markey, member of the committee, has joined us.
DAVID SULLIVAN - NORTHWESTERN DISTRICT - HB 1981 - SB 1242 - Chair Madaro, Thank you for this opportunity. I've submitted, written1226 testimony that's more lengthy and would appreciate your review of that as well. When we think of the opioid epidemic, let's ask ourselves a few simple questions. What can we do about preventing future overdose deaths in Massachusetts? In 2002, as senator Velis mentioned, 2,357 persons died right here in Massachusetts from accidental opioid overdoses. What can we realistically do for these people who live in1258 desperation, unstable housing,1260 and loneliness? And they risk every day of their lives by being addicted to opioids. Is the status quo working? Certainly not. We had a record the last reported year. We all know the answers.
The placement of safe consumption sites to address fentanyl epidemic has never been more urgent and necessary. The vast majority of folks who die in Massachusetts and around the nation have one thing in common. They1291 die alone. As district attorney, 99% of1295 the deaths I see from accidental overdoses those folks who died in a single occupancy home, a room, a tent, a back alley, a fast food restaurant, restroom stall, or the upstairs bedroom of their family home. Alone with no one to administer Narcan, no person to call 911. Some simple wishes of every addicted person. Persons to be helped without moral judgment and blame, to be treated with dignity, to have their disease handled with the same amount of respect as anyone with a chronic disease such as diabetes or heart disease.
Would anyone deny a diabetic a clean natal in a safe medical place to inject? Would anyone deny a heart patient A medically safe place to be monitored and when their heart is out1347 of rhythm to fix it. We are simply asking for a1351 safe place that provides a clean syringe and a caring person to supervise. A person who makes sure the substance, client injects does not result in a fatal overdose. This could be done tomorrow at any community health clinic, syringe exchange program, or hospital. The costs are minimal. The benefits enormous. Safe consumption sites will save hundreds of lives here in Massachusetts. Yes. These sites will be priceless to the friends and family who don't have to grieve for their loved ones. We have been stuck in a state of indecision.
What I would say is a moral judgment Rather than accepting a proven life saving health care strategy, there are presently over a hundred plus safe consumption sites located in 13 countries. Canada, Germany, Netherlands, France, just to name a few countries. And as the chair mentioned, a safe consumption site in East Harlem. They're doing amazing health care work. Safe consumption sites are evidence based. Let me give you real evidence. There's never been a single death at a safe consumption site after injecting an opioid. In all 13 countries, all 115 sites, not a single overdose death. This includes Vancouver, Canada, which has had safe consumption sites since 2003. These sites are living and breathing proof that SCS works.
In prosecutor terms, that’s proof beyond a reasonable doubt, proof to a moral certainty. Over a million safe injections are more than enough proof for Governor Maura Healey and the legislature to move forward with pilot sites. Let's pass senate 1242 and house 1981 allowing for pilot sites. The time to act for these safe consumption sites isn't a year or six months down the road. The time to act is now. It is time for local governments to prevent their operation and let harm reduction or other health care organizations make that happen. Lives are at stake. There's never been a greater sense of urgency. In June 2002, toxicology reports from Massachusetts death show that Fentanyl1491 was present in 94% of our fatal overdose deaths.
Fentanyl is 20 to1496 50 times more potent than heroin. Fentanyl's unforgiving lethality requires immediate action. We have to keep people alive so they have the opportunity for treatment and recovery down the road. These tragic opioid deaths cross1512 all ages, genders, races, and socioeconomic levels. We need to lift up our voices in the same way we have for civil rights, the Vietnam War, and environment. We need to keep these epidemics personal. Raw statistics never tell the full story explain the human impact of this opioid crisis. Our human connections are the real driver of change. I'll conclude with the words of Martin Luther King junior. The time is always right to do what is right. Thank you for your consideration. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER1 - DA, thank you for your time. Questions from the committee? Senator Collins.
COLLINS - Thank you, district attorney. In Boston last year, there was 352 deaths by overdose. And I'd like as you talk about a response, unlike, other types of deaths, murders where the trauma team shows up and may fall people to the emergency room. That doesn't happen. It's a policy item. We have laws on the books currently. They're not being enforced. And I don't know if it's going on in Western Mass, but we have it right here in Boston. And I'd ask you, have you visited Mass and Cass?
SULLIVAN - Yes. I have.
COLLINS - By foot?
SULLIVAN - Yes.
COLLINS - Okay. Just want to make sure because what this means is that that would be, you know, prime example where we will be putting this. We continue to hear that for years. Over the last four years, while overdose deaths have dramatically increased, so have the, Section 35 petitions in the other direction. So while overdose deaths have been skyrocketing, Section 35 petitions have been plummeting. We have people going to the emergency room. Of the 1,500 people who overdosed in my district in the first half of the year. 1,500 in my district, first half of the year. 1250 were brought to the emergency room and discharged. I'm talking about people with a history of substance abuse disorder and mental health discharge to the street with this with hospital slippers on and no care.
Do we have an obligation? Do we have physicians that are coming before us to tell us why this is such a great idea? The same physicians who told us in 2012 that we should not have the prescription drug mandatory system. It should be voluntary. So we had a, a dynamic that was, as you know, before our commonwealth lodging a pill form that had rocked our state. And, thankfully, for our head of state attorney general at the time and our current governor, they, those, were held accountable. Now we have, on the books, a law that we have people in service in protected service, unwilling to perform at a point when someone gets to an emergency room after having overdosed sometimes a dozen times in their history, and then they're just discharged. How do you feel about that?
SULLIVAN - It's a hard call because it all comes down to the individual. And Section 35s have proven1698 to be a temporary solution to a long term chronic illness. Because what happens is that they don't get the support they need when they get out or they haven't made that decision. And when people are involuntarily committed, I can tell you right now from experience, I used to do half the Section 35s in Hampshire County, so I'm very experienced with those Sections, that happen. It's very they're very angry at those parents or those relatives or the individual that committed them. But in the long run, they don't work. They really don't. They buy time, but they really don't work in the majority of cases.
COLLINS- So we're saying do not utilize a tool under the law currently. The Duke study says at six months, it does work. No one likes to cite the Duke study. It doesn't fit the narrative. We like the Harvard site that says less than 30 days, and it's relapsed. Yeah. No kidding. You can't stop biting your nails after 30 days. Never mind, you know Yeah. Getting rid of a drug addiction. So we have a study that says it does work with a sustained amount of time. So we're saying, don't go that route. Let's legalize Mass and Cass. I just I have a hard time Well with these statistics that's that tell us that we have folks in our grasp in the emergency room. You have a history. And as you're, like, an individual with a history, not just in any individual that doesn't, first rodeo, but 12, and we're discharging people outside without treatment on the street.
SULLIVAN - Yeah. I agree that it's, it's shameful that people get discharged without even an induction of Suboxone. But I will say that I had an opportunity to visit, a, safe consumption site in Berlin and also in Toronto. And the one in Toronto is grassroots. It's the first one that was instituted in Toronto. There's absolutely nobody around. There's no crime. And that's what the statistics also say, at least in our criminal justice, is there's no uptick in crime. So maybe we don't, located at Mass and Cass. Maybe we have it, you know, half mile away.
But, you know, I know Mass and Cass is a terrible blight, for the city of Boston and for Massachusetts. And, you know,1825 I don't want to see that repeated, but I think that these overdose consumption sites have proven themselves to be very, very neutral when it comes to crime and also, that people not only get the, the injection, they get nursing care. It will save millions in Medicare money, that's being paid out, Medicaid money, because these1846 people avoid the huge infections that cost hundreds of thousands of dollars when they go to, Boston Medical Center, another facility.
MADARO- Yeah. I'm not so sure that's, you know, factual, but if it is, I'd love to see some more data on that. I don't know if that's what the committee's going to make the decision on, but I do want it to be noted that Proponents are talking about putting them in my district that live in Western Mass, and that's another part of the problem. So thank you. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER1 - Yep. TA, interest any other members of the committee before I had a follow-up?
VELIS - DA, interested because, Obviously, your district attorney and attorney kind of going back to my initial line of questioning. I'm just I find myself spending a lot of time contemplating this, you know, prohibited with the and I hate using this, but commonly referred to as the crack house statute. And I and I really don’t.
SULLIVAN - That was instituted. Yeah?
VELIS - How do how do we go forward as a commonwealth when there is a federal law on the books? Talk to me a little bit about what looks like from a legal standpoint.
SULLIVAN - For over 220 years, local and state government have controlled public health, and this is a public health crisis. So I think that Massachusetts under the 11th Amendment has the opportunity, to bring this forward, to legalize it, and then fight it in, in federal court and in, even before the Supreme Court. We got a great attorney general's office. They defend our statutes all the time, and let's have the courage to pass this legislation and fight it, because I think that the federal government, through that case, is trying preempt Massachusetts from doing what they're legally entitled to do and constitutionally entitled to.
VELIS - That's why I'm expressing so much frustration with the1951 amount of time because I think that's exactly what they're doing. I'm trying to preempt Massachusetts. Why I'm expressing such frustration with the when are we going to get this guidance as it relates to the DOJ and SafeHouse in Philadelphia. I think when that guidance comes, it will allow us to at least provide and plan for a legal landscape. Gabe. I want to be very clear. I'm not suggesting that's a reason for us to go forward or not. I'm just saying that that legal ambiguity and uncertainty, it’s problematic to say the least.
SULLIVAN - And in the safe house case, it hasn't gone up before the highest court. It's gone to, the local US, you know, district court. I think, yeah, the court of appeals heard it. So, it's yet to be decided, you know, for the entire nation. But I think that that statute, the intent of that statute was for crack houses. It wasn't for the crisis that we're dealing with today. And, you know, and, senator Collins, I fully understand. The opioid crisis and its devastation really started in South Boston. You know, my college roommate was a priest, in South Boston, and the number of folks that died from opioid prescriptions was just tragic. And I know that we have to address it for all opioids, but certainly today, with Fentanyl and its lethality, we don't have time to waste.
COLLINS - Just on closing, I appreciate your comments there, and I petition, you know, loved ones myself. So I know you have had experience on the other side. I just if we're not going to enforce the laws on the books, creating new laws that don't get to the root of the problem at the end of the day, that's a perpetuated hospice. And there's no evidence to suggest that people who are using at, these facilities around the world are getting into treatment and living productive lives where employment is in the equation. So if we're talking about the need to a full court press on patients, I agree. The folks who ran the roundhouse down at, Massachusetts, the physicians and nurses who believe deeply in their role said.
You need a year, separation before the dopamine levels are back up where you can function. That's not me. That's the physicians and the nurses. So I just I don't see how this is Getting us you know, it's just like the Housing First model. Unless it's treatment first, exhausting those diplomatic skills, and that last but if we're dealing with people in the emergency room who have a history of overdose, and we're not making sure that they're in treatment. I just think we're doing a disservice clearly to them. We're not, you know, utilizing the tools under current existing law with a public health approach, which is driving the public safety concerns, harm reduction.
We give about a millions needles a year in in the city. 1.5 picked up. I can't take my kids to a park without checking to see if it's swept first. That's just not me. That's everybody in the south end, everybody in Roxbury, everybody in Dorchester. It's getting far and far wide of just that concentrated area. Go to pope John Paul on the, Dorchester Milton border. It's happening. As a, we had, a young woman, that was found at the Carson Beach last week. Same thing. We're just continuing to do this, discharging people, discharging people, And they're the ones who end up, perishing. So we have an ability to intervene with a public health approach. I wish we and I hope that we can do that first before we start going down this path. Thank you. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER1 - Any other questions from the committee? Thank you, district attorney. Thank you, senator.
Next up, rep Donahue.
REP DONAGHUE - HB 1981 - SB 1242 - Chair Velis, chair Madaro, honorable members of the committee, thank you for taking me out of term. I'm here in support of H.1981 S.1242. As was mentioned, I'm state representative Kate Donaghue. The first time I testified2194 on the opioid crisis, I was not a legislator, and my son, Brian Donohue Simpson, was alive. five years ago, Brian died of an overdose alone on the streets of Quincy. We don't know if he would have used an overdose prevention if one had been available.
We do know that overdose prevention sites saves lives. I'll leave it to the others. We've heard testimony already and others to provide more details, but I want to thank you for voting favorably on overdose prevention centers in the past. I ask for a favorable vote on this bill. I can answer questions about my son's experience in, being in emergency rooms and Wishing that they had done things a little differently now that I understand more about the crisis. Thank you for your time, and I can answer questions from the committee. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER1 - Representative, thank you so much for your time sharing, you know, Brian's struggles the way we've talked about it. We've spoken about it a lot and your passion for this. You just exude passion on this. So thank you very much for your continuing to participate in this today.
SPEAKER13 - You all.
SPEAKER1 - Yeah. Questions? Thank you very much, representative.
Okay. Next up, Cambridge city councilor Mark McGovern, who I believe is here with us virtually.
SPEAKER14 - Yes. I am. Hold on. Let me get this turned on. Thank you. Can you see me okay?
SPEAKER1 - Yes. We can. Thanks for your time, counsel. The floor is yours.
MARC MCGOVERN - CAMBRIDGE CITY COUNCIL - HB 1981 - SB 1242 - Great. Thank you. Thank you very much for, hosting this, this meeting today and for the time to testify. I'm speaking in favor of the Creation of overdose prevention centers in Massachusetts. In addition to being a five term Cambridge City Councilor, I also served on the Governor Baker's harm reduction commission during my term as mayor. In that capacity, I traveled to Montreal, where I had the opportunity to meet with elected officials, City administrators, business owners, advocates who run OPCs, as well as some of their clients. In addition to being an elected official, I am also a social worker who has worked for nearly 30 years with some of the most vulnerable children and families in Massachusetts.
Over my time in office and as a social worker, I've seen how the opioid epidemic has increased dramatically and has ravaged families. I've2339 seen children lose parents, parents lose children, brothers, sisters,2343 friends, and loved ones lost. I would bet there isn't a person in this meeting that hasn't been touched in some way by this epidemic. During my trip to Montreal, what I saw reinforced the research. Overdose prevention centers save lives. They get people into treatment at higher rates. They lead to less open drug use. It result in fewer needles being discarded on sidewalks. Now I understand that for many, it may seem counterintuitive. Why would you provide a place for someone to use an illegal substance? Well, the reality is people are using opioids in all types of places.
And far too often, those places result in overdoses and death. We must change our thinking. And based on in a recent poll, complete research, 70% of those surveyed, which to allow overdose prevention centers. There was a comment earlier that we would be essentially legalizing Mass and Cass. I really don't see it that way. I've been to Mass and Cass, And I've been to OPCs. It couldn't be more different. Mass and Cass is chaos. There's no supervision. There's no testing of substances. There's no counseling. OPCs are structured. They are secure. They are supervised. Drugs are tested to ensure there's no Fentanyl. They really couldn't be more different. I will also say that substance use disorder2426 is a complicated and complex issue. We should be funding more prevention measures.
We should be funding more short and long term treatment beds. We should be funding more wraparound services. We should be funding more supportive housing, but none of those things matter if a person is no longer with us, because they died of an overdose. This is about keeping people alive. We are all seeing this epidemic plague our communities. 44 people died on the streets of Cambridge last year and six in the last month alone in Central Square, one neighborhood. Too many people are dying. There is approximately 30 years of research to show that these centers work in multiple ways. We can't wait any longer. Please pass, these bills, And I thank you for your time and attention. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER1 - Councilor, thank you very much. Questions from the committee? Senator Collins.
COLLINS - Thank you, councilor. Just like we asked, Somerville, do you know if the city of Cambridge and its public health officials will be looking to waive their liability If the if this opened, and or asking patients to sign waivers?
MCGOVERN - Thank you for the question. We have a new public health official who just started about a year ago. He is in favor of these sites. We're really we haven't gotten as far as Somerville in terms of the conversation, and developing a plan. But I would also point out that in some of the sites in Montreal, these weren't licensed professionals. These were peers. Trained people who basically, what they could do is give Narcan to someone, which anybody can do. I know how to do it. I hope everyone learned how to do it, and then would call 911 and get help there. So it I think there's multiple ways to look at this in doing this. I'm not sure it has to be a licensed professional, but I'll leave that up to more of the experts.
COLLINS - I mean you're talking about legalizing the use of drugs. So, the whole concept was that it was with some professionals in a setting. I don't think that's before us today. The the legalization outright legalization, this is safe. So what we are talking about are Facilities that would be staffed by professionals. So but to the question of liability, I'd ask that you ask the folks at the city of Cambridge and get back to the committee?
MCGOVERN - I will do that. And just to be clear, I do understand that we're talking about facilities. I was talking about the staffing of those facilities. And in Montreal, it wasn't always a licensed medical professional. That's all I'm trying to point2578 out.
COLLINS - Yep. Okay. Thank you.
VELIS - Councilor, I just want to make sure, I'm sure I got that. Did you say that Cambridge was interested in hosting an OPC that would be willing to host an OPC? Okay.
MCGOVERN - Yeah. So, you know, our form of government's a little different in Cambridge as you guys know. We have a strong city manager form of government. The council has voted virtually unanimously over a number of times to host an OPC. We have a new city manager who used to work at Boston Medical. He's he is very, you know, concerned about this issue and has experience, and our new public health official supports it as well. So we are moving forward.
We would be I believe we would be willing to do it. And, again, like I said, it's, I think people are understanding more and more as we educate people as to why this is important. You know, as to it's this is a complicated issue. This is one tool in the toolbox, that's going to help keep people alive while we also work on treatment, prevention, housing, and whatnot. And we would love some more funding to do all of those things, as well. But this is harm reduction, And this works.
VELIS - And I and I thank you for that. I and I just want to make sure, and I apologize. I couldn't hear you as well as I would have liked, but that was my fault, not yours. You you'd said something about peers, and I think senator Collins started to ask this. I think peers are important, but, I mean, going back to my experiences when I went to On Point in New York City, I think we're going down a little bit of a dangerous path if we if we were to create these without having the requisite medical professionals that were at these facilities.
And I'm I don't think that's what you were saying, but I just want to make sure because I don't I mean, for example, when I went up to East Harlem. I mean, there were there were multiple overdoses that day, and I and I certainly wouldn't be comfortable. And don't get me wrong. I'm a huge believer in the peer support model. To me, you know, my personal experience is that saves a lot of lives. But from a facility like this with the contamination in our drug supplies right now, you weren't saying that this should just be exclusively peers. Correct?
MCGOVERN - No. No. And you know what? Maybe I chose the wrong, you know the wrong word,2710 and I apologize for that. What I should have said was what I saw in Montreal, which they were not all it wasn't They weren't registered nurses necessarily. They weren't peers in the sense that they were other people struggling with substance use, but they weren't legally licensed. Right? They were people who were trained professionals.
They worked at the center. They weren't, it wasn't an another person with substance use disorder helping another person with substance use disorder, although that Happens a lot too on the street. These were professionals, but they weren't licensed medical professionals. And so, you know, I'm not saying that that's the way we should go. I'm just saying that that was one of the things that I saw, you know, up there. So I the word peer was probably not the right term
VELIS - Appreciate the clarification. SHOW NON-ESSENTIAL DIALOGUE
Any other questions from the committee? Thank you very much, councilor.
SPEAKER14 - Thank you.
SPEAKER1 - Next up, we have senator Cyr, who I believe is remote.
SEN CYR - HB 1981 - SB 1242 - HB 2002 - SB 1243 - Hi. Good morning for three2775 last minutes. Good morning, chair, Velis,2777 chair Madaro. Good to be with you, both as a member of this committee, and as, the lead sponsor in the senate of senate bill 1242, an Act relative to preventing overdose deaths and increasing access to treatment. You've heard this morning, you'll continue to hear into the afternoon, why we think overdose prevention centers and sites are another tool in the Harvard auction toolbox that we're going to need to, avert and to stem this, ongoing opioid crisis that has, persisted, gosh, for well over a decade. Massachusetts is still among the top 10 states with the highest rates of opioid related overdose deaths.
A little history here. In 2018, we established legislature established, harm reduction commission that brought together a whole host of various stakeholders, to consider, a number of harm reduction strategies, including overdose prevention centers. The commission looked at the feasibility of operation, the benefits and risks of public health and Safety, legal issues, existing harm reduction resources, alternatives to the strategy. And actually in March 2019, The commission recommended that overdose prevention centers would help combat the opioid crisis here in Massachusetts. You know, we're quite away from 2019.
And I think in part, you know, another epidemic, distracted us a bit from this work. But in the interval, since then, We've continued to see thousands of residents here in Massachusetts, who have died from opioid overdose and even more, who have had, opioid overdoses, and have needed to be revised. You'll hear from clinicians, providers, advocates, why we think this is an approach that works for many people. It establishes, it builds, helps build forming trusting relationships with providers for those who are in addiction. It provides a space to use safely, and then ultimately a Pathway, into seeking treatment. We've looked at this issue very carefully and closely.
The data, whether it be from abroad or now in the United States clearly show that, overdose prevention center save lives. And this Truly, really is about saving lives. And so I just really ask the committee to take a, a good hard look at this once again. I know this Is a bill that's been moved, favorably by the community before. And I just think this is a tool that, so long as we do not advance Overdose prevention centers, at least as a pilot, at least in some form here in Massachusetts. We are, you know, we are leaving a tool, in our arsenal to combat What has been a devastating, epidemic that has.
But where we have lost thousands and thousands of neighbors and friends and family members. And the untold toll as well on family members and loved ones who have lost people to overdose prevention Center.2958 So, you know, we like to be a leader here in public health. I think we still have an opportunity2962 to do so. You2964 know, we'll play a little catch up to New York and Philadelphia. I know a number of other states are looking at this tool as well. I want to be honest as well. This tool is not a panacea. Overdose prevention centers, if they open tomorrow in Massachusetts, would not end this crisis. But I've really come to believe, in my years of work, both in public health,
My years of course, involved with this committee, but this is a tool that really makes very good sense. Also want to briefly just speak to Senate Bill 124, an Act relative to harm reduction and racial justice. This is a bill related to decriminalization, of possession of Controlled substances. And I think it's an interesting approach that, I know the committee has looked at before and has advanced favorably. So I just want to chime in on as well. I'm glad to take any questions you I know you've got a busy agenda today, and just really appreciate not only the opportunity to testify today, but to serve, with you two gentlemen and members of the committee, on what I see as some of the most essential work, that we have before us in the legislature. Thank you. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER1 - Questions from the committee?
Senator Cyr, as the current vice chair, as the longtime chair of this committee, thank you so very much for your advocacy on all of these issues in the behavioral health space. Needless to say, you are a leader. We appreciate your testimony here today. There are no questions, so we will see you soon, senator.
SPEAKER15 - Right back at you, gentlemen. Thank you so much. Take care.
SPEAKER1 - Alrighty. Next up, we have Claire Hoffman, public health planner for the metropolitan metropolitan area planning council.
Thanks for joining us.
CLAIRE HOFFMAN - METROPOLITAN AREA PLANNING COUNCIL - HB 2008 - I'm a senior public health planner at the Metropolitan Area Planning Council. Thank you for the opportunity to share our support for house bill 2008, an act helping overdosing persons in emergencies filed by representative Smitty Pignatelli. MAPC is the regional planning agency for Greater Boston, serving the people who live and work in the 101 cities and towns of the region. Our public health team is working with municipalities on a number of substance use disorder related work, including assisting municipalities in planning for opioid settlement funds, researching youth substance use prevention strategies with students on the North Shore.
Conducting evaluations of municipal Naloxone3122 trainings in Cambridge, and3124 hosting bimonthly roundtables for municipal3126 employees responding to substance use in their communities. We're supportive of this legislation to require first responders to be trained and to carry an opioid antagonist to reverse overdoses. Within our region, many of our first responders already do carry opioid antagonists and have utilized them to save lives. However, there are still examples of residents in the Commonwealth who experienced a fatal overdose in the presence of3153 first responders who did not have this life saving drug on hand. Opioid antagonists such as Naloxone or Narcan are safe, easily accessible, affordable, and do not induce large side effects even if not needed.
You can see here that it's small, easy to carry, and to administer. This legislation will ensure sure that all residents in the Commonwealth, regardless of municipality, will experience the same level of care in the case of an overdose that a first responder is called for or observes. Current law requires first responders to receive first aid training, including cardiopulmonary resuscitation and current first aid standards as set by their department. This legislation would rightly add training in the use of opioid antagonist to the required trainings for first responders. 2022 saw the highest rate of opioid related deaths in the Commonwealth with over 2,300 confirmed overdoses.
Fentanyl is a driving force of the increased deaths and was present in 93% of fatal overdoses. Opioid use is high across the commonwealth and is found in urban, urban and rural areas. Though opioid use touches all communities, BIPOC populations are disproportionately experiencing fatal overdoses. With the rising rate of substance use and the increasing number of fatal overdoses in the Commonwealth, we support all measures to ensure that all first responders of the training and resources needed to address this crisis. We ask that the committee report H.2008 favorably. MAPC will be submitting written testimony, and I'm happy to take any questions here today. Thank you. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER1 - Thank you so very much. I think it's, I think it's speaking for myself, I think it's a great bill, and I think anything we can do to more further disseminate Narcan is a step in the right direction. Questions from the committee? Seeing none, thank you very much for your testimony.
Alrighty. 1st panel,
Gavi Wolf from the ACLU of Massachusetts, Julie Burns, and Andrea Pesalana, floor is yours.
JULIE BURNS - RIZE MASSACHUSETTS - HB 1981 - SB 1242 - Good afternoon, members of the joint committee on mental health, substance use, and recovery. My name is Julie Burns, and I'm the president and CEO of RIZE Massachusetts, an independent nonprofit solely dedicated to creating solutions to end the overdose crisis. On behalf of the Massachusetts Overdose Prevention Centers Coalition, also known as MA4OPC, I testify in strong support for H.1981 S.1242, a bill that would authorize overdose prevention centers in Massachusetts. Earlier this year, the Massachusetts Department of Public Health reported that 2,357 people in our state lost their lives to overdose in 2022, the highest number on record.
This is grim and sobering news. Each one of these deaths represents a person who has left behind grieving family members and friends from every corner of our state, a person who could have been saved. You'll hear about many of them Lives will continue to be lost without decisive urgent action, and one of the most actionable steps we can take is to open OPCs here in Massachusetts. We can and must do more to end this crisis by breaking down the system, structures, and beliefs that stand in the way of progress. Passing this legislation is a logical and promising step in that direction. Overdose prevention sites are evidence based, legally sanctioned harm reduction facilities.
Where people can safely use Pre obtain drugs under the supervision of trained health care workers and get connected to other services. Already successful in hundreds of location around the world, including two sites in New York City, OPCs are proven to save lives. They allow people who use drugs to access addiction treatment information and referrals as well as medical, behavioral health, and social services. zero overdose deaths have been reported at these facilities. MA4OPC is the result of a growing3406 grassroots movement that has been fighting for OPCs in our state for many3410 years. In 2017, a small group including SIFMA, NAU, Fenway Health, and the Mass Medical Society banded together to support the 1st bill that would authorize OPCs.
While the bill did not pass, their3421 efforts led to the establishment of the harm reduction commission in 2018. In 2019, that very commission published3427 list a report recommending that OPCs be established as soon as possible to reduce overdose deaths in our communities. Four years later, we still do not have OPCs in Massachusetts, but Support for these facilities is growing. MA4OPC is a statewide coalition of more than 30 organizations, including providers like Mass General Hospital, Leading trade organizations like the Mass Hospital Association, health care unions like 1199 SEIU, and advocacy groups like the Mass Organization for Addiction Recovery. Lives will continue to be lost, an average of six every day in the state, if we do not act now. Put simply, pass this bill, save more lives, and end this crisis. Thank you.
ANDREA PESSOLANO - BOSTON MEDICAL CENTER - HB 1981 - SB 1242 - Chair Madaro, chair Velis, members of the committee, thank you for the opportunity to testify today. My name is Andrea Pessolano, and I'm a senior manager of government advocacy at Boston Medical Center. The Grayken Center for Addiction at BMC is one of the nation's leading centers for addiction treatment, research, prevention, and education. We express our full support for this legislation as our top substance use policy priority. We know overdose prevention centers could start saving lives in Massachusetts tomorrow. You'll hear more from medical providers later about how overdose prevention centers create a safe, stigma free setting to engage with health care services.
In addition to providing emergency response to overdoses when needed, OPCs offer access counseling,3509 medical and behavioral health services,3511 and substance use treatment. They offer people struggling with addiction a chance to look after their health and take the first step to recovery. Studies have shown more than half of attendees who use these sites access addiction treatment, and frequent attendees go twice as likely to access treatment services. But legislation is needed if we're to make these sites a reality. This legislation would direct the Department of Public Health to authorize overdose prevention centers in a community if sites have been approved by the local board of health.
Further, this legislation provides crucial civil and criminal liability protections, which are essential3546 for overdose prevention sites to operate3548 successfully. These protections target four groups, medical providers and other staff working at these centers,3554 clients utilizing these sites, operators running these sites, and the landlords of the buildings housing these sites. We need legislation to mitigate the risks of opening an overdose prevention center for these groups. The state's harm reduction commission in 2019 found multiple instances in statute and licensure regulation where clinical provider licenses would be in jeopardy should they work at one of these sites. If OPCs are going to operate with licensed medical staff, then these staff need liability protections.
The provider liability protections in the bill are similar in concept to the liability protections the legislature passed last session, which shield providers from legal if they're to provide abortion care to patients from states where that care is now illegal. In addition to staff, clients need to know that they will be protected from criminal action if they are to use these sites and access services. Further, landlords and operators of overdose prevention centers also need assurances that they can open these sites with the state's legal protection. People are dying from overdose faster than our medical providers, 1st responders and family members can intervene to assist. We request the committee favorably reports this legislation to allow these centers to begin saving lives. Thank you.
GAVI WOLFE - ACLU OF MASSACHUSETTS - HB 1981 - SB 1242 - Good afternoon. My name is Gavi Wolfe. I'm here on behalf of the ACLU of Massachusetts, and I'm proud to add my voice to those of my colleagues in support of overdose prevention for so many of us, the opioid epidemic hits close to home.3649 Just this weekend, a dear family friend lost his nephew to an overdose. I'm not here to tell his story, but I can't ignore it either. I can't testify today without wondering aloud if this tragedy, Like, thousand across the Commonwealth, every single year might have been prevented if he had had access to a safe and supervised place to use drugs, connect with services, and maybe start on a path to recovery.
The time for hand wringing about opioid deaths is over. We've done the studies. It's time for action. New York City is already operating two OPCs. Rhode Island has authorized OPCs under state law issued regulations for the operation of those centers and is currently soliciting applications for the operation of those sites. Minnesota legislators authorized OPCs in their most recent state budget and allocated grant funding to set up sites. Yet more people died from overdoses last year in Massachusetts than in Rhode Island and Minnesota combined. What are we waiting for? I started my career doing HIV prevention education and outreach. In the 1990s, the idea of giving people clean needles to keep them alive was hugely controversial.
But you know what? It worked. And now everybody agrees it was the right thing to do. Harm reduction works. Overdose prevention centers work. Last month, Beacon Research conducted a poll of voters across the state on behalf of the ACLU. We wanted to test public opinion about overdose prevention centers, and we learned that the public is ready. Over three quarters of voters see opioid use in Massachusetts as a major problem. They believe the government should be doing more to address this issue. eight in 10 voters would rather see the state respond to the opioid epidemic as a public health problem than as a law enforcement issue.
And here's the most significant finding. 70% of Massachusetts voters support passing state legislation to allow cities and towns to establish overdose prevention centers. 70%. A strong majority in every region of the state and across the political spectrum. To tell the truth, when we decided to conduct this poll, I didn't know what to expect. I feared that the public support wouldn't be there, that stigma would get in the way of harm reduction. But the reality is that a huge percentage of us know someone who has struggled with opioid use, over dosed or died. We've seen enough death. The public is ready for overdose prevention centers. Thank you. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER1 - Senator Collins.
COLLINS - Thank you. Thank you for your testimony. I'd ask any to step forward and answer question has been asked in the past, and there's no real answer at this point. Liability. We have Portugal everyone celebrates. I've heard it ad nauseam how wonderful Portugal is. They make someone who's on drugs sign a waiver that there's no liability if they pass to the facility. What's the what was the thought around that? Because I know this has been socialized for quite a bit.
PESSOLANO - Yeah. I think for liability, the model that the bill has is in the bill. It would protect clients, so that would be users of the site. So folks would not need to sign something or write something up because the legislation, if passed, would protect those people.
COLLINS - So we're asking to pass legislation where nobody has liability on a patient's fatality if they're in a safe injection site?
PESSOLANO - The liability talks about criminal liability for just being using drugs because some these are pre obtained illegal drugs. So it's to protect, say, a client is walking in and a police officer is outside. That's the protection that we're talking about.
COLLINS - What about the facility?
PESSOLANO - And for the facility, it's similar that, you know, law enforcement could, break it up, I guess, would be would be the site or the, center could be subject to a lawsuit because of not having liability protections, which is why we feel legislation is really needed. I I think you heard the mayor of Somerville talk about how they're going to take on some risks to do that, but they're only taking on their risks. They can't take on the of, someone who might show up to the site who could be facing an issue, medical providers who might be there, etcetera.
COLLINS - She's saying, in that case, the city of Somerville would indemnify the employees who are working at this facility?
PESSOLANO - I don't know what the, you3931 know, if the Somerville moves forward without this,3934 you know, liability, they3936 have to decide that themselves, but I think what we'd like to see is state liability protection so that Somerville or Cambridge or other cities don't have to make those choices and3947 that they're protected.
COLLINS - And that's speaking for everybody. So question about this is really for BMC, and I want to ask the others who come forward. So we talk about the deaths, 352 in the city of Boston. We're looking at thousands of overdoses. We have people getting discharged from the hospital. We have demonstrated a history in recent history of overdoses, public health response. We have a trauma team who makes its way to the ER when there's a shooting. That's not the case in the in this situation. To me, we should be utilizing those tools of diplomacy.
That our trauma unit teams have, very skilled, to exhaust the conversation with somebody who just survived an overdose at BMC. To say, I think this is the day you should decide to go to treatment, and you probably have your best shot at a voluntary commitment. But why wouldn't the physicians at BMC, given the track record When someone comes in to the ED, be discharged to the street and not exhausting those diplomatic efforts again to treatment. And if they didn't, last resort, before you discharge them to the street, knowing exactly where they're going to go, why don't they commit to treat. Is it paperwork? Because, again, the physicians are the same physicians.
Who 10 years ago told us it was too much paperwork to do the prescription drug monitoring program mandatory. This legislature had to fight the physicians to do that. I don't want to lose sight of that. So I just I don't understand how the institution does not exercise their obligations under the law to do that and not discharge 1250 people who, ended up back harming themselves and the communities that they're, discharged to. I just I don't understand how is an institution that's possible to be coming and asked to change the law on liability when we have this right in front of us, meeting people with, they come into the emergency room, and why we're not doing that?
PESSOLANO - We feel like this is an important tool for the state to consider. I think, you know from being at BMC in the community, we have 12 clinical addiction programs that are walk in urgent care all the way to, you4088 know, inpatient substance use treatment programs that we operate, but there's not one size fits all for every single person. We feel that What we've seen in studies is, our clinical folks can talk more about what it's like to interact with people.
If someone's not ready to go into treatment at that moment, maybe they'll find another moment where they're ready. We feel that, at these sites, what the studies have shown is providers can build trust with folks. This is another opportunity. Maybe, you know, when they go in the second time to one of these sites, that maybe that's the time that it clicks for them. So we feel that as part of the state's health, public health and harm reduction strategy that this is an important piece of that.
COLLINS - I would just highlight that, again, we have 1,250 the people first half of the year, history of addiction, discharged. To me, that's outrageous. As it relates to harm reduction, I agree with you. In general, we need to be doing this to live around the edges with needles, but when you're giving out million and we find a million and a half in parks and streets in the city, I just I don't see how we're championing that as if it's a great success. We hope it's helping people on one end, but it's clearly harming people on another. So where does harm reduction Become home creation. I think it's something we're really going to have to look at.
WOLFE - I think it might be worth noting that at OnPoint in New York, There has been, they've studied the amount of drug paraphernalia that has been, that they've avoided having it on the streets, right, for just because they're operating there and people aren't using in the parks. They're not using at that playground across the street. They're using inside a safe supervised facility. And as a result, the needles aren't landing on the corner. They're not landing in, you know, in a playground. They're being disposed of properly. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER1 - Thank you, senator Collins.
SPEAKER3 - Representative Markey has a question.
SPEAKER1 - Representative Markey.
REP MARKEY - Thank you, Mr. chairman. I guess a Part statement, part comment is, clearly, these individuals who are suffering from addiction don't want to be there. It's not a choice, I think, when they start in their life or when they start to grow up. The problem is is that We don't have the you we keep talking about the resources and having wraparound services when they get to the point of coming into an open seat. We don't have the resources currently to support people who are seeking help now, and these are people in incredibly sensitive situations where whether it be mental health issues, a whole bunch of variety of reasons why they're addictive.
But if we don't have the resources available now and we open one of these up. Where4263 are we going to get the resources to provide these wraparound services for these individuals when we can't find the mental health and part of the systems of people. We can't, find places for people to go inpatient and they have they're put on waiting lists. Or that we don't have the right medication for mental illness. How is it that we're going to be able to accomplish this wraparound when we don't have all of those needs as an infrastructure before we do something like this? I'm just curious as to how the funding would go.
And how we would be able to set up an infrastructure to accommodate people coming to the OPC. Because right now, I don't think we have an infrastructure in hospitals, inpatient settings, or anywhere to be able to assist. So I'd like to see it's something productive. But I just think this is something that provides Hope,4325 I guess. But when4327 people are very sensitive, and there's obstacles in their way, they give up hope. And I just see this as an opportunity where we could do something, but we need to set up an infrastructure before. I'm just like, you know, what you guys think of that.
WOLFE - Representative, I appreciate the question and the concern about not having enough resources, to deal with substance use disorder in Massachusetts. I think you're absolutely right that we need to continue to increase investments in a lot of different ways for in treatment in low threshold, shelters, all kinds of things. Overdose prevention centers are one piece of that. It's not, you know, as it's been said before, this is not a silver bullet. It's not but it's an important element. And, frankly, you know, as people say all the time, you can't help somebody if they're not alive. Right? That's the point of overdose prevention centers is to ensure that people stay alive long enough to be able to get into treatment. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER16 - And I'll just add that, oh, do you have something else to say, representative?
SPEAKER13 - No. Go ahead. Go ahead.
PESSOLANO - I'll just add that, you know, services look different for different people, and the low threshold, nature of overdose prevention sites might be a place that someone is more willing to engage than in the emergency room where it's really crowded and there's lots of sounds and things it's not, you know, quite the environment to have a one on one conversation about what the next steps in your journey looks like. And so we do think this is an important model and, definitely agree that, generally, more resources is always helpful, but this is a different type of the piece of the continuum that we feel is important.
MARKEY - I appreciate that, but I also think that there's part of it is we Can't make someone do something they don't want to do unless they're involuntarily committed, and it's almost impossible to get that done. I'm in the courts enough by petitioning overhead family members. The clients try to petition it, and it is Very difficult. And when they do and they succeed, there's a short term4465 bid in Worcester or in, Bridgewater, where there's very little opportunity to, follow through with the people who are in incredibly sensitive situations and need to be handled really with kid clubs. And I just don't see us having The infrastructure at this point to be able to help until we loosen up the ability to have people, committed involuntarily, so we have enough beds available, until we have enough halfway houses and real mentoring ship, throughout the state. I just don't think we have the infrastructure.
WOLFE - I would add one thing, representative, which is when, when somebody shows up at an emergency room, They're showing up in crisis. When they go to an overdose prevention center, they're going there because they believe that their life has value, that they want to preserve their health, and they're seeking out a space where they can be taken care of. That that's a very different dynamic, and it, as, Andrea pointed out, it creates the opportunity for a different kind of discussion about, entering into recovery. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER13 - Representative Just the last comment is
MARKEY - I just had the4547 last comment is I've had people at every level looking for help, and there's obstacles everywhere. And I agree with you that It may be helpful to some degree, but if we don't have real infrastructure to assist the doctors who are dealing with the e in the ER rooms, in the mental health professionals, who were trying to treat these individuals. We are not going to accomplish what the goal is of the OPC test. But I appreciate the opportunity you guys did, and I like your passion. It's a great job. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER1 - Thank you, representative Markey. Up next, we have representative Sullivan Almeda with a question.
REP SULLIVAN-ALMEIDA - Thank you, Mr. Chair . It's not necessarily a question. I kind of want to echo what my colleagues have been saying as far as, how do we address kind of the aftermath of these centers, you know. Someone does come in to the center and, you know, you give them all the tools necessary to seek Treatment, but we don't have the infrastructure like my colleague just said, for those that may either need it or are trying to address it. How do we continue the cycle of prevention, and harm reduction?
I think one of my colleagues mentioned meeting them where they're at, whether it be in Emergency room in their homes instead of more so promoting, these safe, overdose prevention centers or what have you. Are we looking at more4634 of a way to meet them where they're at rather than having them come here, potentially overdose, but then quote unquote save their life with the use of Narcan and life saving measures? Instead, are we trying to prevent the use before it even happens?
PESSOLANO - I think they'll just echo that all pieces of the substance use4663 disorder continuum are important, and4665 this is just one of them. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER1 - Derek Collins.4669
COLLINS - No. To the, the4671 rep's point, a challenge is not the 1st 90 days as it relates to treatment and availability of treatment, stabilization, and detox. It's not it. It's the aftermath. four to four to nine months, which is what folks are saying in order to be able to get your dopamine levels back up. That's what you need. So it's to, work, Markey’ss point, we have the resources, we have the resources in our opioid remediation fund, from the SACLA case, and we continue to put resources in our budgets. We put significant amount of resources in our budgets. So as it relates to the treatment side, post detox, that's where our resources are thinned to the representative's point. We should be spending more time.
VELIS - Quickly quick question. So I guess my question is, what actually, I have two questions. What does the data currently say with respect to me I guess, rewinding for a little bit, to me, one of the most compelling arguments in support of is the notion that folks who utilize these OPCs are more inclined to get treatment. And I just the data and I asked this question with great trepidation knowing I'm talking to data people. But What does the data say with respect to folks who utilize these sites internationally in in New York City with their getting treatment. And, ultimately, I think we can all agree that harm reduction has been said many times is it's certainly not a panacea. It's a tool in the toolbox, but what does it say about people getting help?4773
PESSOLANO - Yeah. Happy4775 to send you these studies, but just to lift up that more than half of folks who attended in a study access addiction treatment, and frequent attenders were two times as likely to access. So you're building those touch points. You're building trust, and you're letting people have the opportunity to open their eyes to Maybe something different. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER1 - And I guess no. Please.
BURNS - I'd just like to add that in most of the sites around the world, the all supervised consumption is not the only thing that happens. So individuals who are accessing these sites have the ability to seek treatment for other things, wound care, infectious disease care, all kinds of other things that can tend to be a drain on the system. So there's additional benefits in addition to having for somebody to seek treatment while they're attending these sites.
VELIS - I think that's really important. When I was at OnPoint in New York City, I don't recall the doctor's name. What the doctor said to me is, you know, I and it was the day we were there was the day where there was, like, that 20 page New York Times article, and what she said was you need to realize something. The least important fascinating thing we do here is what you're going in to see. So I hope we never get too far from the, you know, infectious disease control, the treatment, stuff like that. Because if we do, I don't think we're making as compelling of a case as we can be making. I also want to bring up another point, though, because I think this is really important, and I know I know I've said this before, and I think if we don't talk about it, it's disingenuous.
When we talk about and I'm and I'm going to quote A gentleman from it was actually in the OnPoint video. It was prior to my going to visit OnPoint. There was a there was a gentleman, and he had a young child, and he talked about harm reduction, but he said, when we talk about harm reduction, harm reduction for who? And what he was talking about was, like, surrounding neighborhoods. And he talked about walking his daughter to school where they might step on a needle, you know, being exposed to people using the substance out in the public and how he didn't want his daughter have to have to go through that. So this is more of a comment, but I would love your feedback on this as well.
The notion that we can kind of talk about what happens in these sites as a separate silo without talking about what happens outside of these sites, I would argue is disingenuous. And what I will tell you is that When I was at OnPoint in East Harlem, Seth and I walked out of the subway. You know, there was evidence of that of that You know, there was I don't want to say an open air drug market because that has certain connotations, but there were a lot of things where I, as a dad, would be really concerned about my child there. So my question my question is this. How do we take into account that stuff that happens outside? Shouldn't we be The community stakeholders, they have they should have a seat at the table, should they not? And I'd be interested in your response to that.
BURNS - I think they absolutely should, and I think harm for whom is an incredibly important question that you've raised. I think quality of life for whom is equally important and, you know, the value of a human life. So what we have now with the current state of Mass and Cass in elsewhere around the Commonwealth is people using drugs outside in very unsanitary for everybody, and overdose prevention sites will take some of that away because people can go inside, use their substance, whatever it might be, discard their used paraphernalia, and then leave. So it will take some of the burden off community, but I do think you're incredibly on point to ask, you know, who is being harmed and who can be served by sites.
And I think there is an answer for everyone. If you if any of you have had the opportunity to go to Toronto where, overdose prevention sites are actually collocated in community health centers. You wouldn't you would never know. I mean, you walk in the front door. You might go right to the drug use room. You go left to ophthalmology or pediatrics or whatever. And there's no paraphernalia outside. There's no one hanging around. The community is completely of it. It's been going on for about 20 years or so, so they do have more history. And I'm sure in the beginning, it took some time to get there, but it can't they can't these things can coexist and make sure that everyone has the quality life that they deserve.
VELIS - Which is it really locations matter. And that's a really big part of discussion. Locations really, really matter in this discussion, because I agree. Having that co-located, I have not been to Toronto, but I'm aware of you. Many of them, my understanding is that on the first floor, you'll have this. And then even on the second floor, you'll have treatment facilities. Location matters. SHOW NON-ESSENTIAL DIALOGUE
Any other questions for members of the committee? Thank you very much.
Next up, Annabelle Reeves, Nishal Dorismar, Noah Vargas, and Jamea Madara.
Welcome, everybody.
So as my as my friends are getting seated here, I just kind of want to lay the foundation for this because I think it's pretty cool right now with our with our with our guests at our next testifiers. This past Friday, I was at Holyoke High School participating in a a back and forth on any number of issues, and Harm reduction and substance use is one of the topics, and several of the folks in front of us had some really compelling things to say. And I said, you want to know what? I've got this hearing on Monday. Why don't you come down and testify? And next thing I know, they got permission to testify, and and here they are. So I appreciate you folks being here. I appreciate what you have to say. And that was just Friday, not that long ago. And here you all in front of us. So welcome to the state house, and, the floor is yours.
ANIBELLA REEVES - PA'LANTE TRANSFORMATIVE JUSTICE - HB 1981 - SB 1242 - Hi. Good afternoon. My name is Annabella Reeves. I am 18 years old, and I am the alumni fellow for Pa'lante Transformative Justice, a youth led organization based out in Holyoke. I am here to speak on the substance abuse that goes on within our neighborhood and within our own lives. When I was only 10 years old, my father was prescribed opioids for treatment after getting into a car accident, where his doctor was the 1st person to get him addicted to substances. When I was between 12 13 years old, my father's doctor stopped prescribing him the opioids, where it led to my father going to the streets and get the get the same to even worse substances.
During this time is when I started noticing my father's addiction. When he had his 1st withdrawal in front of me is when I noticed it was getting worse. By the time I was 14 years old, my mother, little brother, and I had our house foreclosed on, where my family was put into a homeless shelter due to my father's addiction. The only way my family was able to be protected was for my mother to put charges against him So he stopped the harm he was causing to us and stopped him continuing the harm he was causing to himself. That, my father was put into a drug rehabilitation incarceration through Hampton County correction.
Between the time of August September of 2019, my father was released from jail with no help from the rehab for after he leave incarceration and three weeks later ended up dying on September 5, 2019 from substance abuse. I told you that story to bring to light this that substance abuse isn't just affected on users, but also on the families, children, husbands, and wives all around. If this bill happens, it can help the families of substance abuse, to help the ones they love to seek treatment or even a place to be safe while taking the substances. Thank you for the time in listening to me and my story.
MICHELLE RIVERA - PA'LANTE TRANSFORMATIVE JUSTICE - HB 1981 - SB 1242 - My name is Michelle Rivera. I'm 16 years old, and I'm a junior in high school. I'm a youth organizer with Pa'lante Transformative Justice in Holyoke. I strive to better my community and change the lives of people in need, and may I say, it's a dream come true to be here. My story starts two years ago on New Year's Eve. My mother told me to go downstairs and get the mail at 8:00 PM because we forgot to get it that day. Before, as I was going downstairs, I will never forget what I saw. I witnessed a man overdosing in front of me.
I went inside and told my mom, and she came out and told me to get back into the house while she tried to help the man. We never spoke about it again after that traumatizing moment. My reasoning for being here is to make5322 sure my two brothers and sister never end up witnessing people taking drugs or see someone overdosing like what I saw that day. After that day, I started seeing it more often. It's like my mind blocked it out until I saw it right in front of me. Like, when I went to go throw out the trash or hanging out with my friends, I see more and more needles popping up.
I'm extremely thankful to be here today and share my experience with everybody here and hopefully make a difference in my community. I want to especially thank senator John Velis and Holyoke mayor Josh Garcia and for Pa'lante Transformative Justice for giving me a chance to advocate for my not only for myself, but for the youth in Holyoke that have had my experience, I also would like to focus on the mental health illness aspect of the problem. People are struggling with loss or grief, which is why some turn to drugs and which is also why some turn to the streets. Thank you.
JANEY MADEIRA - PA'LANTE TRANSFORMATIVE JUSTICE - HB 2002 - SB 1243 - Hey, everyone. I just wanted to thank you for taking the time to hear from me. My name is Janey Madeira. I'm 16, and I'm from Holyoke, Mass. I'm a member of a youth led organization called Pa'lante Transformative Justicethat focuses on changing the dominant narrative of Holyoke. We've also had many events that were open to the community as well. Pa'lante focuses on getting to the root of the issue and not only fixing the situation, but transforming it into something better. Now Holyoke has struggled enormously with people using substances.
Often just stepping out of my house, I see at least one person under the influence of drugs. Many times, I'll go to take a walk to get some fresh air, and I'll see dirty, used needles all over the ground. It's a very serious issue. It's gotten to the point where kids can't even go to parks because there'll be people passed on at the slide or they'll be shooting up stuff in their tents that are built underneath the slide, which again are for children. In some predicaments, kids have even had to miss recess due to this. Also, not only does the overuse of drugs affect the person doing them, but it also affects the way they interact with others and the way Holyoke as a whole is viewed.
I, myself, has had to contact the police multiple times because I would hear stumbling and bangs, and it would it would be from someone under the influence asking for help. The amount of needles on the ground has gotten so bad that I refuse to let my sisters go to certain parks. In order for them to actually play in a safe park, we have to drive somewhere outside of Holyoke. People that overuse substances suffer from a mental disorder called SUD or substance use disorder. It's a mental disorder that affects people's brains and their behavior. This leads to their inability to control their substance use, whether that substance is illegal or legal drugs, medication, or alcohol.
That's why, in my personal opinion, there should be a place where they can go to5489 be supervised and while using substances so they won't pass out in the streets and do so in the safest manner possible. Not only does it prevent death, but it keeps people off the streets and the streets clean. This resource can benefit the community even more by providing support to those who want to quit or at least attempt cut down other overuse. Also, knowing that they have someone there who believes in them and supports them could be great for their mental health. It can also bring in the families of those who suffer from SUD some sense of peace.
Because they won't have to worry about that family member dying. In summary, the main reason I'm here speaking to you all If so, in the future, substance abuse isn't as exposed to kids as it is today. And my vision for Holyoke is simple. I just want kids and people in general, whether they are on substance or not, to be safe and out of harm's way. I would like to thank Holyoke mayor Josh Garcia, senator John Velis, and Pa'lante Transformative Justice for making it possible for me to be here standing and speaking to you all today. Thank you very much for your time, and may god bless all of you
NOAH VARGAS - PA'LANTE TRANSFORMATIVE JUSTICE - HB 1981 - SB 1242 - My name is Noah Vargas. I'm 16, and I'm from Holyoke. I work with Pa'lante. Our community has faced a drug problem long before it has ever reached my family. People who are Victims of substance abuse and experience homelessness is a common occurrence in Holyoke. My personal experience with drug use my family members, remind me that the people I love need to be safe, and that they are victims of a much bigger disease in America. My younger sister saw somebody overdose at the park and came back home telling me that she saw somebody die. That day, our city is known for its drug usage.
Ensuring the safety of our community members is important. Younger children are witnesses to what is going on in their neighborhoods, in their parks, and in their families, and susceptible to the drug use. Having a place that is say for addicts5602 and people who are who are going to do the drug anyways and are more susceptible to drugs in a public environment prevents children from witnessing and using drugs firsthand within their parks or by finding needles on the ground. By passing the bill, you allow the safety of the citizens of Holyoke and prevent the cycle of drug abuse that Holyoke citizens are witness to every day. Thank you so much. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER1 - Thank you all so much. So proud of you all coming down here. This was just Friday when I met you all, and here you are Monday testifying on this bill. Thank you so very much for making the trip down here. You did such a phenomenal job. And your experiences, your lived experience that you saw really, really makes a big difference, and it will make a big difference as we continue to have this debate. So please know that as you go home today, Before you go home today, make sure you go up to my office and eat some lunch. Okay? K. Thank you so much for coming here today. Questions?
Questions, members of the committee? Seeing none. Thank5676 you.
5678 SPEAKER245678 -5678 Thank5678 you.
SPEAKER1 - Rep Picnotelli.
REP PIGNATELLI - HB 2008 - HB 2009 - Oh, wow. Thank you very much. Good afternoon, everybody, and thank you, Mr. chairman. Mr. chairman, I appreciate you taking5691 me out of order. I'll be I promise to be5693 very brief. I know you have a long day, But I'm here to testify very quickly on two bills, H.2008, an act helping overdose persons in an emergency. I call it the Hope Act. As you know that there was over 2,300 lives lost to opioid related deaths in 2022. The highest number we've seen since prior to the pandemic. But, yeah, Narcan or other, types of drugs have been able to save lives on a daily basis. But yet our 1st responders are not required to carry, Narcan on their duties. The cities major cities have done a very good job, was carrying Narcan.
But what I'm finding to be a problem is in our smaller towns, in our very rural areas. You never know who is going to be the 1st responder to show up. I actually represent a couple of towns that don't even have police departments. They depend on the state police, to patrol their streets, and they deal primarily with volunteers for, fire and ambulance. So you never really know who's going to be the 1st one to appear. By having this bill, they could be a requirement that all first responders Carry Narcan will5762 be extremely beneficial in saving lives. This came to my attention a couple years ago, when, a young person overdosed, on drugs.
And in the presence surrounded by his family, in the presence of a police officer, the first person died waiting for Narcan to arrive. And at that point forward, I said it should be an automatic requirement. They're being trained in it already at the academy. The Department of Public Health has done a very good job with, regulated Naloxone training and 1st day training. And, chair Madero, I want to thank you personally and your staff, especially, for, making some very key provisions and adjustments in additions to the bill that was voted out favorably by committee last session, and I hope we can do it again today. I think, one 1 life saved is another day closer to sobriety, and I think everybody should be given an opportunity, with that.
So I hope you're going to support H.2008. And, the other bill is H.2009 about establishing a three-year Fentanyl's test trip program. As you know, Fentanyl is a lethal drug that has made its way to everyday conversations on drug use and overdoses, but yet Fentanyl cannot be detected by the naked eye and most people only realize they've ingested the drug once it's too late. Too bad we have too many backyard chemists, trying to, make things a little bit easier for people to reach that high and do that plateauing effect. So The National Institute on Drug Abuse estimated that, Fentanyl accounted for almost 90% of all opioid related deaths in Massachusetts.
There again, this is, an idea. So whether it's marijuana or another drug that you're using, even though marijuana is legal, we're still seeing people buying it off the streets and not from the cannabis stores, and we're seeing it laced with Fentanyl as well. So This pilot program, I think, could help people to do some testing in advance of taking the opioid or the drug, and I hope you look favorably upon that as well. I appreciate your time very much. I know you have a busy day. These bills are critically important, and I think they're ready for prime time with support, and I welcome any questions you may have, and5896 any support to get this bill out as soon as possible. Thank you so much. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER1 - Representative, thank you so very much. Questions from the committee? Seeing none, thank you very much for your time. Next Thank you. Representative Decker.
REP DECKER - HB 1981 - SB 1242 - Good afternoon. It's great to see you. Thank you for this time. So I'm here just like a lot of other people that you're hearing from today to ask you to please, once again, consider giving a favorable reporting to House 1981 and the senate, counterpart to this. My colleagues, representative Fernandes and senator Cyr, and I filed this. I think for me, a couple of things just to say is that I was not the original, co filer of this bill. I sat where you sat, six years ago and listening to test I was a supporter of it for that. I've been on record supporting this, but listening to people testify, as a committee chair.
I felt compelled and obligated to take a deeper, lead role in this. You know, at the end of the day, we're just about trying to save lives. And as I heard, in this very room, something that sat with me that was so poignant was there's only safe and unsafe consumption sites, places where you can prevent overdose, places where you can't prevent over overdose. This is literally about giving people what we know is evidence based, the opportunity to live another day. And for, some people, it's also about an opportunity to actually seek resources when they decide they want them and when we need them.
We know that if those resources are not available the moment has somebody has cited. This is the time for them to seek some support. We often lose the opportunity. In Cambridge, so far this year, we've had our Small town of Cambridge. We've, 6.2 square miles. We've lost six people to overdose. That's six lives that should still be here today, that there's a lot of people who are grieving about their loss of life. And this bill is about recognizing that every life is precious and worth saving. We know that the public opinion overwhelmingly supports this, and it cuts across Republicans, unenrolled Democrats.
The majority of Every one of those voting populations overwhelmingly supports this, and people support it because they know that it works. We now know that New York has moved ahead. Rhode Island has passed this, and I know that you all have been doing really good due diligence, on this bill, and you're doing it yet again. And so I'm here today to join with, with many others to say anything that you can do to help us not only move the bill forward, but also to really help advocate it beyond your committee once it goes out. And just thank you for all of the work that you all do and for paying attention to this. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER1 - Representative, thank you so much for your time here today and for your years of leading this committee and your advocacy in many of these areas. Thank you very much. Seeing questions? Seeing none. Thank you very much.
SPEAKER17 - Thank you.
SPEAKER1 - Alrighty. Next up, we have doctor Keith Humphreys, the Esther Ting Memorial professor of psychiatry at Stanford University School of Medicine. Doctor Humphreys, are you here?
SPEAKER26 - I am indeed. Can you hear me?
SPEAKER1 - Thank you so much for joining us.
KEITH HUMPHREYS - STANFORD UNIVERSITY - HB 1981 - SB 1242 - Thanks for having me, senator. So distinguished committee members, thanks to the opportunity to speak to you about supervised drug consumption sites. Because these sites have become a bit of a battleground in Culture board, you can find people to tell you they are unquestionably transformative and others who argue just as passionately that they are highly destructive. Or as someone who studies addiction, for over the last three decades, I'm just going to try to give you a balanced evidence based appraisal of what their strengths and limitations are. So in terms of strengths, you know, globally, these sites, have overseen millions of drug use episodes with only a handful of deaths occurring.
That's pretty impressive. Someone who uses drugs is probably safer in one of these sites than anywhere else. Second, people staff these sites Tend to be more welcoming to people who actively use drugs than are the typical staff in emergency department or in a primary care practice. So people who use drugs who need, say wound care may be more willing to access help at these sites and other places. third, there is no evidence at all. Some people worry about this, but there's no evidence that these sites make people initiate drug use. The people who are in these sites tend to abuse drugs for a very long time. Terms of limitations, these sites6165 serve a very geographically narrow band of clients.
It would be a very rare addicted person who would commute even 306171 minutes so that they could use drugs in a government funded facility. So the client base is going to be people who live right there in the neighborhood. Second, the intervention is not scaled up much we can conclude that many people in communities don't want them in their neighborhood. In the 30 years, since the first supervised drug consumption site was founded, All the nations in the world combined have built fewer than 200 of them, which is fewer treatment agencies than there are in the Greater Boston area. And by the way, although there's support in the abstract, when you ask people, who support them, are you willing to have them within a mile of your house?
That Support really dissipates. So there's some challenges with citing that also limits their impact on the population. Third, there isn't Convincing evidence that supervised drug consumption sites increase addiction treatment uptake. There are studies showing that people who visit supervised consumption sites at a later point, sometimes access addiction treatment. But that doesn't prove the site caused the person to enter treatment any more than the fact that some people who use marijuana go on to use Fentanyl proves that marijuana makes people use fentanyl. The other thing to think about is that every unit of government has a budget, And the cost of serving one person for a year in a consumption site is about equal to the cost.
Providing them a year of addiction treatment with medications and counseling. So6245 that means there's an opportunity cost you will6247 have to weigh, particularly because the research evidence for the benefits of addiction treatment is stronger than that supporting supervised drug consumption sites. And that includes the superior ability of treatment to reduce overdose mortality not because people are still overdosing and being rescued but because they are using drugs less and not overdosing as much in the first place, I realize the next picture I'm presenting is more complicated than what an activist for or against these sites would say, but I hope The seven is based appraisal of the tradeoffs is helpful to you in your decision process. Thanks very much. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER1 - No. Thank you, doctor Humphrey. Senator Collins.
COLLINS - Thank you, doctor. A couple questions. So I appreciate your testimony. The medical community in California has been unsuccessful to get the governor to support this. I know he vetoed this proposal last year.
HUMPHREYS - Correct.
COLLINS - What do you say about that? I mean, he's the former mayor of San Francisco Who's trying to rescue that city as we speak?
HUMPHREYS - Yeah. So what happened is, in fact, we had one anyway, as is the cases in also in Pennsylvania, though it's not6315 legal, they, persist, and I think we will have more of them. But, yes, that particular bill was vetoed. I find that unfortunate because it was one of the few bills that had a very rigorous evaluation, embedded in the legislation. And so that we could use this as an opportunity to learn, but that was the governor's decision, obviously.
COLLINS - Do you know what the life expectancy is of someone who frequents a safe injection site?
HUMPHREYS - I do not.
COLLINS - So that the study the studies that you've seen and been a part of it did not factor any of that in?
HUMPHREYS - They're too new and because there's no way to6352 sort of experimentally control who goes in them, that would be a very hard question to answer. Different people show up at different times. Some never seen again. Doesn't mean they die. Just means they don't use the site anymore. Period. So no. Can't answer that question simply. I'm sorry.
COLLINS - And some early earlier testimony suggested that people who frequent Safe injection sites were more likely to seek services outside of substance abuse services. No. What services are we talking about outside of services that you would seek in the emergency room if you were brought there after an overdose, including infectious disease evaluation and in treatment and medication outside of those. Like, are they seeking treatment in a residential program? Are they on a job Training path? I mean, what are we talking about in terms of seeking treatment?
HUMPHREYS - So at all services, we see correlations people seek one service are likely to seek another. What we don't know is that that is the service making that happen, or is it that that person has made a decision to make a change in their life, and they access a bunch of different services as a result. People can go from these sites into rehab. I really think that's pretty uncommon. Probably a more likely linkage would be to, Methadone maintenance, buprenorphine maintenance, some treatment like that. Our6433 experience in San Francisco when we still had an informal site running was that the linkages were very rare. Very few people who went into the site, which had a place where they could use drugs safely, could be documented to have any further services afterwards.
COLLINS - Thank you.
HUMPHREYS - Thank you.
VELIS - Dr. Humphreys?
HUMPHREYS - Yes, sir.
VELIS - Senator Collins, that was that was it? Okay. Doctor Humphreys, you said something that I want to I just I want you to unpack that a little bit more if you could because it's something that I had heard when I was up in New York City at OnPoint. You and I don't want to I'm paraphrasing, so please correct if I misstate your position or what you've testified to. You said something along the lines of that. The impacts that we know of in terms of saving lives and what the data shows is that that impact is really felt in the immediate area of where that OPC is located. Is that did I get that right?
HUMPHREYS - That that is correct. When you talk about example, like, within, like, you know, 300, 400, 500 meters is where almost all the client base is going to come, you know, which makes sense. It's sort of hard to imagine. A person might commute in from the suburbs to use drugs in the site and then go back again. That would be a very unusual person. So, you know, they would depend you know, it's very neighborhood focused intervention.
VELIS - Okay. If I understand you correctly, most of the folks who are utilizing these OPCs are from a a pretty close geographic proximity to where the OPC is located.
HUMPHREYS - Correct.
VELIS - Wouldn't it stand to reason then if you were going to really have an impact that's kind of scale, if you will, you would need to have many of these sites?
HUMPHREYS - That is correct. I've been to the neighborhood with the most affected in Boston? I was just there a couple weeks ago. If you open one there, I'm sure you would have a lot of business and maybe some impact in that particular street. But, you know, they're not going to move population indicators of overdose in Massachusetts because you would need an enormous number of them. And, first off, that would probably be economic difficult, but also it's very hard to cite them. You know, there's a there's a lot of resistance to these being in people's communities.
VELIS - Just to just okay. Just to follow-up on that. So You're testifying here today, let's just say hypothetically, I'll just because I'm so impressed with what my constituents just did. Let's say an OPC were to open up in Holyoke, Massachusetts. If I understand you correctly, you're saying that it's not likely that someone say from the Mass and Cass area, which might not mean anything to you, but in the Boston in the Boston area will go to Holyoke to take advantage of those6603 services. There's no data to support that.
HUMPHREYS - That that's right. Yeah. I mean, the data we have shows that people tend to live, hang out close to the sites that they use.
VELIS - Interesting. Okay. And I guess the other thing that I would ask you too is in this data space, and It's actually something that I observed you say, and I'm definitely going to mischaracterize what you said, so please correct me here. You were testifying in front of I believe the Oregon legislature who was on the process of legalizing that legalizing something, and I forget exactly what it was. And you had6637 talked about many of the proponents of that legislation had talked about Portugal. And I and I6643 remember Your testimony being on something along the lines of saying, like, look. There's this tendency to cite Portugal as an example for many things when a lot of times what's put forward has nothing to do with what Portugal is doing. Is that accurate?
HUMPHREYS - That is correct. Yes.
VELIS - So guess my question would be, we talk a lot about what's going on in Europe, in the OPC space, and then, obviously, more recently in the past two years, what's going on at OnPoint? Isn’t fair to6677 say that, You know, before we talk about the Canadian example or where else wherever they are in the world that Before we make those analogies and comparisons, you'd have to know what the proposal is in fact here if it's even going to resemble that. Right? I mean, the location matters. Things that go into it matter. Does it not?
HUMPHREYS - Absolutely.
VELIS - So does OnPoint resemble the Canadian facilities, if you're aware?
HUMPHREYS - I don't know the answer to that, but these facilities do look different in different parts of the world. And even if the facilities are identical, but the people who use them are, different. So for example, I was just in Switzerland. They've had to restrict, access from people who use stimulants because of issues about violence, but that's pretty controllable because firearms are extremely rare in Switzerland. If you're in a neighborhood where a lot of people had firearms, you would probably want to have a stronger, prohibition of people who used, stimulants going into one of these sites because, you know, you wouldn't want anything, you know, violent6739 to happen. That's about the context and, you know, every city, every country's context is different even if the services are the same. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER1 - Senator Collins?
SPEAKER6 - Yes.
SPEAKER1 - Thank you, doctor.
COLLINS - Thank you. The doctor pointed out I think you had alluded to this earlier in the Session, Senator Velis said the folks that are down in Mass and Cass, they're not from Atkinson Street. There's no houses So, they're not they're coming from all over Massachusetts and beyond, and I think, there are a number of reasons for that. So that as it relates6773 to who is you come into these sites and not people from the communities, they're usually showing up. Is that I know you're saying they're not driving very far, but we're talking about folks that are living on the street largely, versus living in the neighborhood, going there on their way to work type of situation?
HUMPHREYS - Yes. So you have people who hang out, and they can definitely be from other places. We see that in San Francisco as well. We've quite a few people who aren't from San Francisco, but who sort of hang out around, where drug dealing is. That's where they spend their days. And those are the kind of people, when the site's open, tend to use it.
Velis - You know, on the other nations that we talked about, Portugal and Canada, I mean, we're talking about socialist countries that have much higher taxes, a lot more revenue. And, you know, in this case, I think we should be throwing the kitchen sink at this issue as it relates to funding, but they are structured differently financially. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER1 - Thank you. Any other questions from the committee? Seeing none. Doctor Humphreys, thank you so very much for making the time.
SPEAKER26 - Thank you, senator. Nice to see you again.
SPEAKER1 - Next up, Jonathan Calkins, professor, Carnegie Mellon University. Professor, are you here? Yes.
SPEAKER27 - I am. Can you hear me?
SPEAKER1 - Loud and clear. Thank you. The floor is yours.
JONATHAN CAULKINS - STANFORD UNIVERSITY - HB 1981 - SB 1242 - Terrific. Thank you for this time and and for this Just as a brief way of introduction, I've been studying drug policy for about 35 years, dating to my time at MIT. These are the opioids. I was on the National Academy studying opioids in pain management. I've co-authored a book on Fentanyl and its Future, and now the National Science Foundation Grant. I think the reason I've been asked to speak here today is that I coauthored both a report and a journal article assessing the strengths and limitations of the On typical evidence on what we called Supervised Consumption Sites. You're using the term Overdose Prevention Centers. I'm not going to try to distinguish those 2, but I may slip and use the word SCS.
The punchline of the reports is that the literature is nearly unanimously positive, but it really has some substantial limitations as well, which are detailed in the report in the article, but I'll mention a few. The first I was going to say is Keith already did, which is that the literature tends to ask, would a supervised consumption site be better than doing nothing? It doesn't ask, could we do more spending the same amount of money on treatment and recovery services? Another is this question of scale. By far, the world's largest SCS is the Vancouver Insights facility, which supervises about a 150 to 200,000 use sessions per year. It's a big number.
But there are well over a billion use sessions of illegal opioids in the United States. So it would take 7,000 Insight size facilities to cover that. And again, Insights is much bigger than the typical, OPC. A third is the literature can observe what happens in the facility, but it extrapolates or assumes effects outside6963 the facility, and, much of it assumes a causal effect when there's only correlation. I could elaborate in in questions if you wished. And a last limitation I'll mention is that About 80% of literature comes from just two of these sites, the one in Vancouver and one in Sydney. They're all highly atypical, and at the same time they opened.
There were some, unrelated shocks that could have influenced the outcomes that are attributed to the facilities themselves. So to be clear, I'm not in any way opposed to these facilities. I frankly see almost no downside risk to them, but I do think that advocates sometimes spin and oversell the strength of this evidence, and, I'd be happy to answer questions about what the literature says7020 and where a careful read of the evidence might suggest, the inability to draw conclusions as firm as sometimes are drawn. Thank you.
VELIS - Doctor, thank you very much. Could you speak to the treatment folks who utilize these, overdose prevention centers and the in the likelihood or the numbers, the rates at which they seek treatment. And you may have addressed this. I had a little trouble hearing what you were saying, but I'm really Intrigued by that correlation.
CAULKINS - Sir, two comments. The first, and Keith alluded to this also, is that People who attend these facilities frequently I should really say Vancouver. Most of this comes from the Vancouver site. People who attend very frequently are more likely to end up in treatment than those who just use a few times. The question is whether or not that's a causal effect or whether or not people who are trying to change their lives both commit to using the SCS frequently and also commit to trying to seek out treatment and services and achieve recovery. The other comment about this is it could depend on this mission of the facility.
I think within the community that staff and support these facilities, there's at least two distinguishable mindsets. one is that the main function of the facility is sort of a hook to try to draw people into treatment and recovery, but then there's also people who don't think that way at all, who think that the entire goal is to provide Ongoing support for safe use for as many years as the person wants to continue using. So there was reference earlier to different facilities you're different. They can differ in their objective, in what the staff perceive the function and objective of the facility to be.
VELIS - Doctor, we spoken a lot today, and I'm sure this is7152 this is something we're seeing in many parts of the country, in fact, the world, about the presence of Fentanyl analogs, here in Massachusetts present, and I believe the number is 93% of fatal Accidental drug overdoses. I guess my question would be is isn't the argument in support of these facilities, is it not strengthened because of just quite frankly how dangerous the drug supplies right now?
CAULKINS - Yes. If there were no overdose risk, then an Overdose Prevention Center would lose its raison d'etre. And the historical data from when the illegal opioids were primarily heroin was an annual overdose death rate of about point 75% per year. So for every 100 people who are using illegal heroin every year, you get about 0.75 annual overdose deaths. And that death rate has been multiplied markedly by Fentanyl. The literature is not sure by how much. I've seen numbers as low as a factor of three and as high as a factor of 20. But, absolutely, being a Person who routinely uses illegal opioids is much, much more dangerous in terms of risk of fatal overdose, today than it was in 2013.
VELIS - Thank you, doctor. SHOW NON-ESSENTIAL DIALOGUE
Questions, committee, for members of the committee? Doctor, we appreciate you joining us. Thank you very much.
SPEAKER27 - Thank you.
SPEAKER1 - Alrighty. Next up, we have Omi Amaresigim, and then we have Aloria Fiorenza for a panel. And these two as well. Doctor Bisola and Karen Carroll. two more. Sorry. There's two more as well as doctor Bisola and then doctor Carroll.
Thank you.
OAMI AMARASINGHAM - MASSACHUSETTS PUBLIC HEALTH ASSOCIATION - HB 1981 - SB 1242 - Thank you, chair Velis, chair Madaro, members of the committee. My name is Oami Amarasingham. I'm the deputy director of the Massachusetts Public Health Association, and we are in strong support of this legislation. I'll be brief before I turn it over to my colleagues. But first, in order to reverse the trend on overdose deaths, the public health community and providers need every tool at their disposal to meet people experiencing addiction where they are at, including overdose prevention centers. And while OPCs, as we've heard, are not7329 a panacea, they're an important part of the7331 infrastructure that Massachusetts is currently lacking.
Other public health tools that have shown great success were met with similar fear and opposition due to stigma than when they were first proposed, including syringe exchange programs and medication to treatment. It is not so long ago that these are programs that were thought would enable drug use. And much like OPCs and other places, this has not been borne out by the evidence and the data. Second, this is a matter of health equity in Massachusetts. Disparities in overdose deaths last year are alarming. Fatalities are up overall with the numbers and rates of overdose rising dramatically for people of color. Last year, we saw an increase in overdose death rates by 41% for black men, 47% for black women, 12% for Hispanic men, and 36% for Hispanic women.
Historically, our nation's And our state's drug policies have been used as a tool of criminalization and oppression that led directly to mass incarceration and the criminalization of black and brown communities. Now as we see new trends with pea people of color and women of color in particular dying at alarming rates. We have an opportunity to meet this moment with compassionate human and health centered policy. Finally, good government has an important role to play in creating the conditions for individuals to make the best choices for their own health and well-being, And OPCs fit into that structure. There is a role for the federal government to play, for the state government to play, and for municipalities as well.
This legislation gives an opportunity for the state to stand in support of communities that are willing and ready to open overdose prevention centers to stem the tide of overdoses in our state. And just quickly on the federal landscape, we have seen, a bit of a shift over the last two years, while there's no clear federal position on overdose prevention centers, there are several reasons to think that the feds might take a more neutral or accommodating position, and in fact, they already have. Over the last two years, DOJ has not acted to stop the operations of the two OPCs in New York City or to stop the implementation of overdose prevention centers in Rhode Island. And it is a well-known tradition in our country that states Our laboratories of democracy7465 is, in our view, absolutely appropriate that Massachusetts would take this step to do what is best for the people of
KARIN CARROLL - THE CITY OF SOMERVILLE HEALTH AND HUMAN SERVICE - HB 1981 - SB 1242 - HB 1981 - SB 1242 - Thank you. Dear joint committee on mental health, substance use, and recovery, my name is Karin Carroll. I'm the director of health and human services in the city of Somerville, one of the state's large cities. I am here in support of overdose prevention centers, which are a public health tool that will save lives in our cities. Substance use impacts every municipality in the state and is a pressing issue, especially in the large cities where 51% of the overdose deaths occurred in 2022.
Disturbingly recent MDPH data shows widening racial disparities in overdose deaths. While rates of opioid related deaths decreased among white women and white men from 21 to 22, these same deaths skyrocketed in communities of color. Substance use disorder and the importance of overdose prevention centers as an effective public health tool are being highlighted in major cities such as New York City and globally in 14 countries around the world. Not one overdose death has occurred in these approximate 200 centers. Several communities across Massachusetts are interested in opening overdose prevention sites, but legislation is needed to establish the legal and framework for them to operate successfully.
By creating spaces where people who use drugs can receive Stigma free evidence based care in Massachusetts. We can save lives, reduce reliance on costly ambulance rides, Emergency department visits and hospitalizations lessen the strain on our health care system and mitigate racial health inequities among people with substance use disorders. Every overdose is preventable. On a recent trip to OnPoint in New York City, I was struck by the sense of community and the wide range of critical wraparound services that were available on-site from clean laundry to showers, wound care, mental health services, food and places to rest, and much, much more. All of these touch points increase the likelihood of people getting the help they need for their disease when they are ready like any other chronic disease. Thank you for your time.
ILARIA FIORENZA - CITY OF WORCESTER DEPARTMENT OF HEALTH AND HUMAN SERVICES - HB 1981 - SB 1242 - Chair Madaro, chair Velis, and members of the committee, it is an honor to be here. Thank you for the opportunity to speak to you today. My name is Ilaria Fiorenza. I am the project manager of the Department of Health and Human Services of Worcester, and I'm testifying today on behalf of Dr. Matilde Castiel the commissioner of health and human services for the city of Worcester, who could not make it today, but is testifying as a public health official.
Understanding that even though the city of Worcester is not committed to opening an OPC at the present time believes that the state should adopt these bills as a public health tool to decrease overdose7668 mortality. Over the last years, Worcester has seen a large increase in opioid related7674 overdose mortality, making it the city with the highest overdose deaths in the state. Last year, we lost a 140 people. That is 66.35 people per a 100,000, which is the highest rate in the state and the highest Worcester has ever seen. These numbers disproportionately affect communities of color, and this is an important equity issue for us in the city.
These deaths are preventable. There are currently around 200 operating OPCs in over 14 countries, and data indicates that there has not been a single overdose mortality at any of these facilities. Data shows that OnPoin, New York had 850 nonfatal overdoses and only had to call EMS 15 times over the span of a year, saving the city $17 million. Besides the financial aspect, a large role of OPCs is also to provide additional resources to clients, such as access to health care, mental health and addiction care, HIV and hepatitis c testing and treatment, housing assistance, legal aid, hot meals, and more. These resources are often sparse throughout a city, and clients are often forwarded to multiple locations.
A center that provides us many resources and referrals has been shown to be beneficial to both clients and providers. This is an entryway for people who may not feel comfortable accessing treatment due to heightened stigma. Increasing engagement with these forces will lead to an increase in treatment. OPCs have shown to successfully increase the adoption of safer behaviors that reduce harm and promotes public health. This includes decreasing drug use in public, increasing the appropriate disposal of syringes, and decreasing injection related litter. Worcester, like the rest of the state, is struggling with a substance use problem. And as published in the recent Beacon Research Report.
76% of voters in the state see opioid use in Massachusetts as a major problem, and 73% believe that the state should be doing more to address this. In public health, our goal is to provide all harm reduction tools possible, including fentanyl strips, Naloxone, and syringe exchanges. Data in indicates that OPCs are also an essential tool for harm reduction. We know that substance use is a disease, and we must give people the ability to engage in home reduction strategies while providing them with treatment opportunities. This is a public health issue that must be tackled with public health tools, And opioid prevention centers have shown to be one of those tools. Thank you.
BISOLA OJIKUTU - BOSTON PUBLIC HEALTH COMMISSION - HB 1981 - SB 1242 - Good afternoon, chairman Velis, chairman Madaro, and other members of the committee. My name is Dr. Bisola Ojikutu. I am the executive director of the Boston Public Health Commission, the commissioner of public health for the city of Boston, and I'm also an infectious disease physician at Mass General Brigham Hospital. I want to start by thanking the committee and the sponsors of this legislation for their leadership on this critical issue. In Boston, as in Other cities in Massachusetts, we are experiencing an unprecedented crisis in opioid related overdoses.
You've already heard that recent data noted that 352 people died from overdoses in Boston recently more than any other year in recent history. From 2019 to 2022, Boston experienced a 36% increase in opioid related deaths, which is more than twice the statewide rate of increase over the same time period. These data also highlight significant disparities in opioid related overdoses. The opioid overdose mortality rate for black and Latinx residents was 66% and 31% higher than white Boston residents respectively. I think we're all aware that these deaths were preventable.
These data indicate that we need to increase our focus on overdose prevention throughout our city and scale7892 up evidence based interventions that we know7894 decrease the harm associated with drug use7896 keep people alive. Boston has a long history of implementing innovative and groundbreaking initiatives to meet the needs of individuals living with substance use disorder. As a city, we have led the country by establishing a robust syringe exchange program, by expanding Naloxone access, and by building a successful low threshold housing system that has given hope for the future to many who are suffering with substance use disorder. Many of the programs that we've established were highly controversial when they were first adopted and required pilots and changes to state law.
As a doctor, I believe that we have an obligation to explore Any and all evidence based strategies, including the establishment of opioid overdose prevention centers to reduce drug related deaths and to potentially increase the number of people who enter treatment. I believe it is time to remove the legal barriers that are standing in the way of making the public health intervention available. The public health community is standing ready to help implement overdose prevention centers in Massachusetts and to provide the full spectrum of necessary harm reduction strategies to patients7965 who are in the greatest need. Thank you, and I welcome any questions that you have.
VELIS - I guess from a well, 1st and foremost, thank you, all the members of the panel, for testifying. From a public health best practices evidence based, you know, we've already kind of talked about how location matters, where these, OPCs would go. Based on the data today, if this legislation were to put forward, where should these sites go?
AMARASINGHAM - So first, just to be clear, the legislation authorizes a pilot program that would allow community or a nonprofit that wanted to open one of these sites to go ahead through Several legal steps. First, regulations would have to be would have to be written by DPH. Other approvals would be necessary. From a public health perspective, it would make sense to have multiple overdose prevention centers throughout the state. We've heard already from others that people are not traveling very far. We know that would be even more challenging in Massachusetts giving our given our vast transportation problems.
And so but somebody has to go first. I mean, that is the political and legal reality, and this legislation would open the door. We know that Somerville is ready to take that first step. Overdoses are happening in every single community across the state, and so I think it remains to be seen where other sites would open. And the legislation doesn't speak to that. So the legislation does not prescribe where states would have to open, but our hope from the Massachusetts Public Health Association would be that as sites open, the legislation also provides for public health evaluation, which is an important component.
The speaker from California spoke to the need for that in California as well. one problem that we clearly have is because of legal restrictions, there are not that many of these sites across the country, and the United8082 States has a unique political profile when it comes to drug policy given the history of criminalization in this country in our vast incarceration system. And that also makes comparisons to other countries a little bit difficult because we don't it's not a one to one comparison. And so it's I don't mean to avoid the question, but we would support any community that wants to open one of these sites. And, this is an important component.
VELIS - No, I don't think you're avoiding the question. I'm just I mean, we've heard a lot about, again, location matters, and we've heard a lot today about where that impact would really be felt. If I understand some of the testimony today, that impact would really be felt in those areas by these OPCs. So, Again, it may be I'm making logical conclusions I should not, but it would seem to follow. I would argue maybe ineluctably follow that. Then where we should be targeting these sites is sites where there's an abundance of drug usage already. Am I missing something? Am I wrong here?
AMARASINGHAM - I don't think you're missing something. I think that we need to meet people where they are at. We know where people are at. The Massachusetts Public Health Association would support the opening of these sites in the places where they are needed most, where there is most demand. But we8153 also know that these sites provide other services. That's been spoken to beyond, just supervision during safe consumption. I would think that people would seek out these sites for those other services. The one problem that we hear about frequently is that there are not enough services in places across the state, and that is one reason that there's, concentration in certain areas because there are more burdens in some communities than others. And I think the more that we have, sites and services across the state, the more that we will see the usage of those sites spread out.
VELIS - Yes. So just I guess where I'm going with this is that it becomes a little bit of a challenge. Right? Because so if you look at it, And, again, this is my understanding of reading the data, and I am not a data person, is that if you really want8197 to force multiply these sites, you need to go where this activity is going on, is my understanding, and I could be wrong. one of the challenges becomes though that many of these communities are already filled with you know, are already doing a lot. And adding something else to the equation could, some might say, you know, overburdens some of these communities' capacity.
To deal with some of the challenges that, potentially, a site could bring. And I'm thinking out loud here, but I8229 I'd love I'd love kind of the public health pushback. I realize I realize the legislation contemplates8235 a community coming forward and saying, hey. We'll go forward. But there's nothing in the legislation that says that that community is a place that is a community where the data would suggest That's a good place to come forward. It's just saying a community can come forward and say, we want to be part of this pilot program. But just because they can do it doesn't mean that's a good place for the site to go. Thoughts?
CARROLL - Again, I would, just highlight the range of wraparound services that are available in what we call the engagement center, part of an OPC, and we currently have engagement centers in our community. These are critical services that are there as well. And, yes, we want to locate them where is the most people can access them, but it's8288 important that we recognize all of these wraparound services that are co-located. And, again, as someone mentioned earlier, the consumption part of an OPC is a very small piece of the range of services. I would also add many of us in our large cities.
Where 51% of these overdoses are happening, have needle exchange harm reduction programs very actively underway, and they give8315 us information data. They know the population. They know the residents, and we already have so many steps towards many of these services. And some are mobile, some are bricks and mortar. It's a bit like, if I can highlight the new virtual or I call it a virtual, but the overdose prevention hotline that the state has set up is an amazing tool. And, again, it's another tool, that's more accessible less by geographic location. So That's an option for some folks as well.
VELIS - Appreciate all of your responses. SHOW NON-ESSENTIAL DIALOGUE
Senator Collins. Thank you.
COLLINS - Thank you all for your testimony. So people go to Mass and Cass not to seek treatment. They go to Mass and Cass because they're allowed to use illegal narcotics without prosecution. I relate it to somebody who will communicate that seven days a week who's been down there. That's The lion's share people are there because they know they can use without prosecution. Not safe anymore, but it that's why they're8382 there. So it's not a community that needs rescue. It's something that is developed based off of lack of, enforcement, and we're talking about public health responses. Needle exchange program. It's now to the point where it's a millions, and we're bringing in a million and a half.
So and as it relates to low threshold housing, we look at the cottages at Shattuck. Needles are through the roof in Franklin Park. And we know that, that the amount of people seeking treatment at these facilities are low. So I'd ask the panel, and I first want to thank, Dr. Ojikutu throughout this process, and it's been a difficult one. There are some differences of opinion that their establishment of the friends and family reunification program has had a major impact. And I bring that up because it speaks to the only group who are really willing, other than now with support of the police to perform Section 35 petitions. Physicians don't want any part of It's like the prescription drug monitoring program. We want to we don't want the paperwork.
Meanwhile, we're discharging meeting people where they are, 1250 at the emergency room for six months. They weren't met where they were. They were discharged out into the street when they were crying out for help. So I guess I want to find out from the panel, in the communities that you lead and serve, why we don't have a de facto position at the emergency room with the public health professionals and the medical folks to say 12 in. 12 overdoses were staring at on a sheet, and someone just got brought thereafter, being brought back to life. I know someone who was here for BMC before. Oh, we don't have find a room.
We don't have a room to talk to people after they've experienced an overdose with a with a8497 with a trauma team? We don't have a room at BMC. That's absurd. So, hopefully, that that gets brought back because, you know, having a setting where we're meeting people where they are, coming to us, or care and service, and then not taking on an obligation there. I think that's a public health failure. I really do. I think, collectively, we have to change course on that. If we're truly taking a public health approach, you have to be looking at that while we're discussing these. In the care that was brought up, the care that happens at these facilities, they're the same that happened at emergency rooms. So that that's the other thing I don't understand.
So this is moving people, you know, to a safe place,8532 allegedly, in our program8534 is another thing to highlight. We're batting8536 900. It's incredible. If we weren't,8538 we'd be losing a lot more people. And8540 I don't know if the safe injection site path is the way to do that.8544 God bless you. But we can't8546 ignore that we're discharged, at least in the8548 city, 1250 people at the beginning8550 the first half of this year out on the street without treatment. Voluntary exhaust the voluntary, but leaving people out on the street without a8559 commitment. I also like to ask what the what the if it's been, read or discussed, the Duke study that says After six months of, involuntary commitment, including outpatient, not just inpatient, is a major success increase for people's recovery.
OJIKUTU - So thank you, senator Collins, for your efforts in this area. I know we've discussed these issues on many occasions. I wanted to mention early in your comments, you said that, most people come to the area to engage in drug use. We have done a number of surveys, some of which I think you've seen the data showing that many people are there to seek services. They're actually there to seek medication8603 for opioid use disorder. They're there to seek out assistance, case management for housing. They're there8609 also to actually seek services.
So and because there's a community there, which I think is important for us to recognize. That's not to discount what you said. It's just to say that there are many reasons why People come to any certain area. I just wanted to add that, many of the overdoses that we're seeing across the city or occurring in the field. They're not necessarily people who are even brought to the emergency room. And we do have, robust teams, our recovery services bureau team, the team from Boston Healthcare for the homeless population who are out there reversing overdoses on a daily basis.
I think it's just important to note that because That area, actually, if you look at the data across our city, has a lower overdose mortality rate than other areas in the city because we have so many people out there trying to reverse overdoses. So yeah. Right. And I just want to ex but I just want to explain that, you know, there are a lot of people working very hard to do this work in that particular area. So just wanted to make that point, That's all. Yeah.
COLLINS - Thank you. But also as part of that community, and it's going to be like uprooting a beech tree at the arboretum, a drug traffickers human traffickers. I mean, that's what we're talking8673 about. That's the community we're talking about. It's not you know? I mean, they maybe operate in their community meetings with Robert's Rules of Order,8679 but other than that, it’s complete chaos down there, and I don't think there's a lot to debate with respect to that. And I agree with you about the knock in. By the way, everyone's doing we're putting them at train station.
Everyone, and that's a harm reduction tool. Still not escaping the 1,250 brought to the emergency room, why we have a policy that is hands8699 as hands off as Mass and8701 Cass8701 and8701 allowing people to leave without care.8703 I just don't see how we can sustain that with credibility and then ask to legalize every drug, that's illegal right now and actually create safe spaces for that because we have an obligation that we're not fulfilling at the emergency room, whether it's a hospital that's owned by the city of Boston or the8720 public, in the case of BMC, in the8722 facilities, long term lease with the city of Boston, or others that get great benefit from the Commonwealth in in the city that'll just let people leave.
I just I don't understand how We can continue that, so I'd ask that that as public health leaders, that you can reconsider the positions, because I don't see how we're meeting people where we are if we discharge let them go, and then say, hopefully, we can get this law passed to legalize the use of illegal narcotics under safe spaces. Earlier, the city of Cambridge said maybe by peers. I mean, this just seems reckless. I haven't been convinced this this hearing, but I would really like to hear why we're discharging people without, treatment.
CARROLL - Thank you, senator Collins. I think we share the goal of not having people in an emergency room post overdose or for any chronic disease. This is what public health does. We try to manage chronic disease in the community where people live and work and play and all of those things. I agree with you. It is an expensive, traumatic, and often not productive in terms of changing the course of the disease. So, I just want to be clear on that, that I agree with you.
It is often not the place that we can really help people manage a chronic disease. Hopefully, it is a place where we can help people. We can put Band Aids on. We can do a lot of those things. But our idea with overdose I mean, overdose prevention centers and engagement centers and harm reduction in our community is to avoid that, to help people get the services they need and take care of what when they are ready in their community. Thank you.
COLLINS - Thank you. Still, I would like a response about, you know, close to a 100 a week, and we're discharging without service, without care. I mean, it's I just that to me needs to get answered if we're going to move forward on this. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER1 -. Ritani Hu.
DONAGHUE - Thank you. I do have a question for the panel, but I do want to comment briefly, in support of what senator Collins has been saying, when my son had, a serious, almost successful suicide attempt, He was served at a hospital. I won't in the hospital. And there was a tremendous8874 amount of support for me as a person, for the family, for my son in trying to prevent a future suicide. Fast forward a couple years, he's at the same hospital, Narcan and just very rudimentary.
You know, just a huge, huge difference in the reaction. My question now is actually people have touched on the finances. People have touched on the cost of avoiding, for example, expensive emergency room treatments, ambulance treatments. What's the discussion? I've read different things on the financial benefits versus cost of overdose prevention centers versus the cost of treating people in emergency rooms, infections, overdoses, and more. Thank you.
AMARASINGHAM - I know that Ilaria had a specific number8932 in her testimony, so I'll pass it to her. But, From the public health perspective, we are we are frequently focused on prevention because prevention is always more is always less expensive than damage control after the fact. And what we see with incredible numbers of people showing up in emergency rooms is that everything has already gone wrong. 911 has had to be called. That's an ambulance cost. That's police. That's fire. That's EMS, plus emergency room costs, enormous health insurance costs whether or not people are insured.
And so the idea of overdose prevention is that by having someone self select into a facility where there are already staff who are trained and have Narcan on hand and supervising as someone is using is that you avoid those, high costs, which ultimately are Often, at some point, borne by the state, and the hospital system, we've had a whole separate hearing about health costs being through the roof in Massachusetts, and this is part of that problem. And so I'll pass it to Ilaria for the specific numbers that she has, from, I think, from New York.
But that you avoid all of those costs, including the human cost and trauma of having to go to the hospital, etcetera. And then hopefully, while overdose prevention centers and what we are testifying to specifically is the prevention of overdose, which is already9006 someone is using, and perhaps in heavy and traumatic9010 use, and so they are at risk of overdose. But hopefully, you also and we've seen this in the studies about other overdose prevention centers that people, not everyone, but peep some people who come through many people who come through do get9022 connected to services to help them through their recovery process.
FIORENZA - Thank you, representative,9031 for the question. I will echo what Omi, said. The number that I had over here at the 17 million, includes what Omi was just talking about. So the hospital cost and the ambulances, etcetera. I do not have the exact number of how the OPCs versus treatment compare exactly, but I will, make sure to include it in my written testimony. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER1 - Pepe Zaros, thank you,
REP XIARHOS - Senator and chair, it's pretty9062 powerful to listen to everybody today. Prior to doing this work, I was a police officer for 40 years in the town of Yarmouth, a small town,9071 and we had 61 deaths, in a town of 26 thousand. And I've seen the deaths. I've given Narcan. I've seen parents destroyed early because their child died. My own son killed in combat, at age 21 as a marine. And part of his mission that summer was to protect the farmers because The9101 opioids in the, poppy fields, that's where it comes from, Afghanistan. And if the farmers Stop doing that. As senator Velis knows, a combat veteran, the enemy would kill them. So the marines were there partly to seek out the enemy of our country after the attack on September 11th.
But also to protect the farmers who are trying to do the right thing. So it's a horrible problem. I've seen it, you know, firsthand. I have it in my family, addiction, the stigma, all those things. So all of your work is so important. Keep doing it. I'm trying to listen all day long with an open mind. But I think senator Collins' point is important. When people get to the hospital, for whatever reason, Yes. There's cost of the ambulance. Yes. There's police, but that's okay. Like, that's our job. And they get saved. And,9169 yes, they, a lot of times, walk out. And I've had parents say, well, you know, how can they do that?9175
Finally, like, they're9177 there, and my son or my daughter now is walking out, who's still out of it, basically, and supposed to make a good decision. So senator Collins, you're on the right track. Not only9193 is this important or not or part of the solution, But I'd love to see more at the hospitals and, to try to almost hold them there so they can get better, before they go back out on the street and do it again and eventually die. We've had people Overdose one person 12 times and saved and then finally died, to your point earlier. It's a horrible problem, But I would like to see more work with the hospitals and keeping them there somehow, instead of just releasing them. So thank you.
VELIS - So I think thanks, Rep. I think it's important to remember as we're continuing to have this dialogue is that one of the challenges, and I that I'd be interested to see if there is feedback, is that when we talk about holding folks, you know, nothing pains me more than when I'm having a conversation with a constituent whose loved one has been Sectioned is released in a very short time period, and it's the kind of look at you and they say, what happened? Why is my loved one back? I thought they were going to get better. But I but I think it's important for all of us to remember that, you know, The nature of a 35, right, a Section 35.
It's a civil commitment, and I don't I don't know how much we can go down the path of holding folks against their will indefinitely, without some type of criminal offense. I think we then go down the path of, does involuntary treatment work? And, again, I'm not you folks are the ones who need to answer that. My job is to ask These questions, but what I can tell you is this. In in my experience, you know, someone who, you know, but for the grace of the God should be dead right now. I know with absolute certainty beyond a shadow of9326 doubt that until I was willing to raise my hand and say, I need help. A9335 hospital could hold me. They could grab me at Mass and Cass.
They could grab me at Holyoke. I was going to9341 keep9341 going until I raised my hand and said, I need to Stop. So I think it's just important. And I love I love someone with a public health degree to come forward today. And I say this with the utmost admiration and respect for what all you folks do, to tell me of instances you're aware of where people have stop their destructive behavior, whatever it may be, prior to them wanting to stop that behavior. If that's happened, I'd love to hear about it. I'm not I'm not I'm not aware about it. So I think at some level, it's really important to remember that and this is why I go back, and I'll be very candid.
If you had talked to me four or five years ago about sites like this, I probably would’ve laughed at you. Very candidly speaking, I probably would’ve laughed at you. Where I'm where I'm struggling right now is the number of people that are dying. I'm struggling with the number of people who haven't used that many times and who are dying. I'm struggling with the fact that people are using stimulants right now that are laced with Fentanyl and are dying, and I had no idea that Fentanyl was even a thing that could be laced with stimulants. So I just think it's really important as we talk about this to remember that If anyone thinks that overdose prevention sites are going to get us out of this crisis, with the utmost respect.
I'm going to laugh at your testimony. But can it keep people alive? And that's and that's what I want to focus on. That's what I want to hear about. I know I think the comparison is great treatment and stuff like that, but an9433 overdose prevention center is not treatment. It's not. I don't care what anyone says. It's not treatment. You9439 might go down a path of getting treatment, but as Dr. Humphreys said, question maybe even the correlation or the causation between that and then getting treatment, but it's this is keeping people alive. To the extent that it's offering positive things, it's keeping human beings alive. Question from the committee. Senator Collins.
COLLINS - Thank you, chair. Yes. You bring up a really good point about where the involuntary treatment works. Again, history, last resort in the emergency room horizontal, pursuing somebody's, Advocating to pursue somebody get treatment while they're upright on substances, virtually impossible. A total impossible mission. So that's where the shift is in. And, again, if you look at studies from Duke suggesting prolonged periods9488 of commitment, You'll get a shot. But to the question about saving lives, as much as this discussion is about that, the intervention that we already have an ability to perform under the law legally, civilly, public health response, it's not being done. It's not.
So Until we can exercise those as a commonwealth at every level, I just don't see this is a completely slippery slope because we're not doing things that we have the ability to do now that can save people. We also have other statistics. If someone overdoses twice9523 in 40:48 hours, they're likely a goner. So you discharge someone out to the hospital without9529 that, maybe he'll if this is becomes legal, they'll get to a safe injection site and turn their pace around. I don't know. But we have people coming to us, crying out for help, and we're just letting them go. And I'll see how that changes the equation if we continue to do that. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER1 - Any more questions? Members of the committee, thank you very much for your testimony today.
SPEAKER33 - Thank you.
SPEAKER1 - Senator Lovely remotely or here remotely. Senator Lovely.
SEN LOVELY - HB 2008 - Mr. chairman, I am here remotely. Thank you for taking me out of order, to you and, and chair Velis. I am here to testify on h two zero 0 8, that I have filed with our esteemed colleague, representative Pignatelli. It's an act helping overdosing persons in emergencies, otherwise known as the Hope Act. This is a refile. It did get a positive, recommendation out of this9588 committee last session. We're looking for that to happen again. Let me tell you briefly what the bill does. Currently, Massachusetts first responders are not required to carry any Opioid antagonists like Narcan while they're on duty.
So this was brought to our attention, regarding untimely overdose death of a Berkshire resident Who was in the presence of a first responder who unfortunately did not have access to Narcan to revive that that resident. So H.2008 would direct your government entities to supply first responders with an opioid antagonist approved by the Department of9626 Public Health So that they have them on their persons, on duty, in in their emergency response vehicle, or on their person. We know that a lot of departments actually already do this, but not all departments have the opportunity to do this, especially those that may be in rural areas.
So we really want to9646 make9646 Sure9647 that every first responder across our entire Commonwealth has an, an opioid antagonist with them So that if they do come across someone who is overdosing, they're able to save that life. That's what we are talking about here today. Just want to shout out to and Quincy did this in 2010, established a program, Revere, our nation's first fire department, dated in 2011. So it has been, done for9675 quite some time in many9677 communities. And like I said, many communities are doing this. I don't think any community is adverse to doing this at all. I think they just need the opportunity directed through the DPH to be able to allow this to happen.
I, too, carry Narcan. I saw a gentleman, drop from what I suspected was an overdose when I was picking up my Thanksgiving turkey one year. And certainly, sure enough, as the first responders, came, which seemed like seconds. They revived him. He came right back up.9708 They took him to the hospital and I hope he's done well since then. But I vow to be trained and to carry Narcan of which I do. It's in my purse. I've just was retrained again this summer. And, just in case just in case come across someone who is overdosing, you can you can save a life. So thank you for the opportunity to testify. I am happy to answer any questions. Thank SHOW NON-ESSENTIAL DIALOGUE
you.
SPEAKER3 - Thank you, senator Lovely. Do we
SPEAKER6 - have any questions from the committee members? Okay. Thank you so much for your testimony.
SPEAKER34 - Thank you.
SPEAKER3 - Next, we'll call up a panel from Team Sharing Incorporated and Moore. Cheryl, Noel, and Lynn, Please come on9754 up.
SPEAKER20 - Can you SHOW NON-ESSENTIAL DIALOGUE
hear me?
CHERYL JUAIRE - CONCERNED CITIZEN - HB 1981 - SB 1242 - My name is Cheryl Juaie, and I am the founder of the9818 nonprofit organization Team Sharing. We're an organization of families who have all lost our children from substance use disorder. I'm not coming to you today in that capacity.9830 I'm coming to you today as a mother who has lost two of her three children to addiction. I lost my son, Corey Merrill, February 24th 2011. 10 years later, I lost his brother Sean on June 25, 2021. I don't usually do this when I speak, but today, I'm going to make myself vulnerable in my role9851 as a supporter for my son, Corey, because I wasn't.
I was taught tough love would make him want to get well, so I wouldn't let him come home to his warm bed when he needed to. Although it broke my heart, I knew he was sleeping in the cold on park benches, but I believed I was doing the right thing at the time. I thought surely he'd be smart enough to stop using. After all, I didn't raise my kids to be drug users. Corey would try and talk to me about addiction, and I refused to listen. Just stopped is what I would tell him. I experimented in high school, but then I got married and had children, and I stopped because I grew up and knew better. So why can't you, I would say. Corey would need a ride to a detox or a rehab.
I would drive him, and my to him when I dropped him off was, will you just get it this time and start making something of yourself? At 23 years old, Corey couldn't keep a job. He had a girlfriend he met in his NA meetings, and they had a daughter together. He was on food stamps. He lived in public housing. As much as I loved my child, I was never so appointed in anyone in my whole life, and he knew it. And then I got the phone call. And so began my years of grieving, my years of guilt,9928 my years of suffering, and now my advocacy. I am a huge advocate for overdose prevention centers. Why? The stigma. Our loved ones can walk into9944 these centers unashamed and be treated like the human beings that they are.
They can bring their drug in, have it tested, and use within a sterile environment with clean cotton, clean syringes, and clean water to reduce the transmission of infection infectious diseases under the supervision of trained health care workers. They are offered food, showers, clothing, haircuts, dignity. And for me, this is the most important. When they are ready, they are offered the services such as counseling, drug treatment, and recovery services. Now back9982 to my child. Had I listened and truly understood addiction as I do now, I would have had more compassion for my son and less shame. He never would have slept on a park bench in the cold, but in his warm bed where he belonged.
I would have understood how these drugs hijack your brain, and we would have worked as a family trying to figure out our next step in getting him off those drugs. And if available, I would have driven him to these overdose prevention sites so that I could have had one more day with my child. And like you said, it's all about living. And then I would have supported him when he10020 went into detox and rehab and into the recovery community, and that's what I would have done for my child. And I will close with this. It's been said, and I can attest this to be true. There is no greater warrior than a grieving mom or dad. We're standing here no longer able to fight for ours, but because of them, We will continue to fight for yours. Thank you. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER1 - Thank you so much, ma'am. So very sorry for your loss, and thank you for coming forward here today with your experience.
LYNN WENCUS - CONCERNED CITIZEN - HB 1981 - SB 1242 - Good afternoon. My10065 name is Lynn Wencus. I've been married for 42 years and have lived in the same house for the past 37 years. I have three children, Jeff, Amanda, and Lauren. All three were raised in the small town of Wrentham, attended local schools, and played town and school sports while enjoying life in a suburban setting. Life was not perfect, and we certainly had our challenges. But I never imagined how dramatically our lives would change. On February 5th 2017, my life as I knew it imploded. My oldest child and only son, Jeff, died at the age of 33.
From an opioid overdose after struggling with substance use disorder for10107 nearly 10 years. I cannot adequately describe what it feels like to lose a child. Children are supposed to bury their parents. That is the natural order in life. I am powerless to change my reality, But I still have a voice, and that is why I am standing be sitting before you today. This state, as you know, has10128 been ravaged by the opioid epidemic, and we have lost thousands and thousands of lives. In 2014, Massachusetts declared the opioid crisis a public health emergency. And although we know that overdoses are preventable, the 2,357 Massachusetts lives lost in 2022 tells10150 a very different story.
During her gubernatorial campaign while speaking on this crisis, Maura Healey said, and I quote. “From the beginning we have all recognized this as a public health crisis that it is and it necessitates Innovative. thinking, innovative approaches, and, certainly, we should do everything we can to save lives. And yet here we are today still fighting to use all of the evidence based tools necessary to address this public health emergency. Our government's war on drugs is a failure. We must acknowledge that drugs will continue to be everywhere and that the supply chain will continue to be deadly.
We must understand that requiring complete abstinence will not decrease the demand or10207 use for drugs. Overdose prevention centers are critical and keeping people who use drugs alive and as healthy as possible. For example, in 2016, my son Jeff was hospitalized with sepsis. He spent five days in the intensive care unit at UMass Memorial and then another six weeks in a nursing center, and MassHealth paid for his entire treatment. This life threatening infection and the treatment it required could have been Prevent it. And if an if Overdose Prevention Center existed then, not to mention a substantial cost savings benefit for the Commonwealth of Massachusetts.
People who use drugs10253 can go to overdose prevention centers10255 to use drugs in a safe, nonjudgmental setting, staffed with individuals trained to intervene in case of an overdose. Disease transmission can be reduced, and individualized support and wraparound services are provided if the person using chooses. Overdose prevention centers save lives, and I can only wonder had they existed when Jeff was alive and struggling if he would be with us today. So, please, let's10287 be proactive instead of reactive to this crisis. And I leave you with this thought. While there is life, there is hope. Thank you. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER1 - Thank you very much, ma'am. Well, sorry for your loss. Thank you.
NOEL SIERRA - MASSACHUSETTS ORGANIZATION FOR ADDICTION RECOVERY - HB 1981 - SB 1242 - Senate chair John Velis and house representative, Madaro and members of the joint committee, we thank you, for hearing me, this afternoon. My name is Noel Sierra, and I'm testifying in support of, the bill H.1981, and S.1242, an act relative to preventing overdose deaths and increasing access to treatment. On behalf of the Massachusetts Organization of Addiction Recovery, which is more to authorize a 10 year pilot program for overdose prevention centers. In fact, Moore is a Massachusetts, for Overdose Prevention Center member as well. I'm speaking to you as a person in long term but also as a representative of MOAR.
I am the southeast regional coordinator for MOAR, And MOAR has been a long advocate for full continuum of care to match the needs of every person in need of support. Our mission is to organize individuals, families, and communities to educate the public about the value of living in recovery from alcohol and other addictions. We became supporters acknowledging that a person cannot get10397 recovery if they10399 are no longer with us. We applaud all the10404 legislators and the executive office and the department of public health, treatment providers and peers, servicing, addressing this overdose crisis. And we it would be, much worse without it right now.
Yet, the overdose still climb. 2022, 2,357 deaths, preventable losses that never should have happened. We know that there's no one magic solution for this complex public crisis, but an evidence based response is desperately needed to save lives. And you mentioned it, saving lives. That's what this is all10451 about. It's about making an impact and making sure that those individuals have an opportunity to get treatment. And I'll close with this because I know I'm short on time. I don't know if you've ever heard this gentleman's name. His name is Theodore Jessel. Theodore Jessel tried 26 times to get a book published, But the 27th time the 26th times he failed. Everybody turned him away.
But the 27th time, He got his book published. And if he didn't get his book published, we10491 wouldn't know about The cat in the hat and green eggs and ham. It was 27 times. It doesn't matter how many times a person uses an overdose prevention center. We never know when that time is going to come, and they decide or they're in the right mind or they're connected to the right person to make the decision to seek treatment and to take advantage of the treatment that's being offered to them. We plead with you today. Side with this. Let's make this happen. Massachusetts is supposed to be on the forefront of addiction treatment. Let's keep it that way. Thank you for hearing SHOW NON-ESSENTIAL DIALOGUE
SPEAKER1 - Thank you very10537 much, all three of you, your lived experiences. The we it's it's10541 greatly appreciated. Thank you very much for being here. Members10543 of the committee, questions? Seeing none, thank you very much for coming here today.10548
SPEAKER35 - Thank you.
SPEAKER1 - Folks, we're at that time. We're going to take a quick mental health break as is customary in this committee to get up, stretch, move around a little bit. I know there's still a lot of people that need to testify. We are going to get to each and every one of you. We promise, so please come back. We'll see you in a little bit.
Alrighty, everybody. Welcome back.
We're going to get right back into it, and we have a panel. Doctor Sarah Wakeman, doctor Miriam Camaromi, and doctor James Baker.
Thank you so much for joining us.
SPEAKER12 - Okay.
SARAH WAKEMAN - MASS GENERAL BRIGHAM - HB 1981 - SB 1242 - Hi. Good afternoon. Thanks so much for having us. Hello. My name is Dr. Sarah Wakeman. I'm an addiction medicine physician and general internist and senior medical director for substance use disorder at Mass General Brigham. Thank you for hearing us today. I would like to voice my strong support for an act relative to preventing overdose deaths and increasing access to treatment. As physicians, we heal when we can, but the reality is that much of medicine involves preventing the negative consequences of chronic health conditions.
In this work, we center the dignity and value of every person's life and their right to the highest quality of health possible. We base our approaches on scientific evidence, ensuring we are embracing interventions that are likely to reduce mortality and improve health. That can mean anything from prescribing medicine to interventions like radiation for cancer, dialysis for kidney disease. It also means public health10671 interventions, like ensuring there are10673 cardiac defibrillators in public spaces to prevent sudden cardiac death. Take that latter example. Having defibrillators immediately available in airports and shopping malls.
Means that people who would have otherwise died from sudden cardiac death no longer do. Support for this doesn't mean that we don't also support treating coronary artery disease or preventing cardiac disease in the 1st place. High quality health care means investing in multiple overlapping layers of intervention. This is every bit as important for substance10699 use disorder as it is for coronary disease. As an addiction medicine physician, I care deeply about prevention, effective medication treatment, high quality psychosocial interventions, and recovery supports. I10711 also care deeply about life saving public health interventions like overdose prevention centers.
The evidence is actually overwhelming when it comes to mortality. Overdose prevention centers save lives. They treat people with dignity. They improve linkage to other health services, including addiction treatment. They operate effectively in countries around the globe as one component of broad evidence backed interventions to reduce mortality and address the health needs of people who use drugs. The choice is not between having overdose prevention centers or people not using drugs. People will continue to use drugs in unsupervised settings, behind bedroom doors down the hall from their parents, in public restrooms, and in alleyways.
The choice is between creating centers where people cannot die and where they can build trust and begin to engage with professionals who can help address their broad range of health needs versus the status quo, where we are on track to lose another 2,357 of our neighbors, friends, and family members this year alone across the Commonwealth to a preventable cause of death. I, like many in this room, have lost far too many people I have cared for and cared about to overdose. As a scientist, my sincere10776 hope is that we can follow the evidence and fully back this life saving intervention.
As a physician,10781 my heart aches for the patients I have10783 lost overdose, and I hope to see a10785 future where my patients can access an overdose prevention center. And as a mom, I weep for the10790 parents who have lost their children, whose lives could have been saved if they were in an overdose prevention center. Amidst the worst overdose crisis in history, Massachusetts can and should join other states like Rhode Island and New York and lead on this issue. We will never get back the thousands of people whose lives were cut too short, but we can and should do better going forward. We owe it to them, to their families, and to our community. Thank you very much.
JAMES BAKER - MASSACHUSETTS MEDICAL SOCIETY - HB 1981 - SB 1242 - My name is, Dr. James Baker, And I'm here today as the voice of the Massachusetts10824 Medical Society, 25,000, positions across the Commonwealth. And I'm also president of the Massachusetts Society of Addiction Medicine. And because it has come up times today. I I'll mention I'm, board certified in emergency medicine, and I performed, I'd say, thousands of resuscitations, from opioid overdoses. And, for I'm also trained in, pain and palliative medicine so I prescribe, high doses of high potency opioids every day for people near the end of life.
It's a, medication I'm very familiar with. And, Long story short, the Massachusetts Medical Society strongly supports H.1981 and S.1242 because it offers an opportunity save10882 lives, to build connections with the patients with this10886 disorder, who present10888 there, they have an opportunity, As I see it, to have a pathway to recovery. And the you may not know it and may maybe you do, but the world's leading authority on addiction recovery is doctor Wakeman, and she created, the Bridge Clinic at Massachusetts General Hospital, which is the model, worldwide for how recovery can10913 occur.
And from my10915 perspective, if patients can get to an OPC, survive, build trust, feel that they have dignity and that they deserve help, can Some of them will make it to her clinic and to recovery. I just want to tell you about a personal story that some of you already know, maybe not. But on December 23, 2016, My youngest son, Mackie, was 23 at the time and in recovery from heroin addiction. That was that was the day that the surgeon general issued, a call to action, for, response to the opioid epidemic. And I shared those thoughts with him, and I said, Mackie, what do you think we can do?
And he really said, dad, why isn't treatment available everywhere? Is it stigma? Is that what's in the way? Do people not understand we want to get better? And we talked about that. We had Christmas. I said goodbye. I love you, Mackey, on that day, and he went over to his mother's house. I didn't realize she was away, for the holidays. And on the 28th, he was found dead alone in the bathroom upstairs. So what Would an OPC if he knew he was going to relapse when he pawned my camera on the morning of 27th, would he have gone to one10998 and Stayed alive. That's my hope for you that you'll be in support of the both of these bills. Thank you.
MIRIAM KOMAROMY - GRAYKEN CENTER FOR ADDICTION - HB 1981 - SB 1242 - Good afternoon, Chairman Madaro, Chairman Velis, and members of the committee. Thank you so much for allowing us to testify today. My name is doctor Miriam Komaromy. I'm an addiction specialist and the medical director of the Grayken Center for Addiction at Boston Medical Center. At the Grayken Center, we have a very active health policy agenda to try to promote legislation11041 that can combat the harms of and promoting the passage of legislation to authorize overdose prevention centers is our top priority.
And this is really because, we deploy so many other evidence based tools in terms of treatment and other forms of harm reduction. But this is one evidence11062 based intervention that is11064 sitting on the shelf that we're not allowed11066 to deploy in order to try to save the lives of the patients who were dedicated to serving. The poll that was released this past week shows that members of the general public Do not buy into the image of overdose prevention centers as scary, threatening interventions or interventions that are permissive toward drug use.11087 Instead, they see this as a common sense measure that can help to save the lives of their loved ones.
Medical providers who care for people with substance use disorder also support over overdose prevention centers as common sense measures that can help to keep our patients alive while we work to engage them in treatment. As people who devote our careers to treatment11113 of substance use disorders. We know that treatment alone is not enough. People deserve to survive whether or not They are interested in or ready for treatment. Human life has value totally irrespective of someone's level of interest in addiction treatment, And the value of their lives is not11134 measured by the extent to which they engage with treatment.
We need every effective tool to help our patients survive long enough for them to stabilize completely in treatment or to survive even in the absence of their interest in treatment. Overdose prevention centers are not a solution to every problem. And as senator Velis said, they're not a substitute for treatment, and they're not meant to be a substitute for treatment. They're designed to address a couple of key important issues, preventing overdose death and preventing serious infection. I would also say that, many patients are assaulted at, while they're using substances on the street.
And so another really11181 important benefit of OPCs is to help people maintain their physical safety. We're calling on the legislature to take action to legalize overdose prevention centers, and we need this in order to protect landlords from potential liability and protect the professional licensure of medical and nursing providers. Authorizing OPCs with an executive order or opening an OPC without legal protection would leave landlords and medical providers vulnerable prosecution and would discourage the implementation of OPCs. We're imploring the legislature to gather the resolve and courage to authorize implementation of overdose prevention centers. Thank you all very much. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER1 - Thank you very much. Questions from the committee. Senator senator Collins.
COLLINS - Thank you, senator Velis. I just want to want to point out that the research we continue to cite was commissioned by a proponent of the legislation knowing they11244 get involved in a lot of different things and good work. But the Beacon Research was done by an organization commissioned by an organization who had, prior to11252 the poll, taking a position that basically said exactly what the poll said. So just want to make that I wouldn't be aware of that. And this just to ask a question, because you said everyone deserves to live regardless of whether they're ready for treatment. Does that mean that people who overdose and, of course, the emergency room should be brought to treatment voluntarily first, but if not, with a record of overdose, brought to treatment.
KOMAROMY - Thank you for your question, senator Collins. I do want to correct the record, to say, there's been a suggestion11287 that somehow at Boston Medical Center and other emergency11291 departments, we offered treatment to people who come in to our emergency department with an overdose or other substance related crisis. In fact, Boston Medical Center has had, project ASSERT, a program focused specifically on that issue since 1990, and, we've also implemented peer recovery coaching, programs specifically to help people to engage with addiction treatment after an emergency department visit. So we're very much aware of the need to offer that form of treatment, and we do everything in our power to repeatedly offer that and encourage patients to engage.
COLLINS - Understand. But there's a decision not to commit people11336 to treatment by the hospital. 1250. 150 people, 1st half of the year. We're saying safe injection sites to keep people alive, but discharge after an overdose, after 12, I doesn't add up. So I just it's a position of the hospital is we're going to stay the same, stay the course. I don't see how we stay the course with credibility and have this discussion.
BAKER - So, senator Collins, I you were out of the room. I mentioned I I'm an emergency physician,11371 and, I'm very familiar with what you're talking about, And I share your, frustration. There's someone right there. We just saved their lives, that person's life. Now they're awake. They're cogent, but they're also in withdrawal. And, there's only one thing that they can do to stop that withdrawal, and that's to go out and use again. And,11394 as much as we want11396 to help those, people, the vast majority of the time, they don't want to have help. And If they if they don't want to have help, then we can't help them. And there is the involuntary, commitment option, but we in the Mass Medical Society don't feel that it works. That involuntary treatment We'll protect that person for 30 days, but as soon as they get out, there's a hunger, for opioids and a higher risk of relapse and death.
COLLINS - And you hit on the head, 30 days. I just had a relative who's there for 60. Much different. six months, much different. Superintendents make that call. What I'm talking about is an in, unwillingness, whether it's Support from social workers at the hospital who are affiliated with BPHC or physicians themselves. And, again, the same mass medical society who said absolutely not, legislature. We will not participate in an involuntary prescription drug monitoring program. That should be up to our discretion because we took the oath, and I'm married to a position. I think that's absurd. Totally absurd. And then what we're we do everything we can.
To rescue somebody and then dispatch them on the street in the same condition. I don't know. I just don't see how we continue down that path and then have credibility on this discussion. If there's no going to be no change, and maybe that's not the physician's role. Maybe it's the social worker's There's a lot of people who are eligible to do that. It's uncomfortable? Yeah. Sitting in a courtroom with a family member and tell them and then, you know, months later, say, thank you for doing that. Course doesn't feel good up front. How could it? Paperwork? We got to figure out a way to streamline the paperwork if it's a paperwork problem. But we cannot continue down that path where people are coming to us.
You're we do the difficult task of rescuing them and then put them back out in the street. While I was saying but this is a great idea to but this11513 is a great idea, too, instead, I11515 should say. We should do this do this,11517 but continue down A path that is discharging people who are coming to us for help. I just I don't see why we I have that authority under the law. Legal. This before us is not legal. We have physicians now that are saying, we have to do this. What they won't do was within their power, and we're not hearing that from the medical professionals that have come to testify and say, this is a great idea. We're not going to change the status quo as it relates to the discharge. I don't see how we have credibility with that.
WAKEMAN - I think it's wonderful. I think we're having a disagreement of compassion, and I think your passion for this issue is palpable, and I appreciate that so much. I I think there's always more we can do in the medical system, and we have a lot of work to do, and we've made mistakes across the board. And I personally have dedicated my career to trying to bring addiction treatment back into the medical system, so Every single touch point like you're mentioning is an opportunity. But I think we do want to offer what we know works, and, unfortunately, the evidence around involuntary treatment.
Really is not great, and our own data in11576 Massachusetts suggests a higher rate of overdose after involuntary treatment. And so I think11580 Building out what we know works, which is voluntary, welcoming, low barrier addiction treatment at every single touchpoint with physicians, with nurses, with social workers, psychologists, recovery coaches, the entire team, and making it available at the moment when someone comes in is the strategy forward, and It's not a choice of overdose prevention centers or more treatment. I11600 think we've heard that a lot that a dollar here is taking a dollar away from there. That's not the conversation here. We need more of everything. It's not one or the other. It's all of it.
COLLINS - No. And I and I support11621 the increased investment. All I'm saying is you we're talking about studies that are 30 days or less. Do we have a study that says if you've been committed six months? No. We do have that from Duke, and it says something very different than what you're saying. But when we populate with studies that already say, you know, the, the polls that say what we want us to want them to say prior to a hearing, and then we do studies that say if you have less than 30-days treatment, you're going to11647 relapse?11647 Of course. You won't stop biting your nails in 30 days.
So, I mean, we're talking about apples and oranges as it relates to commitments and what that means, extended11656 commitment, which superintendents now are being have11660 a lot more pressure on them because of the11662 33% drop. It's not family members that don't want to do this11665 anymore. It's the people in the public health and medical space who said, great. I don't have to touch this. This is uncomfortable.11671 I don't want to touch it anyways, I'm certainly going to touch it less if the if in the11675 ether, people are saying, no. No. No. Because a 30-day study tells us you're going to relapse. Yeah. I just think we need better data if we're going anywhere to suggest what, like, Duke study says.
If there's information that says Extended treatment gives you one outcome versus limited treatment gives you a worse outcome. That's just logic. It's medicine, but11697 it's logic. So we should be, in my opinion, pursuing all options on the table, not saying we're going to continue discharging people from the emergency room, but we should create safe injection sites. I don't see how we if we're really doing all options on the table, how we're just talking about this. And, again, the Mass Medical Society, I'm amazed. The same group that says we shouldn't do this and had major gains on the amount of, pills that were hit in the street. I'm glad we did it.
And I think that if we're going to come forward here11728 and hear testimony about why was she doing this stuff with medical Professionals, I really want to hear the answer of why we're not committing people to treatment11736 who overdose and are at the emergency room. Whether it's the physician that positions them or11740 not, welcome in, parties. So social workers have the authority as well. I just think paperwork's not a good not a good answer. Discretion, alone tells us what people are doing in the emergency room. 33% drop in the last six years, four years. So if we don't have a system change, we're going to see that drop while we're seeing, you know, overdoses increase. Again, while we're seeing the prevalence of Narcan.
Everyone doing their job. We get different agencies now. We have different people, that are carrying this. The precision is quite something. I mean, we're clearly doing this a lot if our continued precision climbs, which is troubling too, that that's where we're going continuously. And if we do not exchange at the, the most, significant point of intervention when11788 someone's hit rock bottom. Even exhausting diplomatic efforts, and not just the person in the room. As I heard earlier, you11794 know, we don't have a safe space to have a discussion in a hospital. When there's 1500 people going there the first half of the year, we should find the room. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER1 - Everybody, everybody, please calm down. Proceed, senator Collins. Thank you. So
Questions, members of the committee?
Seeing none. Thank you very much.11838
SPEAKER22 - Thank you.
SPEAKER1 - Folks, just as a reminder, obviously, we know this is a topic that engenders a lot of back and forth, both pro and against. If we could just be mindful and respectful of everybody's right to express their opinion, ask questions they want. Thank you very much. Representative Fernandez, floor is yours.
REP FERNANDES - HB 1981 - SB 1242 - Thank you. Good to be with you guys. I'll be very brief. I know you have, A busy schedule today. Thank you for taking me out11880 of turn. Here today11882 to testify in support of my bill and act relative11884 to preventing overdose deaths and increasing access to treatment. The legislation, as I'm sure, has already been mentioned, it11891 follows on a state commissioner report that studied this, and recommended overdose prevention centers as one of many pieces of harm reduction that we should pursue. And since 2000, over 25,000 residents have lost their lives due to the opioid overdose, epidemic, and more than 2,000 people are dying every year. So it is beyond time that we follow through with this recommendation.
And join the rest of the developed world and our neighboring states in the US. And allowing and permitting, overdose prevention centers for places that want to have them and health care professionals that that want to be a part of them. And the reason behind this is simple. We need to keep people alive If we're going to get them into treatment, you cannot get treatment and achieve long11942 term recovery if you are dead. Like, there's just11946 it's a very simple calculus, in my mind. People may have questions about overdose prevention11952 sites. I think that's fair. But the one thing that is unquestionable is that they save lives, and no one has ever died in one. And not only that, they reduce life threatening diseases like HIV and HCV that have11964 been on the rise because of needle sharing.
And recovery is a journey. And we need to keep people alive during that journey so that they can reach full recovery and have, full and meaningful and productive lives. We've spent billions of dollars as a state on this, epidemic. And with all that that money spent, deaths are still on the rise. And so we need more solutions, health court care organizations are asking for when thousands of people are dying. The only thing that's holding us back from passing this is stigma, and we're supposed to be a state without it. So thank you for your time. I'm deeply grateful to the committee's, passed, support, for this legislation, and12024 thanks for taking me out of turn. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER1 - Representative, thank you for your time today. Questions from the committee? Seeing none, thank you very much, representative.
SPEAKER38 - Thank you.
SPEAKER1 - Next up, we have Sunny Kung, medical director, Merrimack Valley Bridge Clinic, Mass General Brigham Community Physicians.
Virtual.
SPEAKER39 - I'm so sorry. Can you all hear me?
SPEAKER1 - We can.
SPEAKER28 - Okay. Great.
SUNNY KUNG - MERRIMACK VALLEY BRIDGE CLINIC - HB 1981 - SB 1242 - Thank you so much for having me12063 today. Good afternoon, members of the joint committee in mental health, substance use, and recovery. My name is doctor Sunny Kung. I'm an addiction medicine physician and primary care doctor practicing in Haverhill, Massachusetts. I'm the medical director of the Merrimack Valley Bridge Clinic at Mass General Brigham as well as the co-chair of the Health and Public Policy Committee of the Massachusetts chooses chapter of the American College of Physicians. I'm here today to speak in support of S.1242 and H.1981, an act relative to preventing overdose deaths and increasing access to treatment.
Many people have already spoken about Overdose prevention centers and OPCs about this bill specifically. I think it's important to emphasize that OPCs these offer an important opportunity to reduce the risk of overdose deaths and infectious complications12114 associated with drug use. These are legally sanctioned sites that offer medical supervision of drug use, sterile supplies, and access to treatment for people who use drugs. As a model, On Point, which has been mentioned multiple times during this hearing, and New York City has been running two OPC sites since November 2021. Their sites have been accessed by people almost 94,000 times according to their website, and they have reversed over 1,131 overdoses since opening.
That's over 1,100 lives saved. Notably, there have been zero overdose deaths in over a 120 OPC sites located worldwide. I care for patients with opioid and stimulant use disorders who have experienced unintentional overdoses from contaminated drug supplies with Fentanyl. I also do a lot of homeless outreach, and many people never access, medical care. They never go to the hospitals or emergency rooms because they are often stigmatized there. There is only so much counseling you could provide about how to safely use drugs when people are living on the streets and or struggling to access sterile supplies. My patients are often unsafely housed with limited opportunities for access to safe spaces to utilize their drug of choice. OPCs provide a way to not only have safe and monitored environments to prevent and reverse overdoses.
They can also provide a pathway to health services, including primary care and addiction treatment if they so choose. Data for long standing OPC sites like on-site, Like, Vancouver show reduction in public injections as well as publicly discarded syringes, increase in access to tox vacation services for people who use drugs as well as decrease in the transmission of HIV. This is extremely important in communities like Lawrence, where most of my12220 patients are actually from, where there12222 was an HIV outbreak among people who injected drugs between 2015 and 2018. Importantly, OPCs do not provide drugs. They do not promote drug use nor do they increase drug trafficking, assaults, or robberies in the area. Therefore, I urge the committee to report this bill favorably favorably. Thank you so much for your time. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER1 - No. Thank you Thank you very much. Questions from the committee? Seeing none, thank you very much for your12250 time today, doctor. Have a great day.
SPEAKER29 - Thanks. You too.
SPEAKER1 - Next up, we have Caroline Zah from BU Chobee and Adwizian School of Medicine.
Welcome.
CAROLINE ZAHN - BOSTON UNIVERSITY - HB 1981 - SB 1242 - Hello? Okay. There we go. Good afternoon, and thank you all so much for the opportunity to testify. My name is Caroline Zahn. I'm a First year medical student at Boston University, And I currently live in the south end about one block12301 away from Mass and Cass. I'm12303 here today to stand in strong support of S.1242 and H.1981. Before medical school, I worked as part of the San Francisco Department of Public Health on their overdose prevention team, including for a while at the site that Dr. Humphries actually mentioned earlier. Most of the people that I worked with were chronically homeless, long term substance users. Many people have been placed on involuntary holds many times.
Many people had been mandated into drug courts repeatedly. And repeatedly, what I saw over and over was that these systems didn't work. Often, I would see these same names come up over and over in the hospital records I would review, in the program admission data that I saw, and then painfully often in our medical examiner's records. International research backs up my experiences. In 2015, a review of compulsory drug treatment found that in 78% of studies reviewed, there was no positive impact on recidivism or drug use due to involuntary treatment. A RAND Corporation studied a review of all of the available evidence on involuntary treatment in the US, including the Duke study found that, I quote.
“Empirical evidence on the effectiveness of outpatient treatment is slim.” What I saw worked based on my experience was at our local harm reduction center where the same counselors and staff and nurses12377 worked every week, where they knew the names of every single person who came through the12381 doors. What worked was the case manager on-site who would spend her lunch breaks walking clients to treatment programs to ensure that they felt safe when they entered. What worked was creating a space where people felt like they were wanted regardless of whether or not they were using drugs. We've already heard a lot of data about the immediate impact of OPCs. Overdose is reversed, medical and psychological care provided, reduced EMS cost, reduce needle litter.
Improve utilization of primary care. Based on my experiences, many of those benefits exist because of the relationships that are built there. For the people who are hardest to reach and for our most marginalized communities, many of whom have had bad experiences with medical care in the past, I've seen over and over how these individual relationships can tip the scales and make the difference in encouraging someone to go get care that yesterday they didn't want. This is why I believe so strongly in the need for OPCs. Their premise, providing a safe place where people are can use substances in a welcoming, non stigmatizing environment, affirms that people who currently use drugs' lives are valuable, that they deserve a place to receive care whether they plan to stop using drugs tomorrow.
In a year, or in 10. And if that's foundational trust building and those ongoing relationships that people build with their peers and care providers on those sites that ultimately drives that behavior change to make that difficult step choose to enter recovery. I'm just starting out my medical training, but in four years, when I have patients of my own who come to me and say, I still use drugs, and I want to live. I want to be able to have OPCs as a resource for them. I want to be able to tell them that, yes, we can provide you care that affirms12474 your dignity and humanity as a person who uses drugs not in spite of your substance use. So once again, thank you for your time. Happy to take any questions. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER1 - Questions from the committee? Thank you very much.
SPEAKER25 - Thank you.
SPEAKER1 - Good luck with the rest of the school.
SPEAKER25 - Thank you.
SPEAKER1 - Next up, we have doctor Friedman from Baystate Health and Liz Wynot from Tapestry.
SPEAKER41 - Hello? Can you hear me?
SPEAKER1 - Yes. We can, doctor Friedman.
PETER FRIEDMANN - BAYSTATE HEALTH - HB 1981 - SB 1242 - Great. Thank you, chair Velez and, Madero, another member of the joint committee. I wish that, like others, express my strong Support for H.1981 and S.1242, which would create pilot programs for over Overdose Prevention Centers or OPCs In Massachusetts. I am the chief research officer at base state health associate dean for research at UMass Chan medical school base state in Springfield. I met her in chief of the journal of substance use and addiction treatment, the past president of the Massachusetts Society of Addiction Medicine and addiction medicine clinician investigator Funded by NIH for over 25 years.
We heard from Doctors Humphreys and Calkins about the limitations of the research and the challenges of obtaining valid evidence. But the fact remains that OPCs reduce overdose mortality and infectious complications among those who access them compared to the current alternative, which in many cases is use in public spaces. The evidence that OPCs facilitate entry into treatment is indeed modest Because many patients are not ready. The same is true in emergency departments, hospitals and jails. Right now, We only have brief counseling and Naloxone to reduce overdose risk among these patients. When I see patients who are not ready for treatment.
I wish I had a place to send them to keep them alive until they become ready. OPCs provide an opportunity for clinical staff to develop therapeutic relationships and build motivation. Research has largely debunked the concerns about syringe litter and other public disorder, and modeling suggests that these programs will save millions in medical costs in high volume areas. It12616 is true but the benefits are isolated to the local community where the OPC is cited, but the bills before you are targeted to let localities Make the decision whether and where to open such centers.
The Mass Medical Society and Harm Reduction Commission reviewed the evidence and recommended adoption of the proposed pilot program. Since those reports, the epidemic of overdose deaths has worsened year over year despite efforts, well funded efforts by DPH, the healing communities initiative, our community coalitions, and many others to expand access to naloxone and medication for opioid use disorder, the only effective ways to reduce that we currently have to reduce overdose death. Fentanyl and Xylazine in the street drug ply have stymied our best efforts, and we'll continue to do so unless we try something different.
Since last session, the urgency for OPCs has only increased in highly impacted cities and towns in the Commonwealth. And we heard that 70% of Massachusetts voters are ready to allow localities to make the decision to establish an OPC. Other states, including our neighbors, New York and Rhode Island, have set the precedent for allowing cities and towns to decide. New York's On Point program opened in 2021 and has saved countless lives. Its opening allowed Chair Velas and others to visit and see for themselves that OPCs are safe, effective medical interventions that save lives and give survivors the opportunity to seek recovery.
I don't see any downside of our commonwealth and its cities and towns serving as laboratories of democracy. We legalized Schedule one cannabis for recreational use despite federal law. And I would contend that12719 in the midst of an unremitting epidemic of opioid overdose deaths,12723 the impetus is even more compelling to develop and evaluate a lifesaving medical intervention supported by our State Medical Society and the great majority of our citizens. I have strongly urged the joint committee to issue a favorable, recommendation for these bills. I yield back. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER1 - Thank you, doctor Friedman. Liz.
SPEAKER14 - Liz.
LIZ WHYNOTT - TAPESTRY TAPESTRY - HB 1981 - SB 1242 - Hi, everyone. I'm Liz Whynott. I'm the director of harm reduction at Tapestry in Western Massachusetts. And we have harm reduction, also known as Syringe Service Programs, located in Hamden, Hampshire, and Franklin County. I wanted actually to talk a little bit about the work. I've been with Tapestry for12773 15 years, and the entire time I've been here, I've, been a part of the syringe service programs, also known as needle exchange. And I think the history of the harm reduction programs are important to mention. The first thing I wanted to mention is in the mid-nineties when I wasn't involved in in this process, obviously.12793
But the, the state of Massachusetts debated a needle exchange program bill, and eventually, they passed for, a limited amount of cities to implement a pilot program for needle exchange. And 1990 6th Tapestry opened the only one west of Boston. It was located in Northampton, Mass, and that continued to be the only one until 2012 when the state of Holyoke opened 1. In addition to that, it wasn't until 2006 that it became legal for anyone carry a needle without a prescription. Up until that time, you could be arrested for possession of, a hypodermic needle in many people war. And then it wasn't until 2007 that programs and agencies like Tapestry were able to distribute Narcan.
So Before that in 2007, people's access to Narcan was extremely limited. I started at Tapestry in 2008, so that was after Narcan was just, implemented, and it was extremely controversial at that time. It was impossible for us to get into any treatment centers or, you know, work with anyone, really, because it was so controversial, there was so much stigma around Narcan. Things have changed a lot, and so I'm not going to talk anything about that. But I see a lot of parallels between SSPs and OPCs. And I just I guess since I've been working at Tapestry, I've been absolutely there've been so many times where12887 I've been inspired by the courageous action12889 of so many people, including, reps and senators and the legislative body.
And I hope I can see that continue as I continue my work in this field. I also wanted to say I think it's important to know that I, myself, have personal experience with heroin use. I struggled with, for a few years with injecting heroin. And I, you know, went through the struggle of using and getting off of heroin and then going through the recovery and just getting to where I am now. I was reflecting recently, not for the 1st time, but if I was 10 years or 20 years younger, I'm not sure if I would still be alive, and that's unfortunate to think of. And I think that there's a lot of lot of other people like me who are no longer using heroin that are all questioning, would we be alive if things were if I couldn't do what I did? SHOW NON-ESSENTIAL DIALOGUE
SPEAKER1 - Miss Wynot, doctor Friedman, thank you both so very much. Spoken to both of you at length about this subject as well as many others. So I just appreciate your willingness to always come forward, to always participate in these Very complex, nuanced, but absolutely vital debates that we're having. Questions from the committee? Oh, okay. We rep Dubois, floor is yours.
REP DUBOIS - Thank you so much, chairman Velis and chairman Madaro, for hosting this Very informative hearing. And I just want to take this opportunity to ask the12987 doctor, Ms. Whynott12989 So12989 I represent Brockton. And just,12991 two weeks ago, there was a two hour meeting in at this Brockton City Council, disgusting a homelessness issue that we have here in Brockton and all across the state for a multitude of reasons. And so The aspect of drug addiction came up. And I will tell you, five of our 11 city councilors were still calling for a one exchange on the needle exchange, which, you know.
we had someone from Brockton Neighborhood Health Center there who stood up and explained to them. That that is scientifically proven really not to be an effective way to operate a needle exchange. And so, regardless of, you know, my own personal feelings about this or, my community as a whole's, I think, feelings about this. How do you envision, when you're facing, you know, elected city bodies who will be making the determination if this bill passes, who are still, skeptical of needle exchanges being able to make that leap to even approve them in their cities.
We I mean, we don't we don't even have enough trash barrels on our main road to deal with the trash. We're dealing with the, opioid epidemic, and There are no public bathrooms, that we have in Brockton. So our built environment is really not conducive, to the issue that at hand, never mind our housing. So how are you, like so I hear from, like, Cambridge and Somerville and some folks in Boston, they really want these. And, you know, how are you envisioning you're going to be able to deal with communities that are opposed to this, that are the communities that are really Having a lot of, homeless folks there if this law passes.
FRIEDMANN - So I can speak, you know, I'm helping the Department of Public Health with the evaluation of the jail programs, around medication for opioid use disorder. And as you probably know amongst the sheriff’s certain sheriffs, there was a lot of skepticism. This august body passed, legislation to allow A pilot program of medication for opioid use disorder in jails. Not every jail stepped up, right, to participate. I anticipate for this pilot program, and I'm going out on a limb here. Brockton will not be one of the sites that will raise its hand to say, I want to do a pilot. Right? But the fact of the matter is we you do the pilot, you gather the data to See whether or not it works.
And then you share it with your colleagues around the state to see whether or not they want to participate. And incidentally, as you also probably know, now all of the jails in the state are offering medication for opioid use disorder. So there is a process through which you go you go through. So and state and localities are in different states of readiness. Right? You know, places like Summerville or Holyoke or others, are in different place from, You know, Rockton, Boston's13186 probably somewhere in between. But we have many communities in these state that13190 would benefit from such a program, all the way from, you know, Pittsfield to Lawrence, you know, Fall River, New Bedford. So it's really going to be up13201 to the local community sort of decide where and when to put these programs.
DUBOIS - Thank you. Thank you, Mr. chairman. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER1 - Any other questions from the committee? Doctor Freeman and Liz, thank you so very much. We'll certainly13217 be seeing you soon.
SPEAKER41 - Thanks, everybody.
SPEAKER1 - Alrighty. Next up, Sadie Ochoa, BU Medical School.
SADIE OCHOA - BOSTON UNIVERSITY SCHOOL OF MEDICINE - HB 1981 - SB 1242 - Hi. My name is Sadie Ochoa, and I'm a first year medical student at Boston University. I live in Boston right next to the medical school, and I strongly support the acts relative to preventing overdose and increasing access to treatment. My support for this initiative is deeply rooted in my personal experiences working at a needle exchange program and my13267 current status as a medical student in an area with a significant homeless population and a high prevalence of substance use disorders, particularly in the vicinity of Mass and CAS.
The opioid crisis has inflicted immeasurable suffering, leaving those affected without resources, support, and cut off from family and friends. Accessing treatment is frequently the least their worries. However, with an expansion of harm reduction services, we can connect with more people starting with proactive community outreach and fostering genuine human connections. I'd like to share a story about a patient I worked with at a needle exchange clinic. His experience is emblematic of many others we encounter. Over the course of a few months, I developed a close relationship with him. And after a few weeks of consistent visits, he started requesting a Suboxone prescription, showing promising signs of overcoming his addiction.
However, one day, he approached our mobile clinic after a few weeks of not seeing him, and he apologized for his absence. He explained that he had been struggling to focus because his nephew had tragically passed away from an overdose. It was evident that he had likely injected heroin just moments before our encounter. While I empathize with him and commended his determination to continue seeking help, I felt powerless with the resources at my current disposal. Although needle exchange and harm reduction measures are effective tools, they often fall short of connecting with patients before and during drug use to prevent overdose deaths. If I could have connected this patient with an OPC, we could have avoided the lapse in his care.
He would have been able to maintain a connection to vital resources13351 while navigating setbacks without feeling shame about his relapse. Perhaps if he had access to an overdose prevention center, his nephew might still be alive today. For those who proactively seek harm reduction services, they often have some form of support that motivates them to get better. However, for those Without much support, they often use drugs alone, leading to traffic tragic overdoses and loss of life. When I interviewed13373 many of our patients about their opinions on OPCs, sees the majority expressed strong support, a sentiment that's easy to understand considering the profound losses our community has experienced due to opioid crisis.
I chose the path of becoming a physician because it would provide me with the means to directly help others. I won't dwell on the extensive data regarding OPCs as it's been presented extensively. To summarize, OPC's work, they prevent overdoses. They save lives in our communities and help individuals overcome substance use disorders by connecting them with a range of essential resources. As a medical student, I've learned the importance of updating clinical practice with the latest and most relevant research data. Allowing OPCs to be implemented is a practical and compassionate step forward in this direction. I hope that the community and legislators can see it13418 that way as well. Thank you for your SHOW NON-ESSENTIAL DIALOGUE
time.
SPEAKER1 - Thank you for your time. Questions from the committee?
Thank you very much, and good luck with school.
SPEAKER25 - Thank you.
SPEAKER1 - Alrighty. Next up, panel number 4, Sarko Gerhirian and Stephen Murray.
SPEAKER23 - Alright.
SARKO GERGERIAN - CONCERNED CITIZEN - HB 1981 - SB 1242 - Chair Madaro, chair Velis, and members of the committee, Thank you for the opportunity to speak today. My name is Sarko Gergerian, and I'm testifying in support13473 of H.1981 S.1242, an act relative to preventing overdose deaths and increasing access to treatment. Before I continue, I'd like to ask a question. Why are we mixing this with hospital policy reform and holding adults against their will in hospitals? I'd just like to say I don't think we should, and I don't think we have to. I'm here13499 lending a voice to help keep people alive Because without a living, breathing human, we don't have the possibility of healing, recovery, and reconnection.
I bring a perspective to the conversation formed by my many years of experience in law enforcement, counseling psychology, addiction, and recovery coaching. These are my own perspectives, and I'm not13518 representing anyone other than myself. People must be aided in staying alive. They must be offered safety. They should be extended a helping hand by highly trained professionals without fear that outdated laws from the war on drugs will negatively impact them or their caretakers. This hearing is about a life saving measure that must become part of our multipronged response to the overdose epidemic.
Caused by medications in the pharmaceutical narcotic analgesics class of substances. Tragically, what we are in is a syndemic, Multiple epidemics concurrently hitting our people. During such times, all life saving options which elevate the dignity of the individual should be enacted. Criminalizing and pro prohibiting self directed behavior has undoubtedly made a dangerous situation much worse. It has made the street supply of this class of medications much more toxic because of this. It is incumbent upon us to provide safety to those in need so they can live one more day, a day which may change the trajectory of their life towards healing and recovery.
Overdose prevention centers, a solution we have known about for years, has yet to become a reality. We know they save lives. We know they13599 reduce harm. Each day that we do not offer such places to our people leads to more deaths, deaths that should weigh on each one of our hearts and minds because each one of these deaths is preventable in an overdose prevention center. We have led the nation by moving forward ethical and highly moral solutions to some of the most challenging13620 biopsychosocial challenges that our residents face. Such a solution is the Good Samaritan law.
I place overdose prevention centers in the same ethical and highly moral law category. Overdose prevention centers create Safety for a highly stigmatized, marginalized, and criminalized group. It is time we welcome people that have high risk relationships with intoxicating substances into more services and support as opposed to ostracizing them onto streets and into alleyways. It's time to allow communities who want overdose prevention centers to be able to open them without fear. It's time to13661 truly have all options on the table to end preventable deaths due to these pharmaceutical medications. Deaths which exceeded a 100,000 in 2022. Thank you. I'm happy to answer any questions. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER9 - Hello. Alright. Good.
STEPHEN MURRAY - BOSTON MEDICAL CENTER - HB 1981 - SB 1242 - Good afternoon, members of the committee. My name is Stephen Murray. I'm the harm reduction program manager at Boston Medical Center, where I work as an overdose researcher and oversee the Massachusetts overdose prevention helpline, which is a 24-hour service, that provides It's remote drug13700 consumption, over the phone. I also have significant personal lived experience as a multiple overdose survivor myself, And I'm lucky to be alive today. And I just want to echo Liz Whynott's statement about I think about this a lot. When I was using, I was back in the pharmaceutical era.
I do not think that I would have survived Fentanyl based off of how I used and where I used. I'm on the lieutenant panel here, because I'm also a retired lieutenant and paramedic. Spent almost a decade working as a first responder in the city of Pittsfield and then in Northern Berkshire County, where we provided high quality prehospital care to over 265 square miles, of rural northern, Berkshire County. As a paramedic, this crisis impacted me in ways I never would have imagined. I have told parents that their son or their daughter is dead. I've told kids that their parents are dead. I've told spouses that their partners are dead.
The most heartbreaking reoccurring nightmare was to find someone had13761 died with naloxone right next13763 to them, but no one there to push the13765 plunger. I'll13766 never forget the 1st fatal overdose I ever responded to, a young father lying in a bed of his children's shoes13772 in their mudroom. Even though I never saw the kids, I knew they were asleep upstairs. Not only do first responders see the immediate loss of life, we see the ripple effects on the family and the community, and this impacts us all greatly. I just returned, late last night from a trip to Europe. So I'm currently on European time. But I saw three sites like this operating in three different countries, during my trip.
It really13799 frustrates me that year after year, we have to come before this body, to beg for your help and your permission to protect the people that we care about. Instead, this year, many of us13811 in this room buried more of our friends.13813 I would be remiss to not mention the massive absence that we all13818 feel in this room today with the loss of Rivera13820 advocate, Chris Alba, who died only a few weeks ago. I spoke to him on the night he died, and the last thing we talked about was this bill and that we were excited to be seeing each other today. Instead, I had to stare at his body and wonder how things could have been different if the legislature had passed this last year when we were here asking for your13839 help.
I also want to address chair Velis’ concern about the legality. Sometimes we have to break things in order to fix them, especially when they are unjust. In June, I trained over a 180 members of the legislature and their staff on how to administer on Rep. Donaghue, son's, advocacy day. Today, we're joined by advocates in this room, such Gary Langus, who were harassed13871 by police and even arrested for giving out naloxone and syringes not that long ago. And now it's so commonplace that you have two first responders here who hand out naloxone while we're working. So something is so normalized now that folks had to fight for, in in the past. And so I just want to13888 end13888 on that thought, that just because it's just because it's illegal doesn't mean we shouldn't fight to break it and fix Thank you. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER1 - Members of the committee, questions?
Thank you both very much for your time, Jim. Appreciate it. Oh, thanks. Sorry. Sorry. We got diarrhea.
SPEAKER12 - I just wanted to say Thank you for the training that you did, and it was an historic moment. And, everybody said it was one of the best trainings they've been to. Thank you.
SPEAKER6 - Thank you.
SPEAKER1 - Next up, Mary Wheeler.
SPEAKER25 - Hi. Can you hear me okay?
SPEAKER1 - Yes.
MARY WHEELER - NOMAD - HB 1981 - SB 1242 - Okay. I'm Mary Wheeler. I'm the executive director of NOMAD. I've been providing care to people who use drugs She says for 23 years, and I've responded to many public overdoses. I know you are all probably exhausted by listening to this testimony today, But I am exhausted by all the people I love that I can't ever call or see again. To start, I just want13950 to touch on our legal existing safe consumption13952 sites here in Massachusetts, Casinos, bars, and other alcohol serving and selling locations note alcohol related death is the fourth cause of death in the United States among adults, and casinos can ruin an individual's life in just one or two rolls of the dice.
However, I have never been to a casino bar or store that offered me treatment counseling, cessation management, or sedation monitoring from a trained professional who can address my whole person needs even after suffering alcohol overdoses on numerous occasions. I had the opportunity to visit the safe consumption site in the Tenderloin of San Francisco that was referenced earlier. It was a full service facility with medical care, housing case management, substance use treatment, and opportunities to shower and eat. After that site was closed, the city almost immediately saw a 41% increase in overdose deaths. This is from a publication from Health Rate 360.
You can look it up on their website. The message people are receiving right now is that they are not worthy of life or connection until they are no longer using anything. Not everyone has the desire, willingness, or ability to stop using drugs, and we need to re recognize and respect that. We can't force people's substance use14020 away. This has been a standing approach for decades. However, I digress as this is not a hearing on involuntary treatment. We as service providers are held accountable for repairing damage that was not created by us, and we are continuously scolded for not fixing it and14035 not fixing it fast enough.
As we struggle to manage our programs with minimal resources and people in power who choose to not listen to us. Let's fund public health harm reduction and treatment at14048 the same level as we fund, say, the DEA and allow us to run our programs that are backed by science. Services for the most vulnerable are scrutinized, restricted, data collection heavy, and forced to solve problems that have been decades in the making, Sometimes all within a two year grant cycle. People who don't use drugs are not dying from overdose. We establish safe places for them where they can gain connection and service.
But once the drugs show back up,14073 they're kicked out. They're not14075 allowed there. They have to go back behind the14077 dumpster, sit alone in their tent, go14079 hide in their bedroom. Just you and your shame. Shame is deadly. And those of us on the front lines watch these deaths firsthand daily, including having to respond to overdoses in the street where we find a human body already dead, and we still have to try and revive them when we could have them sitting in a safe, clean environment, and we wouldn't have to experience that as fellow human beings. Thank you. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER1 - Thank you very much for your Questions from the committee? Seeing none, thank you very much for your testimony today. Next up, we have panel, Carrie Rich Gauss, Dana Longabardi, and Brian Sink from Fenway Health.
CARRIE RICHGELS - FENWAY HEALTH - HB 1981 - SB 1242 - Thank you, chair of Velis, chair Madaro, and members14150 of the committee for the opportunity to speak today. My name is Carrie Richgels. I'm the manager of policy and advocacy at Fenway Health, and I'm joined today by two of my colleagues, Brian Sink, who's the program manager in our drug user health program, and Dana Longobardi, who's the pre the director of public health prevention in our drug user health program. We're here on behalf of Fenway Health to strongly support H.1981 1242, and we ask that you report the bill favorably.
Fenway Health is a community health center based in Boston whose mission is to serve the LGBTQIA plus community, people living with HIV AIDS, The BIPOC community, people who inject drugs, people experiencing homelessness, and those who are vulnerable to health care access inequities. We strive to provide care for14202 all who come through our doors. We're committed to addressing and breaking down barriers to health14208 care, and we work towards the principle that health care is a right, not a privilege. Harm reduction is health care.
We're here today as advocates who've supported overdose prevention centers since legislation was first introduced on them in 2017. Since then, we've all witnessed over 13,314 deaths from overdose in Massachusetts. My heart goes out to everyone here today whose loved ones and friends are part of that tragic and unacceptable number. This is a public health crisis. When you treat people with dignity and respect, they have space to make choices and participate in their own health care.14257 I'm compelled to address the testimony of researchers we heard from earlier. The argument that these sites.
Will only be effective if there are dozens of them should not mean that we don't begin the work on OPCs now. Syringe service programs began in Massachusetts with just three sites in nineties as you heard from Liz Whynott. There are now over 50 cities and towns with SSPs in the Commonwealth providing a network of harm reduction ready to add this critical service. We're all14291 here as partners eager to add this tool to the approach Massachusetts can take. I thank you from hearing from us today, and I ask you to share the urgency of this crisis and this one possible solution with your colleagues in the building.
DANA LONGOBARDI- FENWAY HEALTH - HB 1981 - SB 1242 - Thanks, Carrie. Good afternoon. Thank you for this opportunity. As Carrie said, my name is Dana Longobardi. I'm the director of prevention programs at Fenway Health. Very happy to be here today to express profound support for the legalization of overdose prevention centers in Massachusetts. Access Drug User Health, one of the programs under my oversight, uses a syringe exchange Program as a foundation to14346 bring medical care to people who use drugs. Since employing this model just two years ago, it became abundantly clear to us that one of the sole reasons.
That our clients engage in medical services is the fact that medical care is offered in a space in which they feel safe. For most of our clients, access is the one place they can go and think clearly about their drug use. They can speak openly about drugs, make decisions pertaining to the way that they use. They can test their drugs. They can connect with service providers whose Primary interest is to support their ability to take charge of their own lives, health, and safety. This paradigm shift effectively removes the chaos that is so often associated with drug use. With less chaos, the folks14390 that we serve are able to make healthier choices.14392
Want to talk for a moment about what these choices might look like. Maybe the first choice that they make is to catch a nap in our space rather than in the alleyway down the street. Maybe after they decide to ask for sterile needles. Because in that drop in space, they learned that sterile needles keep them safe from Hep C and HIV. Maybe later on, they decide to get to for Hep C, and maybe they decide to get treatment right out of our clinic. Maybe they continue to see our primary care provider to treat their hypertension. Maybe they decide to meet with our therapist to help cope with depression or see a housing search specialist right on-site.
As time goes by, maybe they start to feel better overall, more stabilized. And with that feeling of stability, they're able to think and decide to Pursue medication assisted treatment to support them in their, recovery journey. And so now all of a sudden, you have someone who may have been using alone or sharing needles or engaging in other high risk behaviors who probably only saw a doctor when they went to an emergency room Who has now14459 decided to take control of their own well-being in a way that works for them. And that's great, but it's not enough. When a client needs to leave our space to use, their circumstance again becomes chaotic. There is no one there to clean the injection site or to make sure that the equipment Sterile.
A trained professional is not able to assist them in evaluating how much to u Brian Sink se or the least harmful site for injection. In many cases, there is probably no one to immediately detect and respond to an overdose. We are still not able to help our clients remove the chaos during one of the most high risk situations, the act of consumption itself. And because of this, people are dying. There is zero reason that our friends and neighbors Need to be dying from14502 drug related overdose. We know the evidence. We know this model works. No law or government should get in the way of allowing people to make decisions to protect their health safety. I urge members of this committee to move swiftly in pushing this bill forward, and thank you for your time.
BRIAN SINK - FENWAY HEALTH - HB 1981 - SB 1242 - Good afternoon. My name is Brian Sink. As you've heard already, we're more than just a syringe exchange at Access. We're a place that strives to provide community in connection for people who use drugs, folks, as you know, who are routinely stigmatized and marginalized in our society by shame, fear, and indifference. At the access program, we do our best to support the host holistic needs of our friends, but we're not a supervised consumption site, and we're limited in our capacity to monitor the vitals of those who present in our space Deeply sedated or showing the signs of an impending overdose.
People who utilize our program know that if they use out on the street or in the square can get to our drop in quickly, and they'll be in14563 the company of peers and those who will watch over them if something horrible happens, but not everyone can make it to us. Our team at Access has, on many occasions, ran several blocks respond to an overdose because we were fortunately alerted by someone banging on our door or window. What I personally fear while running to that scene is that we may be arriving too late. If you've been to our space, you've you would have seen our walls covered with photos, candles, handwritten letters.
And personal effects of our friends and neighbors for whom help came too late. In just the14594 last year alone, the memorials have grown rapidly, and we collectively grieve some of14598 the kindest and most beautiful souls you'll ever have privilege to know. one of those souls was a young man who was well acquainted with our staff. He was a frequent flyer, as we'd say, someone for whom we worried about when we hadn't seen him in a couple14611 of days. He was in and out of jail14613 for crimes of survival, estranged from family, and living primarily on the street.14617 He was often robbed and victimized when under the influence in public. He was arrested and spent two weeks in custody.
And on the night of his release, he returned to an area he was familiar with, quiet street near Central Square and with no one around, he tragically succumbed to an overdose. He was found the next morning two blocks from our exchange, he was 22 years old. We often hear our neighbors in Cambridge complain to city hall that they don't want to see folks openly injecting or nodding off in public spaces. And quite frankly, it's no picnic for our clients either. If people who use drugs were able to use in a safe and sterile supportive environment, I have no doubt that we would see a cascade of positive change at the individual neighborhood and societal level.
Contrary to popular belief, these centers do not encourage drug use or lead to greater crime. In fact, the opposite is true. People who utilize these sites feel more supported and go on to explore treatment options sooner and in greater number and with even more success for long term and stable recovery. These sites also help contain the spread of HIV and Hep C among injection drug users, which directly impacts the overall public health of the city and state where they operate. In BC, after 25 OPCs were established by the Canadian government, in that 1st year, over 545,000 visits were logged. Nearly 3,000 overdoses were responded to. Not a single fatality occurred at any of those sites.
And as we've heard today at InSite in Vancouver and OnPoint, New York and14705 beyond, not a single person has died of overdose14707 at a supervised consumption site wherever it's been When people have a safe and sterile place to use, they are more likely to make decisions and prioritize their health and well-being, and in turn, cities become safer and healthier and more equitable. So I respectfully urge the members of this body to move quickly, please, in passing S.1242 so that once again, Massachusetts can help lead the by example ample and investing in the evidence backed public health interventions that lead to positive outcomes for all in the Commonwealth. Open to taking your questions. Thank you. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER3 - Thank you very much.14740 Members of the committee, questions? Thank you very much. Appreciate you coming forward today. Thank you. Thank you.
K. Next up, we have Jim, Derek, Michael Gray, and Nancy Tobin.
SPEAKER4 - Okay.
SPEAKER5 - It's a gray in14785 my face.
14797 NANCY14797 TOBIN14797 -14797 CONCERNED14797 CITIZEN14797 -14797 HB14797 198114797 -14797 SB14797 124214797 -14797 Hello.14797 Good afternoon. My name is Nancy Tobin, and I'm Scott's mother. My son, Scott, died of a heroin overdose at 22 years old. Scott was kind, funny, athletic, creative, loved Family and friends, everyone that knew Scott loved him. In his14818 senior year, he was a passenger in a serious car and spent five days in the ICU. Scott was only 17. When he was discharged, she left with a prescription of OxyContin. I think everyone here knows what happened next. He was 18 and soon would begin college and he was in pain. So he did what everyone does when they are in pain. They try to stop the pain.
The progression from pills to heroin comes quickly. The effect on Scott and our family was devastating. During the last two years of my son's life, he willingly went into rehab five times, and each time came home determined to Stay in recovery, but would relapse. Overdose prevention centers are places of safety and counseling, a place where inside the doors stigma is erased, and someone suffering from this illness will receive the respect and treatment of they deserve all while keeping them alive. Please give our children and the others this chance. Why don't we have overdose protection centers already? This is long overdue.
How many more Children, brothers and sisters, mothers, fathers, friends, neighbors, etcetera, need to die, need to overdose and die. Why do six people in the Commonwealth of Massachusetts, whose state house we sit in now, have to die of an overdose today because six will die every day until something more is done. Scott knew the dangers of heroin, and he knew that injecting alone had risks. But what option did he have? Scott died in our family's home in his childhood room, sitting on his bed alone at four in the afternoon. He was four months out of rehab and doing well. But that afternoon, the disease spoke too loudly, so he bought heroin.
And while my husband and I were out doing our errands. Our son, Scott, died alone in his room. I'll never14960 know if Scott would have gone to a local overdose prevention but I do know that he didn't want to die that day. I do know that others should be given the chance to decide to go to an OPC. By doing so, they acknowledge the risk, but also that they want to live. The connections and respect They receive at an OPC can lead to the realization their recovery is possible for them. I speak for myself as a mother and for my son, Scott, who cannot speak any longer for self.
We must rise above the stigma and stand with courage to challenge our opponents and move forward to a place of awareness and hope for recovery, and most importantly, the prevention of accidental overdose Deaths, please take action now because each day in Massachusetts, six more families will get that devastating or find a loved one themselves having died from an overdose alone. This has to stop. Overdose prevention centers are proven to save lives. I wish my Scott would have had this option. He might be alive today. Please open OPC centers in Massachusetts and give that option to someone else's child. Thank you.
JAMES DERICK - CONCERNED CITIZEN - HB 1981 - SB 1242 - Good afternoon, and thank you, for this opportunity. My name is Jim Derick, and I am, a dad, for 15 years, I have been a facilitator at Learn to Cope, which is a support group for families, suffering whose loved ones are suffering, and I am a cofounder of Safe Coalition in Franklin where15077 I direct family support services. Today, I speak to you for my own personal experience. 14 years ago, I buried this young man, Jack, Derick, after a, approximate 15-year battle with addiction, substance use disorder,15093 And15095 with respect to senator Collins' continued, pressing15099 on the emergency room Issues.
I agree, senator Collins. There is certainly an issue in the emergency rooms. My son was15107 in and out of emergency rooms at least 15 times during this battle, but It is an awful thought to think that we would shut down something as important, another tool in our toolbox Because the emergency rooms haven't gotten their act together or because there's some sort of legal liability loophole that we can't get our arms around. Come on, folks. We are better than this. It is time. It is long. This is a this is an epidemic like nothing we've ever seen, and we have to roll up our sleeves and get busy about solving15142 this problem.
So until, we can do that, we are going to continue to see The carnage that we're seeing on the15152 streets right now, we have plenty15154 of evidence out there that this works. And so I just ask you all to15161 really put OPC legislation at the forefront of your mind, let's give another tool to those of us that are that are fighting this fight. And let's not get distracted. You know, my son called me five times the day that he died. And on the 5th phone call, he had arranged for detox bed at Sunrise Detox Center. And he had a bet. He died alone on a Burger King floor bathroom floor. He died of hopelessness.15198 Please, let’s walk and chew gum at the same time. Let's get this done. Thank you.
MICHAEL GRAY - CONCERNED CITIZEN - HB 1981 - SB 1242 - Good afternoon. My name is Michael Gray. I want to make it very clear that anything I say doesn't represent anybody in city, any group, any I speak on my own, and I get pretty animated about this. I'm not in recovery. I've never been homeless. I lost one best friend on Marty's Mile, the police Marty Walsh created and is solely responsible for by putting people out of sight where they could just use drugs and up all of the rest of the city. I think he should be charged with a crime for what he did. Anyway, it's turning 10 years old soon. The mile. I'm there every single day on a volunteer capacity. It's not what I do for a living.
But I believe in it. I've Narcaned 300 people, maybe, maybe more. Does anybody on this panel have Narcan right now? I bet one person does them I can think of, but does anybody else have it on you right now? Yep. These empty it's like thoughts and prayers is what we're dealing15279 with right that's the equivalent of this it's me there's nothing here of substance. I get upset when I talk. I was here four years ago testifying about this. How many swans of the badge are you going to get? Well, we're worried about legality. Weed is illegal federally. We15296 have pot store stores everywhere. It's a cop out. We're going to move forward with this.
And the thing of, well, if they're in the emergency room, you get a hold People have civil rights. Excuse me? Committing the involuntary commitment Section 35, which up who's putting men in prison. This excuse me. Like someone said before, right now, safe consumption sites Applebee is a safe consumption site for people with alcohol, which is the most dangerous drug there is, the most destructive for families, and etcetera. The stigma here is just killing me because addiction is not a crime. People have rights. People need to have treatment. And like you said with the Burger King bathroom floor, I found someone dead on the floor of a tiger recently. I was at the mile last Sunday night.
I found someone on the other side of a fence who was dead, and somehow I brought it back. I don't know how it worked out. Thank god. But there were some police officers right down the street. Operation Clean Sweep ripped people. I could go on for an hour about this because I was there in 2019 because there's another sweeps coming up. November 1st, Methanol is getting torn out. People are going to get hurt again, and letting the Boston police lead it is just horrifying. These people could be in a facility where15372 you give them a sandwich, a handshake, put your armor on them, See, we want to help you. We want to do something about this, not what's going on right now.
This is insanity we're even arguing about this. Are we coming back in four more years? We should've done something. Only, what, 400,000 more people are dead? Rep Donaghue. I'm sorry you have to hear some of this stuff My hack was out to you.15394 I can't even explain of some of the15396 just insensitive, horrific things that you have to say to everyone is, and I just offer my deepest condolences to what you've gone through, and I'm not done with this. Anybody who wants to see me, I'm actually at Methadone Mile every single day at Marty's Mile, when I have a conversation about it or the truth and get down to brass tacks, what we actually have to do about this, come see me. I'm pretty easy to spot. I'm 64270, and I'm pissed Thank you. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER3 - Members of the committee, questions?
Questions, members of the committee? Thank you very15431 much. Appreciate you coming here today. Thank you.15433
Alrighty. Next up, Lori McDougall, Gary Carter, Joanne Baca, Ravecchio.
SPEAKER7 - I feel really short.
SPEAKER8 - Is that better?
LAURIE MCDOUGALL - CONCERNED CITIZEN - HB 1981 - SB 1242 - So my name is Laurie McDougall, and I am just your typical Middle class housewife who has had to sit outside my bathroom door and hold my own safe consumption site in my home because I Witnessed my son's overdose about three days before. And, yes, he was willing to get treatment, but the barriers to treatment were ridiculous. I had to and, I'll just let you know, he struggled. He had struggled for quite a few years. He was in graduate school. He had a job. He's married, and he's still struggling with substance use disorder. I don't know if any of you know how freaking difficult it is to take someone who has overdosed and they're basically blue and dead, and take that body and put it on its side.
I can tell you right now, I thank god my husband was there because I couldn't have done it by myself. I also couldn't have done CPR to him by myself. All I can say is thank god I have about 75 boxes of Narcan in my home because that is what saved my son's life. That is, it. I'm angry. I'm so angry here today because I heard so many stigmatizing things going on, and I'm Sorry to these families that lost their loved 1. I've had to witness my son overdose Probably 11 or 1215593 times, and I'm going to tell you right now. 30 days, 60 days, 90 days, nine months is not a magic button. It doesn't work that way. I've heard dopamine thrown around here like Dopamine is the magic button, the magic key to treating substance use disorder.
It is not. It is complicated. It includes the nucleus accumbens. It includes it includes the frontal cortex. It includes serotonin. It includes the trauma response. And I will tell you right now That we're not talking about we're not talking about legalizing drugs or legalizing Mass and Cass. What we're talking about is criminalizing the trauma response and basic human behavior. That's what we're criminalizing, and that's why we need overdose prevention sites. Thank you. And I'll just say, there aren’t a lot of me up here. You'll notice I'm probably15670 one of the only ones because the stigma keeps us family members that are living with this down. It keeps us quiet. But I work with families, and15680 I'm telling you, there's lots of us running safe consumption sites15684 in our own house. So please put it with the medical professionals.
GARY CARTER - CONCERNED CITIZEN - HB 1981 - SB 1242 - Thank you for giving me a chance to speak. I just want to say I'm a dad, a dad of loss. I lost my son five and a half years ago. Excuse me. And we never got to meet his son. But I'm not going to talk about the things I planned on because I've been listening today. First, I want to say and I'll I'm I want to address you, senator Collins, and this is by no means any kind of an attack or anything. I can already tell you you're passionate and you're a more intelligent guy than I am. I'm a 35 year truck driver, but addiction is misunderstood. Not everybody understands addiction.
You are me six and a half years ago. I lost my son five and a half years ago after a seven year battle. I didn't understand addiction. Sorry. I wasn't going to do this. It's not logical, and you're a very logical person. And I'm sure there are others that don't understand. It's not logical. It's not rational. So we have to think out of the box and do what you may seem may think is irrational. Okay? Took me till the last year of my son's life to understand that he could not think Rationally. And then I couldn't just shake it out of him. Smarten up. You got to stop doing this. He finally turned a corner, and we weren't expecting that call anymore, mistakenly.
But, you know, he was he was in recovery. He was still on Suboxone. We were planning his wedding. He met a beautiful girl. They had a child on the way, and he was very15802 excited for that. And15804 he had to have his appendix out. So we went to the hospital and they insisted on giving him Fentanyl to push. He was still weaning off at Suboxone, and they said they had to do it to push the Suboxone off of his pain receptors. He pleaded with them. He told them he was an addict, that he wanted nothing, and they insisted. We met him there as they're prepping him for surgery, and he pleaded with us to plead with them and I plead with nurses.
And they said no. We have to give him Fentanyl to push Suboxone off of his pain receptors. It's the only way to control his pain. Sadly, I had to tell my son that they had to do this. Apparently, they don't do it anymore. And what happened was as my son knew what happened, it led to a relapse. He died in his bed next to our bedroom while we slept. We had to call his fiancé the next day on her birthday to tell her that he was gone. But I have to explain to my grandson, who is now five and a half years old, try to explain to him Where his father is. Addiction is a disease. It alters the brain.
We need this safe consumption site just one other tool. The whole subject about the hospitals, that's a whole another issue, and that should be a whole another bill. I agree with you a 100%. Nobody should feel the pain that we feel. My son is one of those numbers. His15911 life battered. Again, I apologize. These safe consumption sites will do many things. It will alleviate some of the overflow in the emergency rooms because they won't have to deal with the overdoses. It will alleviate some of the trauma15930 that our first responders are dealing with with how many times they have to respond to an overdose.
Okay. Firefighters, police officers, and if you think that trauma does not affect them, you're very wrong. I'm sure there are many cases where some of them may have either committed suicide. Because of what they've seen over and over again or developed drug problems themselves because of self medicating for the trauma. That's what drives a lot of We celebrate our 1st responders as heroes and justifiably so. They do the irrational. They do the what would be against logic. Firemen run into a fire when they should be running away from it. Police officers run towards gunfire When they should be running away from it. Okay? They are heroes.
I'm asking the legislature in this state to stand up, be heroes. You can save lives by doing the irrational. It's just one other tool, but we need it. Okay. People in these sites and it's I googled it just a little while ago, over 257,000 Referrals from safe consumption sites up in Canada between 2017 and 2023. Okay. And that's because they people are using the sites, excuse me, and developing a rapport and a trust, finding no16013 stigma. And there's a very high percentage that once that happens and they've been in there enough times, they will turn and say, I want help. So I'm begging you, stand up and be a hero. Thank you. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER10 - To move Frank.
JOANN RIVIECCIO - CONCERNED CITIZEN - HB 1981 - SB 1242 - Hello, everyone. My name is JoAnn Rivieccio, and I'm here as a mother. I have a sad story, and I have a happy story. The sad story is I lost my son, Frankie, in 2009. He had a motorcycle accident about 10 years prior, and It was very, very difficult for him because of the stigma. I went to the hospital with both my children, and it was a sad, sad experience. I wanted to just climb over the bed and strangle the person on the other side how they were treating my son. My son was a wonderful young man that everybody loved. He was the life of the party. You know, his only problem is that he decided that he wanted to drive a motorcycle.
He was 21 when his accident occurred. He went to Mass General Hospital and had his whole left side was mangled. He needed to have his wrist, Fixed. He had two broke broken bones in his leg, and he was in bed for 12 weeks. And at that point, he was addicted to OxyContin. He struggled. He worked every day. He made $50,000 a year. All of it went to his addiction, buying off the street OxyContin. To the point that some of these people get three two to $300 in debt a day. How can anybody survive $21100 a week? When my son had the accident, then I couldn't get transitional help to him. He had to come and live with me.
In all his hopes, he had lots of Ideas and inventions that he wanted to make. He was going to be a shop steward, but one day someone said, “Why would we want to vote for you? You're an addict.” Alright? three days after that, my son said to me, mom, I don't want to die. And I said, I, of course, Peter Manuel, console him and say, oh, no. That's not going to happen. Don't worry about that, honey. You know, you you're going to get through all of this. And then Saturday morning came. I was making breakfast. He hadn't been out yet. I went into the room and found my son dead. He had been working all week to get help through his employee assistance program. Before that, he was using mine. I worked for Verizon.
And they were helping him, And I said it's time for you to help yourself. He asked me if I would Section him, And I went to the courthouse in Somerville, and I had him Sectioned. two weeks later, they throw him out. How is this going to work? Like I16233 said, all these people are talking about these new tools and everything that we can find. Let's do what16237 we can do That's humanly possible to help the people that are out there. My son died in his bedroom because of stigma, and he had his own stigma, so I think that's why he wasn't able to really go out there and get The services that he really needed, he didn't want to lose his job. You know? And I've seen parents that have lost their kids at 16, 17, and 18 years old.
They had a full future and gone because we're not teaching them about drugs. Maybe we should do a little bit more. I've been in the situation where I would go to the high school. I actually worked at my high school at Summerville. And you don't really know me, but after I lost my son, I was one of the first people to have Oh, well, I was a cofounder of a program called Somerville Overcoming Addiction. We were out there rallying to get knock in All legal red tape. That's all I heard about is legal red tape. In the meantime, I don't know how many people we've lost Since my Frankie died in 2009, I went to an event. It was a learning Somerville.
And I'm sitting there listening about data and statistics data and statistics. That's all I heard the whole time. They put up, a picture up on the wall, and it was how many losses there were. And in 2009, there was only one. OAnd I looked at that, and I said, you don't really know16335 what's going on in my mind right now, but I'm going to tell you. That number one was Frankie Rivieccio. He had a name. When you have a child that you lose, and I know a lot of these parents here and a lot of people that have lost their children, if they would have had a chance to save their life and16352 bring them to the, I'm sorry. I can't OPC, they would've done it.
Be human. It's not dollar signs. I'm a taxpayer. Frankly was, but he's no longer here and he can't help pay you, pay for the things that we need in the state. So please, please, really reconsider and open one of these things soon. I was here at the statehouse, and they were talking about safe consumption sites. How many years ago was that? How many people have died since then? And I hope none of you ever lose your children, or maybe you have, and a lot of people aren't talking about it, and that's the problem. People do have stigma, and they will not talk about it. But I'm here to do that. Thank you for listening to me. I had a lot more to say. At least three hours. SHOW NON-ESSENTIAL DIALOGUE
And I wish I would.
SPEAKER7 - And thank you to all of the moms who have been here for
SPEAKER10 - I only have a voice message that goes on my phone that says, mom, happy birthday. I love you. That's the only thing I have of my son in this picture. Please please Get everyone to agree to having these centers open.
SPEAKER3 - Thank you very much. Questions? Member, Senator Collins.
SPEAKER11 - Thank you very much for your testimony. Just wanna say in response that Lost too many of my childhood friends to overdose as well, and I'm walking with a loved 1 of mine through her battle and challenges. So don't stick me here. Thank you for your testimony. Sorry for your loss.
SPEAKER3 - Sorry for16478 your losses. We appreciate you coming here today. Thank you very much.
Next up, we have doctor Mark Eisenberg, doctor Alex Wowley.
MARK EISENBERG - HARVARD MEDICAL SCHOOL - HB 1981 - SB 1242 - Hello, everybody. I'm Mark Eisenberg. I'm a primary care doctor16517 With board certification in infectious diseases and addiction medicine, I practice at Mass General Hospital and Boston Health Care for the homeless. I've been prescribing Buprenorphine or Suboxone since 2003. I thank the legislature for the opportunity to testify today in support of this bill. Last week, I visited my patient, my primary care patient, Nicole, in the ICU at Mass General Hospital. Nicole is a 46 year old mother of a teenage son. During my office visits with her, she talked a mile a minute.
Sadly, three weeks ago, she developed endocarditis, a heart valve infection, as a complication of injecting drugs under unsanitary conditions. This has resulted in multiple strokes, rending her mute. Prior to this, it was hard to get a word to an ed wise. This infection did the trick. This complication of infection injection drug use is entirely preventable. If Nicole had a safe hygienic space to inject, this would not have happened. A few months ago in this building, I testified about Jessica, a vivacious redhead, a 51 year old woman Found by her teenage son,16597 slumped over kitchen table, dead of a drug overdose. And two years before that, I testified about Bill.
A 29-year-old man with the sweetest smile I had ever seen, he was a father of a six year old boy. Billy was found by his roommates Dead in his bathroom after a drug overdose. This child is now as orphan as his mom has died as well. I could spend the rest of the day regaling you with stories about Annie, about Edwin, About Richie, about Stevie, about Brenda, among the dozens of patients, I've lost a drug overdose over the past 30 years in practice. On Tuesdays, I work on Mass and Cass with Boston Healthcare for the Homeless, with people are being demonized in the press and by politicians for their public drug use. This is not by choice. No one want to sit on a trash strewn sidewalk Injecting drugs.
This is happening because they have nowhere else16672 to go. In addition to housing, we can help solve this problem by opening overdose prevention centers. Study after study has shown that besides preventing overdose deaths, Infectious complications, they decrease public drug use. They decrease syringe discarding, and a decreased public distorter. Everyone benefits. This is a beautiful building, but, honestly, I'm tired of coming here to16700 testify. I've been doing so for the last seven years. Meanwhile, more than 12,000 Massachusetts residents have died of a preventive overdose. You have the powder of versus needless carnage. Please please don't make me come here again. Thank you for your attention.
ALEXANDER WALLEY - BOSTON MEDICAL CENTER - HB 1981 - SB 1242 - Chair Madaro, chair Velis, and members of the committee, I'm grateful for the opportunity Speak to you briefly today in support of H.1981 S.1242, an act relative to preventing overdose deaths and increasing access to treatment. My name is Alex Walley, and I'm a primary care and addiction specialist physician at Boston Medical Center, professor of medicine at BU School of Medicine. I provided life saving treatment and harm reduction to my patients in primary care, at methadone programs, and16754 on BMC's inpatient addiction consult service.
I've led research studies that have demonstrated that naloxone distribution and medications like Buprenorphine and Methadone are associated with reductions in overdose death16768 in Massachusetts using Massachusetts, data. And while I'm not here speaking to you on behalf of the health department since 2007, I worked with the Massachusetts Department of Public Health on overdose prevention, including as the medical director and director and standing order writer for the health department's statewide efforts to support Naloxone distribution through community programs and through retail pharmacies.
I've had many patients and friends who are alive today because there was someone there to rescue them with Naloxone and they were treated with medications like Methadone and Buprenorphine, and I've had many patients and friends who've needlessly died from overdose because they were alone Without someone there to administer Naloxone or they were not treated with medications. In Massachusetts, the tools that we have and we know work like Naloxone and medication are not enough with the current toxic criminalized drug supply. We need more tools proven to work, and that includes overdose prevention centers. Fentanyl contaminates heroin, cocaine, methamphetamine, and counterfeit prescription drugs like Percocet, Xanax, and Adderall.
Fentanyl's an especially fast acting and potent opioid that dramatically narrows The overdose response time window from minutes to hours, typical with16845 most opioids, down to seconds to minutes with Fentanyl. And the great majority of people who die from overdose do not have anyone immediately present who could help them when they overdose. Naloxone only works when there is someone else present, equipped, and ready to help. Medication for opioid use disorder protects people from overdose, but fewer than half of the people in Massachusetts with opioid disorder are able to access it. Just like other medications, people go on and off their opioid treatment all the time.
People who discontinue are particularly high risk for overdose. Further, not everyone at risk for overdose has an opioid use disorder but16882 may be using contaminated Drugs like cocaine,16885 methamphetamine, and counterfeit pills. The base best safety plan16889 is to use drugs in the company of a trained an experienced person who is equipped and ready to help. Overdose prevention centers provide this16898 and much more, Like ready access to treatment, naloxone, and safer substance use materials, drug checking, public health screening, vaccination, medical treatment, and social services. I urge you to support this bill, favorably in committee and, lead the passage of it in the legislature. Look forward to any questions,
VELIS - Thank you very much, both of you. So I was reading a stat last night, and it was late at night, so bear with me16936 if I don't if I don't have it right. But I think it was I was start reading a little bit about On Point in New York City and East Harlem and then Washington Heights, and it said Something along the lines, not something along the lines. You said that there have been about 55,000 instances of people coming to their OPC, to to use whatever the drug of choice would be. That's 55,000 separate incidents, But it has been only about 23100 people, so not many people going there a lot, would be my Lay characterization of some of those numbers. Again, to above 2,000 people, but going, you know, repeatedly, if you will. I guess my question is, why aren't more people utilizing it?
WALLEY - So you said there's 2,000 people that are using it.
VELIS - It was, like, 2300 give or 10.
WALLEY - Per 55,000 drug events.
VELIS - Correct. Events.
WALLEY - So, people are going and using over and over again. Which I think is really kind of gets to what these centers can, can establish, which is a place where people who are using drugs can really engage in a place where stigmatized. There are more than 2,000 people who use drugs in New York City, for sure. But I think we've heard, and I don't think there's ever been any dispute, really, that the biggest impact of these centers are in the immediate area around the centers. And so I visited The OnPoint, OPC. And, you know, there that's it's in New York City. It's a very dense area, but there you know, 2,000 people actually seems17045 like a lot of people to me. I mean, you know, and for that neighborhood, I think it's going to really make a huge impact. For the whole of New York City, you know, there probably needs to be more of these centers to thelp the safety of other communities within New York City.
VELIS - So you agree with what we talked about earlier? The I see, I was I17066 I looked at that, and I was kind of taking it back out.17068 I thought that was an insignificant number of people, but, again,17072 I was looking at it from a New York City, thought there'd be more. But when you look at it through the lens of people are going to them Really, only if they're in the immediate area.17084 So that's something that you both would agree with as well that in order for them to have an impact, there needs to be a lot of them?
EISENBERG - I mean, ideally, if we start this in Boston, there'd be more than one, for sure.
WALLEY - Yeah. I'd also say that the impact has, it has a huge impact on the people who use17105 Right. And so this issue of what impact it has on people who don't go there. So and also the neighborhood around it. Right? So and I think that's what's been seen in Community after community in the in the overdose prevention centers that have been established in Canada, in Australia, and in Europe, and now in New York City. The message that it sends, I think, is also important, which is that, we're going to value the life of somebody.
We're going to do whatever we can in order to reduce the chances that when somebody uses, they use alone. That, to me, where I'm at as far as thinking about overdose is really the thing that we need to worry about. It's that17144 despite what we've done already, people are still using, drugs alone and the drugs are more dangerous than they ever and so we have we have a fewer time a narrower time interval in interval in which we can help people if they overdose. And that really, to me, is what's compelling around an overdose prevention center.
Is that person is going to be there with somebody who's equipped, who's experienced, and knowledgeable. That's the the first step. But then these centers don't just offer that protection. They are an engagement center. They're a place where they can engage. And we're talking about some of our most desperate folks, can engage in other services. And, folks, can engage in other services. And we have research that shows that that is what happens. They do engage now on their time line, not, you know, Not on one that we can force on that. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER2 - Members of the committee?
SPEAKER3 - Thank you both for your time.
SPEAKER14 - Oops.
SPEAKER3 - Alrighty. Next up.
TJ Thompson and Azimani Mali.
Good afternoon.
17253 SPEAKER1517253 -17253 I17253 feel very short.
TJ THOMPSON - CONCERNED CITIZEN - HB 1981 - SB 1242 - Hi. My name is17259 TJ Thompson. I would like to the committee for, giving me the opportunity to testify today in favor of bills H.1981 and S.1242, an act relative to prevent overdose deaths and increasing access to treatment. I'm here today under the umbrella of a person with lived experience. For half my life, I've struggled with substance use. I've homelessness. I've used IV drugs. I've undergone emergency surgery in which I narrowly escaped17283 having the lower half one of my arms amputated17285 due to an infected, Abscess from using a questionable17289 syringe while hiding in a filthy public restroom.
I've lost countless family members, friends, and colleagues to Substance abuse and fatal overdoses through the years. I sit here today, alive, savory house for over two and a half years now and in recovery and what I consider to be a direct result of overdose prevention centers and my efforts to bring them to Fruition in our commonwealth. four years ago, I joined SafeMoon Maine now, and I began my journey of advocacy for17322 this very legislation. I'm here again speaking on behalf of today. This led me to be involved, be invited to join the city of Somerville SDS task force.
I worked on the program and design committee and was credited as a peer research on the needs assessment feasibility report17336 from my work administering surveys and collecting data from people who use drugs. It17340 is imperative that these voices be heard, at every stage of this process. I17345 also organized two focus groups involving people17347 who use drugs with lived experience to educate, collect feedback, and, mostly important, to get Paul said exactly what folks needed and what17354 they wanted to have in an OPC. I was also fortunate enough to visit, tour, and witness the day to day operations of the first legal sanction OPC in the United States.
On Point in New York City, as you've heard, has been operating and saving and changing life for two years now. Being able to see the facility operating in real life was so much more amazing and inspiring than I could have imagined. Since they opened their doors they have served 4,000 participants with 94,000 injections, reversed over a 1000 overdose with zero fatalities, mirroring results from OPCs and over a dozen countries all over the world, as you've heard over and over and over again Dave, proving that the work that, that that work works just as well in our country as does everywhere else, which is a good thing to hear.
Because I've been hearing that for years where people are like, oh, it works there. Work here. But it does. It does work here, and I've seen it I've seen it happen. It's really good to See, this this cornerstone of harm reduction at work when folks had a safe, clean space to use with dignity support and zero judgment. Really it really put into perspective how important it is to keep advocating here as I go forward. I want other people to have the same opportunities I've been afforded, and more importantly, I want them to live. Right now it's become incredibly clear to me that the most important part of what we're doing right now with overdose prevention centers is the legislation.
This legislation not only gives clear guidelines to the process to open OPCs in our commonwealth, but it also provides protection for the people that need it the most, folks that utilize the space and the Dedicated medical17448 professionals need to kept needed to keep it afloat. Massachusetts voters have been recently polled by the ACLU of17454 Massachusetts, and more than two thirds of registered17456 voters, your constituents are in favor of opening OPCs in our state. It is past time moving this legislation forward. In the four short years since I joined this fight, 8,000 Human lives have been lost in our state and hundreds of thousands in our country. Enough is enough. People deserve a chance. Please give us a. Thank you.
ISRAEL MANNY - CONCERNED CITIZEN - HB 1981 - SB 1242 - HB 1981 - SB 1242 - Chair, committee, My name's Israel Manny Walia. I am a community advocate. I'm a harm reductionist of around seven years, but I've been working in public health. I'm also a person who uses and injects drugs. I first, like, really want to share my appreciation for all the mamas who got up and spoke today. I can't tell you how deeply it shakes me to hear folks who have suffered deep loss, but also folks who are Within the confines of what we have to operate with, continuing to keep their loved ones alive, just absolute beautiful determination that I see from that.
I didn't come to advocate I came to admonish and indict. I've sat in rooms like this since 2017. This legislation should have been passed back then. The fact that we are still having this conversation now in 2023 with the amount of lives that I've seen lost is an absolute We should have OPCs, and we will have OPCs regardless of what goes on, in this or really any, legislation within17557 the Commonwealth of Massachusetts. We will find ways to protect our people as we have for the past years that I've been in this fight, and will do so either with the cooperation or in spite of legislation within Massachusetts.
I didn't really prepare all too much, so I'm just going to read off something that I jotted down, a couple of weeks ago when I was mourning the death of one of my colleagues. I also want to call a name into the room before I leave, and that is Aubrey Esthers, who17595 sat next to me We sat next to me at one of these hearings, and then when we were called back for further testimony, both of us were given, and I paraphrase, because it's been quite a while, the statement back to us that, you know, we're both set in our ways, but the legislation is trying to save people. I had to join my colleagues and comrades in burying her, and I had to join my17622 colleagues and comrades burying Chris Alba.
Two people who with OPCs in the state of Massachusetts would still be with us currently, and that's what I come to both admonish and indict. The rest of what I'm saying, I'm saying to both you, the room, and the Commonwealth of Massachusetts as a whole. Awareness is when we acknowledge that something happens. Protest is when we say we don't want it, but resistance is when we see to it that it stops. We no longer have times for awareness campaigns and toothless protests. We no longer have time to wade through cold bureaucracies to play nice with politicians, Law enforcement and the judicial system, we no longer have time to humor endless streams of crocodile tears.
We no longer have time to be respect respectable, palatable, nor sufferable. We are dying. We have been dying, and we will continue to die. Sacrifices on an altar of indifference,17681 offerings to a system that wants and needs us dead. Now17685 is the time for resistance. It's time to fly in the face of what we have been allowed. It is time to hold those in power accountable for their hindrance and complicity, It's time to preserve life by any means necessary. In closing, I brought some moist towelettes, And I want to offer them to the contractors from these bills and the past bills that you may wash the blood from your hands. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER3 - Questions, members from the committee.
Jim Stewart, Gary Langus, Nicole Rossi, and Robert Alba.
SPEAKER17 - Alright. Take
SPEAKER18 - Gary, you want to kick it?
SPEAKER19 - Oh, alright.
GARY LANGAS - CONCERNED CITIZEN - HB 1981 - SB 1242 - Thank you, folks, for this opportunity to, present on some things around OCPs. You know what? First off, I like to say Harm reduction is not, like, a17799 road to the you know, a yellow brick road to recovery, to treatment, to any of that stuff. I've been committed to harm reduction working on harm reduction, since, 1986. My wife was first diagnosed with HIV, and I, started to come up here in 1990 To, do some advocacy around syringe access. Took us more than 20 years, and I don't know how many thousands and thousands and thousands of deaths to people.
Who were injecting drugs with contaminated needles, we came up here and we went to all of these hearings, you know, and it's been one thing after another. The knock in. I started to dispense knock in in t 99. So if you do the arithmetic, it's seven years before the law was passed in Massachusetts. Since I was practicing medicine, I was a licensed I was passing out syringes without a license. You know, I've been up here for the good, Sam. The faces have changed, you know, and, I'm really tired of coming up here to save lives because that's what we do in harm reduction. It’s not to get people in treatment.
It's not to get people, like, any place other than just Keep them disease free, infection free, and alive. You know, and it's just been a struggle. The barrier seems when we come up here, we can't Move it takes us years. It takes us decades as lives go by. In in in 2013, there were 961 deaths in in Massachusetts from fatal overdoses. In 2023, I don't know what it's going to be, but, like,17911 it was 2,000 357 last year. As we battle up here for, like, you know, years, you know, like I said, the faces change. Since I've started doing this stuff, I've lost this I've lost my wife. I've lost a son. I've lost a grandson, and that doesn't count for, like, my17933 friends. Chris Alba, this is his son.
And he was a17938 dear friend of mine, just passed away a17940 few weeks ago from an overdose when he had a cotton of Knock in. You know, and I hear folks talk about, like, you know, punitive Section 35s, put them in. They'll get yeah. You know what happens? Their tolerance goes down. They're at higher risk for overdose. You put people in forced treatment or prison. When they get out, they're 12 times more likely to die. That's the outcome. That's what happens when we force people to do things. You know? And it just doesn't work. I'm here to tell you it doesn't work. And I'm sure that if the studies on it, the studies will tell you it doesn't work because it kills people.
And the stuff that we do and the things that we limit to people, like limiting the you know, with that they have to shoot dope behind a dumpster chew dope in a McDonald's. We're killing people. Prohibition has killed people. That's what's got us to where we are now. We did a great job. No more17999 heroin now. No. Now we have a lethal chemical Concoction of swill in the street because of our drug policy. And it's not me making the drug policy. I mean, it's not me. We come and beg for it to change, but what do we have to do? We just have to witness our family and friends die. Yeah. Yeah. You know, I'm tired. Tired. Here you are.
NIKKI ROSSI - CONCERNED CITIZEN - HB 1981 - SB 1242 - Hi. My name is Nikki Rossi. I'm a AHAM reduction, and I've been working as a outreach worker and, the HIV field for 23 years now. And at these times, you never forget The smell of urination in human feces, the feeling of cold dirt beneath your knees While being cautious not to get stuck with a dirty needle. Heart is racing. Adrenaline is rushing. Barely able to breathe myself while performing mouth to mouth for several minutes, minutes that feel like hours to someone that is cold, stiff, and near death.
That woman ended up dying alone in an abandoned building with the same smells, rats, in cold dirt, leaving her daughter behind and now an orphan. She could have used an overdose prevention center that not only revives people, but offers health care treatment and unconditional love. Unlike an abandoned building behind a dumpster and alone in a parking lot or tent. Hopefully, you won't have a lifetime of faded traumatic images like they are with me. Do what is right. And for every signature that objects from moving forward, blood is on your hands.
ROBERT ALBA - CONCERNED CITIZEN - HB 1981 - SB 1242 - Hello. My name's Robert Alba, son of Chris Alba. Me and my dad had a really special relationship. I was with him the whole way through recovery. He was clean for nine years, and he relapsed. And he was gone, and I found him. And that was a month ago today. Me and him talked about, safe injection sites Almost every day since 2014, it it's been around. It's we've been talking about it. I've written, like, every essay I had in college about it. There's evidence backing it. It reduces crime rates. It is beneficial to communities. They just we just need to remove the stigma and stop the war on the18181 people. It's not a war on drugs.
It's a war on the people, And I have nothing else to say. I just hope you guys consider how each person That dies to this isn't just affecting one person. It's not just statistic. It's affecting the whole community. Fathers, sons, mothers, daughters, aunts, uncles, best friends, Even the guy you talk to every day at Dunkin' Donuts, like, it you're losing valuable community members every day to this, and people have to suffer in silence due to the current drug policies we have today. People have to hide. People have to go behind the dumpster. There's nowhere for18233 people to be themselves, and I really hope you guys consider saying this bill. Thank you. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER14 - Do you
SPEAKER22 - want to sit here?
SPEAKER15 - No. Sit right here.
JAMES STEWART - CONCERNED CITIZEN - HB 1981 - SB 1242 - I want to thank the committee for giving us an opportunity to talk about this. What I put in front of you is a 104 studies that we have been able to, secure. I'm not a physician. I don't have access to a medical library. We were able to get a 104 studies. Should be an index18273 in there. My apologies if we forgot to do that. But every one of the concerns that, people have raised about,18279 Overdose prevention centers or, safe consumption sites are addressed18285 in those studies, and the concerns are resolved in favor of overdose prevention centers.
Senator Collins and, Dr. Humphrey, several people have talked about, Methodological concerns.18300 And, yeah, you can always raise methodological concerns. But if I'm not mistaken, even the two, folks, Dr. Humphreys and the other gentleman, I'm sorry. I can't remember his name, testified that, yeah, the overwhelming majority of literature says these are good this is a good thing. People Going to those places will be better, than they would be if they didn't exist. And so I just think the evidence is overwhelming, and so it should be off the tables in terms of whether it's efficacious or not. Then I just had, like, two questions I wanted to ask.
I hope, Somebody in the committee will be able to help me. Has there been any, communication from either president Spilker or from speaker Mariano as to How they regard this issue, I think all of us in the room know that it's a kind of top heavy or top down organization here in the house and in the senate. Right? And so if there isn't buy in from leadership at a pretty high level, Doesn't really move. Right? So I'm wondering, Rep Madaro, has there been any, communication from the18366 speaker's office about how they're on this matter. I maybe you haven't heard. I just feel like I should ask, though. Alright. And I guess that's the same man answer, from, excuse me, president Spilka. Right, senator?
VELIS - Tell you is18385 in this issue, we're having conversations. But, I mean, someone in the house, I think this is really, really important.
STEWART - Okay. Well, I would just underline that, you know, we've been here several times in this in the last several cycles, and we seem to get that support, but it just seems to die at a certain level, and I think it's at leadership level. Just had another question. Has there been any communication from the, commissioner of public health? Has there been any communication from human services secretary Walsh around this matter to the committee. Has there been any communique oh, sorry, senator?
VELIS - I was going to say we are having ongoing conversations, but with this committee, anyway, and I can't speak for others. The public18433 hearing is really what begins as kind of the genesis for that conversation. But We are engaged in a lot of conversations with everybody you've referenced.
STEWART - Alright. Now I'll just ask one more question. I assume I think I already know the answer. There hasn't been any communication from the governor's office to this committee, has there? Because by speaking personally for myself, I think the sort of posturing by the current administration has turned people like us and this committee into pain sponges. You know? We come up here, and we try to present our concerns to you. And you guys try to act in a responsible way, and you have to suck up all the pain that we bring here, but It never seems to get to the level where there can be action. So I just like to say, I appreciate your willingness to join us There's being pain sponges, and hopefully, we can get some movement on this. Thank you very much. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER23 - Questions.
MADARO - I just want to thank the folks who have testified. We have heard several panels who have Provided heart wrenching testimony, very personal stories about their lived experience and the experience of their family members. Thank you. It is so important that we hear the stories, These stories in a particular, Robert, I'm so sorry for your loss. We heard from your dad last session who shared some18512 powerful testimony, and he has certainly missed. Thank you. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER3 - Any members? Thank you very much.
Thank you. Next up, Kim Powers.
Virtual.
SPEAKER15 - Do we
SPEAKER3 - have a Kim Powers here virtually?
Okay. We'll keep on going. And next up, we have, Mia p From Access
Hope? Same thing. We'll keep on pressing. Juan Jaramillo from SEIU.
JUAN JARAMILLO - SEIU LOCAL 509 - HB 1981 - SB 1242 - Good afternoon. Chair Velis, chair of Madaro, members of the committee, the wonderful committee staff, and staff versus staff of this committee, Thank you for the opportunity to testify today. My name is Juan Pablo Jaramillo, and I'm the deputy legislative director of the 20,000 member strong. Service Employee International Union, Local 509. And I'm here to testify in support of H.1981 and S.1242 an act relative to debt, to overdose prevention deaths and increasing access to treatment. As an immigrant from Colombia, the war on drugs is deeply tied to my personal story.
Because it is at the root of18627 my migration story. The violence unleashed back in18631 Colombia is a direct result of our country's punitive and aggressive domestic and foreign drug policy that has also exacerbated the substance use epidemic Here at home, costing the lives of millions from East Boston to Russell, Massachusetts, and from Massachusetts to Oregon. The workers of the Service Employees International Union Local 509 recognize That harm reduction is not only the path to less violence abroad, but the key to saving lives the lives of our loved ones here at home.
The members of our local provide direct services to the commonwealth's most vulnerable families.Families often involved in the DPH, DCF, or DMH system because of the lack of resources around substance use and recovery. The mission of our members18687 is to build stronger communities by providing the tools and resources that families need to have healthier lives, communities, and the country as a whole. The message from these workers and from the data you've heard today, it's clear. There's no recovery in dying, and the18710 state has the duty
Department of Mental Health, Understand this to be the path forward because they see the way substance use ravages our communities, But also see what recovery can do in uplifting families in our commonwealth. That's why they have endorsed this piece of legislation so that we can continue to expand our toolkits to deal with the substance use epidemic. Thank you again for your time, And we urge the committee to report these bills favorably out of committee again for swift passage by the legislature one more time. Thank you. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER3 - Questions, members of the committee? Thank you very much. We appreciate your testimony. Next up, doctor Alex Kroll. Virtual.
Doctor Kroll here.
SPEAKER25 - Yeah. Can you hear me?
SPEAKER3 - Loud and clear.
ALEX KRAL - RTI INTERNATIONAL - HB 1981 - SB 1242 - Excellent. Thank you so much for, giving me the opportunity to speak today. I'm a distinguished fellow at RTI International, which is a nonprofit health research institute. I'm an infectious disease epidemiologist. I was Trained in part at Harvard School of Public Health, not too far from where you are. Been conducting research on drugs, since 1993 and published over 100 papers in peer reviewed journals. So what sets me a bit apart from all the other experts who who've done a great job testifying today is that we've actually conducted all the studies that they've talked about.
So, all the ones that are published on US based, overdose prevention centers, are studies that we've conducted. So we evaluated an un sanctioned center. We, evaluated the government sanctioned center in San Francisco last year, and I'm on the evaluation team for on point centers in in New York City. You know, the global research, as everyone has said, on OPCs, has shown great results. And our US based research shows, you know, that these centers do help, people who use the sites and, as important to that, the neighborhoods in which they're placed. So, you know, one of the papers we had, which was published in the New England Journal of Medicine.
Evaluated five years of data from an unsanctioned overdose prevention site. They had over 10,000 injections that18853 were supervised. 33 overdoses18855 were all reversed by staff, and no one needed to go to ambulance to the ER. So that's one of the things that that's big about this too, is you're actually reducing the need for ambulance to come to these sites very often. two months ago, we published a study in their National Journal of Drug Policy which showed, that the sanctioned overdose prevention site in San Francisco Reversed all 333 overdoses that were at its site last year. Similarly, the sanctioned site in in, in New York City that many people have talked about has reversed, about 1200 overdoses in in in its almost two years of operation.
The other piece of it then is, considering the impact of OPCs on neighborhoods. And so we published a study in the peer reviewed journal drug and alcohol dependence, which showed that Crime in a 500 meter radius around the overdose prevention site decreased during the five years of operation as compared to the five years before that. And this month we also published a paper,18912 that that showed that public drug use and publicly discarded drug supplies like syringes went down in the San Francisco neighborhood after they opened an overdose prevention site as compared to a similar neighborhood.
And, I should also mention we published a paper in a peer reviewed journal that shows that installing one of these overdose prevention centers, like the one they have in Vancouver, has been very well researched, which that would save three and half billion dollars every year. So that that's a lot of money you could be have actually have savings on there. So, you know, these studies all echo the results from global studies. I've been listening during this whole panel and frankly have an answer to all the questions they've been asked all along, you know, this is a is a life saving service. It saves money, and it really helps, helps communities that18960 they're in.
VELIS - Doctor, did you say did you say that their studies already exist with respect to On Point in New York City?
KRAL - Yes.
VELIS - Help me understand this. Then why is and I fundamentally do not know the answer to this question. Then why did the net why is the National Institute on Drug Policy, the $5 million for the four years to NYU and Brown to study both New York City and then, obviously, what Rhode Island does. Why are they funding that if that data already exists and that research already exists?
KRAL - Well, they they've started the research on those sites. And so the Department of Public Health in New York City has paid for, part of an evaluation that started, you know, well over a year ago, and then now, you know, as of as of, I think last spring, money came from the National Institute of Drug Abuse to do that as well, but you can't just study these, like, in two months or one year. It takes time to collect this data to consider all the various things that that you'd like to know about these studies.
VELIS - Do you think that it makes sense? Because we've heard a lot about data. Obviously, the gentleman before just dropped off a big book with a lot of the data that's out there. Is there merit to the notion that Some of the data that we have should be data based on what's happening here in America to the extent that exists with the two government mandated sites In New York City, in the very soon to be opened one in Providence, Rhode Island, or do you think it's safe from a data empirical research standpoint for us to look at Europe and say19056 that that's instructive.
KRAL - I think you know, the data we have19062 from over 35 years now from Europe, Australia and can and Canada is very strong. one of the things that's interesting about, you know, this last five hours is you can't find a doctor or a researcher to come in here and say, hey. This doesn't work. Or we can point to a peer reviewed study that shows it did something bad. That's just not true of an evaluation of absolutely anything, including treatment. Like, you can't find, you know, a complicated topic like this on a type of service that's been around for that long that you can't find a research study that shows something negative about it.
And so, I mean, to answer your question, you know, we do have some data from the US, Including, the you know, what we conducted in in San Francisco that's now published that show that these work, you know, but there is merit to actually studying them in different scenarios because as many people have talked about, you know, environment does matter. And I know a lot of people have talked about here also about, you should get people into treatment. Well, how much treatment do you have in that area for people to be linked to is a big question.
So, like, in San Francisco, for example, doctor Humphreys19130 talked about that saying, hey. There wasn't as much that's because they're already full up with treatment. So you can't Sort of link people to treatment that doesn't exist in in some sort of way either. Right? And so it does matter what kind of place you're in and having one in Boston or in in Massachusetts or having a few of those, it would be always be valuable to see, hey. Are these working? Are they not working in these particular conditions Regarding what's going on there?
VELIS - Well, I just think you, in some respects, kind of just demonstrated where I was going with that. I mean, you know, the availability of treatment. Mean, it's to say that it varies based on where you are geographically would be an understatement. So to look at the different models, health care models both in Canada, USA, Europe, there's obviously differences, different approaches to treatment that I think would have an impact on a study. And, again, I'd say that for no other reason than curious about this $5 million study for four years if we already have a lot of this Empirical data, but I think it sounds like we have some of it, but not necessarily the longitudinal results, if you will.
KRAL - That's exactly right. That's exactly right. That study of which I'm the co investigator on that on that study, of Rhode Island and New York, that that's going to provide even better answers to some of those questions. Yes.
VELIS - Okay. I appreciate19209 that clarification, doctor. SHOW NON-ESSENTIAL DIALOGUE
Questions, members of the committee? Rep Dubois, vice chair Dubois.
DUBOIS - Thanks again. Doctor, I'm just hoping that you can, just Speak for a minute, on your, like, giving me some understanding as to why you think governor Newsom vetoed safe injection site legislation, last year in California. I know that they do have these two. I'm just trying to understand a little bit more. As I read the article and Emily read one or two, it he seemed to talk about the worries about How the neighborhood surrounding the safe injection sites already19251 had a lot additional open, drug use and The consequences to the surrounding neighborhood. So could you speak to that a little bit?
KRAL - Yeah. You know, I'm merely a scientist. Definitely not a politician. I did testify, to, the California legislature in the same manner I'm doing now. You know, governor Newsom, two years before that,19277 said he would actually, when a prior governor, governor Brown, vetoed it. Governor Newsom immediately said he would support this. I don't know what's changed his mind, now, but, you know, he's got a lot of things to consider in what he's doing, and I'm not privy to, you know, why he might have done that a year ago.
DUBOIS - Well, in your19301 in your analysis of, these sites and their values, I've heard a lot of talk and it's and I I've got to tell you, this has hit home for me and my own family and in my own community. Brockton has a lot of, drug use and a lot of, sadly, early death as a result. So, I am looking for a way out and a solution, but, from my reading and I have family in California that have19329 reiterated this to me that, there is significant, and it's hard to go up against when there are family members who have lost loved ones. And I understand that that they're in pain and they want solutions.
But That there are negative19347 impacts in the surrounding communities where they're placed, and it's just hard to solve a problem When you're trying to weed through the way to solve a problem and there's just a reluctancy on one side or another to actually face the difficult consequences of some actions. So in your studies, do you because all I'm hearing from people is it gets better. It's great to have it. There's no problem in the surrounding community. And I'd like to just have some realistic I mean, I live in Brockton. I live in the19380 real world here. I don't live in a fantasy. I don't live on the left wing of progressive land where life is different.
I live, you know, I live on19389 the main streets of Brockton here, and I just want to know that19393 when we have, professionals testifying That they're doing it with open eyes and can actually say that there are problems. It doesn't solve all the problems in the neighborhood Unless, you know, my family in California is not telling the truth and, you know, other people are not telling the truth. So I'm just trying to understand a little bit more about that because if we were to make this legal, we'd have to deal with that, and I'm just figuring out how we could deal with that.
KRAL - Yeah. It does not solve all problems. There's no way that it could. And I think that we're in a situation where we've got a crisis and it's never or at19430 this point. It needs to be and. And so, you know, we need to consider this. This doesn't solve homelessness. It doesn't serve solve, you know, all kinds of problems that are happening, especially in various cities, you know, around19442 the country. I mean, with respect to the19444 data, you know, we conducted one19446 study that that looked at crime. It literally looked at crime in the 500 meter so, like, about a 5, six block area in a, you know, very dense city.
Around that for the if there was going up in that neighborhood for the five years before that and literally the very year they put it in, the five years after that, it all completely went down. The same thing we saw with public drug use and needles in the street. We had literally had people going out and counting and looking at the streets, looking every block to see if we could count people Who encountered people who were using drugs, who, the kinds of equipment we'd see on the streets, and we saw immediately a downward slope once one of these sites That sites came in.
And so, you know and the last thing I could say, which is not my study, but in in Australia in Sydney, Australia, they did a community poll in the neighborhood before they started19493 an OPC, and then a year19495 after it opened. And actually, the publics were way more in favor of The OPC a year after they put one of those in in the site. And we're seeing that also in New York. I mean, in New York, they've literally outside of those o those19510 OPCs in New York, they've literally removed 2,4 million pieces of drug of drug,19518 you know, supplies because they're doing now doing it inside.
And so rather than having everybody outside and then pot and not having somewhere to put these things, You're just moving people inside so they're not out. And you're actually making sure that once they use the, you know, use their drugs, they leave all of the the drug use, you know, supplies there. And so, you know, that's why the police are very much in favor of those sites in New York, and I've talked to the police there. I mean, I haven't actually seen any scientific studies that show anything negative regarding the neighborhoods. They're placed.19550 It's actually all been positive. SHOW NON-ESSENTIAL DIALOGUE
Oops. I think you're on mute, or I can't hear you.
DUBOIS - I guess I'm just not reading the same studies as you, and I appreciate, I appreciate your efforts. Thank you so much.
KRAL - Yeah. I mean, they would need to be peer reviewed for me to pay attention to them. There's literally is not one reviewed study on this topic anywhere in any country that shows something negative about the19579 neighborhood or about the site about the people who use them. That there isn't 1.
DUBOIS - Thank you. Thank you, Mr. SHOW NON-ESSENTIAL DIALOGUE
Chair.
SPEAKER3 - Questions from the committee? Doctor, thank you very much for your testimony today. Thank you.
Richard Johnston, here or in virtual?
Thanks for sticking around.
RICHARD JOHNSTON - CONCERNED CITIZEN - HB 1981 - SB 1242 - Chairs and the committee, for hearing me today. I'm in here in support of This, legislation, you know, something is striking to me. I don't know what the written testimony is so far on this bill, but everybody that's spoken today is for this legislation, is in support of it, And, I think that's telling. You know? Personally, I'm, I'm an addict, an alcoholic in recovery for almost 30 years now. I'm also the parent of a child. I feel actually fortunate listening to some of these other stories. I witnessed one of my son's overdoses. I still remember it like it was yesterday. It was about seven years ago.
And, I was home in my, Watching the patriots game back19667 when they were winning all the time, and it was a joy to watch19669 them even though they did pretty good yesterday. And I remember saying When my son came home, my antenna had gone up because19676 of the his behavior. And, he was in his room, closed19680 his door, and I wanted to Go in and talk to him at halftime. I remember thinking that. Something made me19686 go in his room before then, and when I went in there,19690 he was face down on the bed. I turned him over. He was blue, and he was limp. I immediately ran and got some, Narcan that I had. Narcan saved my son's life that night, as well as the 1st responders.
Called 911, gave them two doses of Narcan. Don't even really remember doing it. They came and they bagged my son for 10 minutes. I saw him on the floor. I thought he was dead, and, my son did survive. And, you know, I've taken my son. I had him Sectioned. I went to court and had him Sectioned. I've taken him to emergency rooms. I've taken him to mental hospitals and been psychiatrically committed. You know, if my son continues to, do he's doing pretty good right now, but I still have my antennas up.
You know? It's not an easy disease to live with. And If you chose to use again, I would rather he be in a safe setting doing that Then, you know, out on the street and, you know, being an addict, I I was very not into harm reduction at all for many years. I thought it was enabling. I thought it was doing all this stuff. And, you know, I just want to I hope the legislation gets passed. I think it's an important bill. You know, the data I also want to mention that this19772 is a pilot program. You know?19774 Everybody's got all these ideas about what. It's all new. You know, it's very new. I think it's needed.
I think it's a pilot program where data is going to be collected if I read the bill correctly. 10 years, every year it's going to be reported on. After that, we can all make a decision whether it's working or not. And I like what what's been said. If it doesn't work, then nobody's going to get killed from this legislation. And if it does work, it's going to save lives. And so I think it's very important that this bill be passed, without delay, you know, I firmly believe everybody in this room, if they saw a drowning person and they had a life preserver, they would throw it to that person. This bill is a lifesaver. Please pass it. Thank you for your time. SHOW NON-ESSENTIAL DIALOGUE
Do you have any questions?
SPEAKER3 - Members of the committee. Sure. Thank you very much for your candor today coming forward. Thank you for
Reina Hill?
Richard Baker and Benjamin Lewis?
RICHARD BAKER - VICTORY PROGRAMS - HB 1981 - SB 1242 - My name is Rich Baker, and I stand before you today as a public health expert and a passionate advocate for harm reduction. I'm the deputy director of Victory Prevention Services at Victory Programs overseeing programs that provide essential harm reduction services and support for individuals experiencing homelessness and using drugs. Also serve as19876 the coordinator for EndHepCMA Coalition, a collaborative effort of consumers, advocates working towards19882 hepatitis c elimination in Massachusetts. I'm here to voice my strong support in the Overdose Prevention Center bill establishing the 10 year pilot, project in the Commonwealth.
In my seven years working in public health and harm reduction, I've witnessed19896 the evolving landscape of substance use. The potency of drugs has increased, and the overdoses have become more prevalent. An19902 overdose prevention center is not a singular solution, but it's a critical tool to reach those forced into the shadows of stigma, by drug use providing an opportunity for conversations about safer use and pathways to get people to a more stable place in their lives. For victory programs, we see this intervention as a necessary addition to the spectrum of services supporting individuals who use drugs. We firmly believe that individuals have the right to define what recovery means to them.
But put plainly, people might not be able to be afforded a path to safer use or abstinence based recovery if they aren't afforded a safe environment to consume The path to recovery is rarely linear. Sanctioning a space that mitigates the shame and stigma associated with substance use offers a Critical point of engagement. It offers a chance to educate, build healthier lives, and regain trust in social service systems. That's what fosters The stability and, the lives of the people that we serve. The evidence of the efficacy is overwhelming, and residents here in Massachusetts agree.
In fact, a recent poll conducted by Beacon Research found that 70% of Massachusetts voters across party lines, support the establishment of overdose prevention centers. These facilities prevent infectious disease transmission, contribute to mortality reduction, and reduce burden on our health care system all without increasing public consumption of drugs. Massachusetts has an opportunity to lead in public health once and for all and work towards ending the overdose epidemic by passing this legislation. To strive for a safer, more stable community, we need to be embracing in evidence based interventions that have proven successful in saving lives.
BENJAMIN LEWIS - END OVERDOSE - HB 1981 - SB 1242 - Hello, committee. Thank you for allowing me to testify before you today. My name is Ben Lewis, and I am a grad student at MIT Studying, or pursuing a master's degree in technology and public policy. My research centers around drug policy as it relates to race. Additionally, I'm the founding president of the Boston chapter of a national nonprofit called End Overdose. Our mission at End Overdose is to do just that. And overdose related deaths were providing education, naloxone, Fentanyl testing strips, and Xylazine testing strips to the drug using community at no cost. I'm here to voice my strong support for House 1981.
This is important because we know that drug overdosing is a leading cause of death in young adults. And only 40% of overdoses is someone else present, which means that because20049 of the stigma related to drug use, 60% of overdoses occur when a person is alone. This clearly, dramatically increases the likelihood of death in the event that someone experiences an overdose because if the person is alone, then there's no one else there to help them. OPCs can help reduce the rate of overdoses, that occur in solitude and their associated chance of death. Through leading into overdose, I've had the opportunity to table at events and chat with people in the community who've lost loved ones to overdosing.
Specifically, from the exposure of Fentanyl. Fentanyl's presence20084 in the illicit drug market alone is reason enough to invest in OPCs in the state of Massachusetts. The lethal substance is present in Massachusetts and can be laced in pretty much any powdered substance. I know this because End Overdose Boston does our best to warn the Boston the greater Boston community on social media anytime we find that someone's has been tested positively for Fentanyl. This past summer alone, we sent out three such warnings. Overdose prevention organizations like ours and public health services cannot do this work alone. We need you to invest in bills that prioritize safety over stigma.
Our current systems simply are not working. The problem of overdosing will continue to expand if we don't make radical changes to address this growing issue. We need comprehensive avenues for drug users to get the help they need, avenues whose availability aren't predicated on the idea that A person will or should eventually become sober to receive them. At the same time, overdose prevention centers, can provide a vital first step towards recovery by keeping individuals alive. If you care about young people and about vulnerable populations in this, I urge you to be in favor of house 1981. Thank you so much. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER3 - Thank you both very much. Questions, members of the committee?
Thank you very much. Thank you.
Next up, Hannah Bard.
HANNAH BARD - BOSTON UNIVERSITY - HB 1981 - SB 1242 - Good afternoon, chairs Velis and Madaro and honorable committee members. My name is Hannah Bard, and I am a second year medical student studying at Boston University. And I'm here today to voice my support for h 1981 and s 1242. I still remember the first time I witnessed a man down from an overdose on my Street corner. After reviving him with the Narcan I so proudly carry, I went home saddened, thinking about The details of his life and his ultimate fate. Only a week later on my way home from school, I found him again.
This time, one block over, barely alive with a needle still in his arm. We have to do better. I currently live on Albany Street, only one block away from Mass and Cass and a five minute walk to Boston Medical Center. I walk to and from my apartment in the early hours of the morning, and I come home late at night. Addiction does not sleep. No matter the time of day, I can without fail bear witness to multiple individuals visibly intoxicated and deeply struggling. I see people using car windows as mirrors to inject into their necks because all their other veins no longer work.
I see people in crisis in the middle of crowded intersections yelling in absolute terror at demons only they can see. I see people staring directly at me knowing they are not seeing me back. I see groups of people whose lives have become absolutely ravaged from drug supplies laced with Fentanyl and Xylazine. I give these examples to emphasize the magnitude of this public health crisis. All people suffering from20289 addiction deserve access to support and resources that keep them safe. We know harm reduction works.
We know overdose prevention centers work. There is a reason that there has never been a single overdose death at any of the approximately 200 centers that exist around the world. There's an absolute urgency and necessity for these centers to exist in Massachusetts. And as the results of a recent Beacon Research poll show, 70% of mass voters support their establishment. They save lives. They20324 promote trust. They are a gateway to recovery. Thank you for your time and commitment to protecting the health in the citizens of the Commonwealth. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER3 - Thank you very20337 much. Question, members of the committee. Thank you. Good luck with school.
So, Teja, Adam, and Cassie heard? A panel? Virtual.
Material aid and advocacy program.
SPEAKER30 - Hello. Can you hear her?
SPEAKER3 - Yes.
SPEAKER30 - Alright. I'm going to speak first.
TEHYA JOHNSON - MATERIAL AID AND ADVOCACY PROGRAM - HB 1981 - SB 1242 - My name is Tehya Johnson and I am a harm reduction advocate with CFMA Now, a board member of MAAP, Material Aid and Advocacy Program, and a nurse practitioner working with people at the intersection of experiencing homelessness and substance use disorders. I'm here speaking in support of bills H.1981 and S.1242. I first spoke to this committee four years ago. At that time, I was still a student speaking in support of establishing Overdose Prevention Centers known as OPCs. And increasing access to harm reduction, drug user health, and substance use treatment services, all of which can be accessed through OPCs.
In reviewing my past testimony for a similar bill, I was struck by how little has Changed. At that time, I spoke about the ethical standards and principles which emphasize my responsibility to not only provide care but also advocate for all patients to ensure a sense of dignity, respect, and personal autonomy. Since that time, I've done my part to fulfill my responsibilities and obligations to protecting the autonomy and rights of people who use drugs. Then and now, it is the state and legislature's turn to do the same and ensure the commonwealth is able to provide evidence based harm reduction services most especially overdose prevention centers.
All people regardless of their substance use history deserve the right to evidence based care that would give them best chance to live and in turn work toward their self determined goals in life. The creation of overdose prevention centers wraparound, harm reduction and preventative medicine services could be included, would not only save people from overdose as seen in hundreds of facilities across the globe and over decades of20482 time. But could save people from medical complications20484 as well. To sit here today and state that there isn't enough data or evidence to support such claims is willful ignorance and fails to recognize the hundreds of peer reviewed publications.
Decades of work done by and in these OPCs and the positive experiences of thousands of individuals who've used these spaces worldwide. These centers, especially when peer workers are included, meet people who use drugs where they're at and send a message that their lives are just as important as everyone else's. By providing care and services we know work, we tell our community members who use drugs that they deserve to be loved and respected. I have watched since the last time I spoke here both patients and loved ones. People I consider to be within my chosen family Die. So many people I've lost count. This year alone, that number has passed 20.
Across the state, people like myself collectively lost an estimated 2,357 people last and based on this number, at least one person has died since this hearing began today. With over a 100 people dying every month in Massachusetts for years now, Literally since 2013, the frustration, pain, and grief I and all those who have lost family members, good friends, and patients goes unanswered. This is unacceptable when there are evidence based harm reduction practices including OPCs which can be adequately supported and established in this state. Please support these bills and make it possible to provide necessary, effective, and dignified care to people. Keyword here, people who need overdose prevention centers the most.
CASSIE HURD - MATERIAL AID AND ADVOCACY PROGRAM - HB 1981 - SB 1242 - Good evening, I guess. My name is Cassie Hurd. I am the director of the Material Aid and Advocacy Program, where we offer20600 direct support and organize alongside people who use drugs and people who are unhoused, And I'm also a founding member of CFMA Now. I'm speaking today to once again share my strong support for an act relative to preventing overdose deaths and increasing access to treatment. Others have shared the abundance of evidence that supports overdose prevention centers. I will simply reiterate that there have been zero deaths at any overdose prevention center over the past 30 years.
Yet in the past three years Alone, we have lost 21 beloved MAP community members to overdose death. Each person was a pivotal member of our20637 shared community who cared for friends, Family and strangers often acting as first responders for overdoses and injection related wounds. Had the legislature authorized OPC enabling us to offer us to a safe and legal place for them to consume their drug of choice, their deaths may have been prevented. MAAP's leadership, board, and organizers have worked tirelessly to support people. Who use drugs and meeting their self identified needs and goals and advocating for evidence based solutions to20667 the overdose crisis. As members of CFMA Now.
We have fought to authorize OPC in Massachusetts since 2016, advocating for and helping to develop the legislation we are here about today that would authorize overdose prevention centers, engaging in community education, and holding rallies and die ins at the state house. We've lost over 12,000 people in Massachusetts to preventable overdose since legislation to establish OPC was initially introduced in 2017, we desperately need the support of policies that prioritize people's health and authorize the establishment of OPC now. MAAPS staff, board, and community members were, were members of Summerville's supervised consumption site task force Where we engaged in community outreach and conducted research.
As TJ mentioned earlier, with people who use drugs, which found that 90 4% of the people we interviewed said they would use an OPC. Further, in 2021, MAAP Staff and organizers conducted a 112 interviews with unhoused community members in Cambridge. 99 of those respondents identified as people who use drugs. Of those 99 respondents, 81 identified that they would utilize an OPC in Cambridge. This information shows that our community members both desperately want to live and have identified OPC as a solution. We in our community are doing what was in within our power to support people and save lives. The responsibility20754 to save people's lives should not continue to fall on people who use drugs. We're balancing so many other crucial needs and commitments, and act as first responders in this crisis.
I want to share a portion of testimony from Jay, a beloved MAAP community member. We have been fighting this20771 since Nixon. Some of the approaches around drug use and addiction have changed now that it's not just Black people dying, but white kids like me. But not enough has changed, and we have to do better. People are still arrested and criminalized for using drugs, a nonviolent Crime, especially on the streets, because there is nowhere safe for us to go. OPCs would reduce arrests for people using substances in public, reduce the number of people using substances in public, an ambulance in response to overdose, which would save the state and taxpayers money.
Most importantly, overdose prevention center saves lives. I don't want to go to another funeral, and I don't want one my loved ones to have to go to mine. To be clear, delaying the passage of this legislation is causing people to continue to die in the streets, in public restrooms, and behind closed doors. I ask that you listen to people who use drugs, who are telling you they desperately want compassionate care to live and not be criminalized. I once again urge you to swiftly order an act relative to preventing overdose deaths and increasing access to treatment out of the committee and do everything within your power to pass OPC legislation to save lives matter. People's lives depend on you. Thank you. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER3 - Questions from the committee? Oh, we have another person on the panel. Sorry.
ADAM - MATERIAL AID AND ADVOCACY PROGRAM - HB 1981 - SB 1242 - Greetings to all. I'm in it. Thank you for affording me the opportunity to, share testimony with you all today, and I thank everyone who has learned their voices in20866 support of, supervised consumption sites Overdose prevention centers. I think the writing is on the wall, and, you know, history is instructive. Our own nation's history and that of other nations that, are observed, you know, by international observers, pardon me, I did not write a testimony, so, please forgive me, shooting from the hip. That, you know, countries like, the Nordic model of democracy.
Democracies, you said, are, rated far more effective than our own or more democratic rather and have far more comprehensive health care. Options Available to all regardless of their class, race, economic Background, you know, because they put the quality of life of their citizens above that of, you know, economic growth. You know, since I had my 1st experience with homelessness at 23. And, even though I've kept jobs and worked very hard, as I've grown20953 older. You know,20955 the safety net of, well, the social safety net is slipping as more things become privatized. I don't know. I'm just rambling on. For people I don't know.
I mean, we could all I could just recite statistics that you've all Heard a20974 dozen times, but the thing is it's all very abstract and Somewhat dehumanizing. People have shared their anecdotes of the loved ones that they've lost, and I lose people every day. I was born in Boston. I have only spent one year of my life outside of the Boston metro area, and it's just a21003 daily occurrence. I Basically, spend most of my time these days between Somerville Cambridge and the Austin Brighton area. And I lose friends every day in the most grisly of circumstances. For instance, one of those people in Cambridge was a dear friend of mine. Even though she was staying in a building.
That is managed by the Cambridge Housing Authority. She was dead in her room for 10 days, while the stench of death wafted into the halls of the building at the YWCA and the other residents there begged the staff to please do a wellness check. For 10 days, she, was not heard from. When they finally, answered, To21070 the concerns of the residents, well, It's gruesome. She could not be identified, by anything but her teeth because the roaches21085 Had, consumed her because of the position her body was in, rigor mortis, what have you. And, the size of a room, which was the smallest in the building, her body had to be sewn in half. People should not have to the only crime is poverty. The only crime is poverty.
You know, people are marginalized on the basis of, you know, history and culture, for instance. I I'm a descendant of the victims of the transatlantic slave trade as, well, I think she may not have been, but she is still of the African diaspora. And, by all accounts, the quality of life of, people of African descent in this nation has been declining, In comparison to the peers, since the seventies on all fronts And with each economic crisis, the situation gets worse,21170 and we you know, Houselessness, drug use, these are all more reasons to marginalize people And disregard their humanity on the basis that they're somehow criminal. And I thank SHOW NON-ESSENTIAL DIALOGUE
you
Thank you so much.
SPEAKER9 - Thank you
SPEAKER3 - very much.
Questions, members of the committee?
Seeing none, thank you very much, sir.
Brian Foran.
BRIAN FORAN - CONCERNED CITIZEN - HB 1981 - SB 1242 - Good evening, and thank you for the opportunity, to provide Good morning. My name is Brian Foran, and I'm a public health social worker who spent the past nine and a half years Serving individuals affected by addiction, mental health, and homelessness in the Mass and Cass neighborhood, previously at Boston Medical Center and previously holding office in my hometown of Arlington, Mass. I currently have the privilege of serving as community liaison for the coordinated response team with the office of mayor Michelle Wu, I offer testimony today in my personal capacity as a person who has lost loved ones to overdose and as a community member, pleading with the legislator to support this bill.
When I first entered the field, I was by no means an advocate for harm reduction or for overdose prevention centers. Only after witnessing the systemic barriers to treatment, Shelter, housing, and employment faced by individuals with substance use disorder, did I begin to recognize harm reduction's critical role in saving lives, in creating a pathway to treatment and in promoting long term recovery. Overdose prevention centers do21295 not promote drug use. They acknowledge the realities that drug use exists and that our current approaches are not enough to address record high rates of fatal overdoses here in Massachusetts. I recently had the pleasure of visiting OnPoint in New York City.
Unlike any facility I'd ever visited before, OnPoint has created a comprehensive model of services, as many have discussed, open to any individual in need regardless of where they may be in their pursuit of recovery. OnPoint operates a walk in clinic for medical care, for medication for opioid use disorder, and for case management services. They provide referrals to treatment. They run therapeutic groups, and they connect individuals to housing resources and to mental health support. While research consistently indicates this to me, it was blatantly clear in person, that OnPoint in overdose prevention centers Create a pathway to treatment for those most at risk of overdose.
And significantly increase the likelihood that individuals seek treatment and engage in long term recovery. If you consider yourself someone an advocate for recovery, this is your intervention. What most surprised me about my visit to OnPoint was the program's strong partnership with local police and nearby schools, doing outreach in the21373 community, visiting areas where individuals have historically used substances in public and encouraging individuals to accompany them to their program, OnPoint’s staff have helped to keep parks, playgrounds, and community safe community spaces safe and needle free. In fact, immediately upon OnPoint's opening, needles discarded in public spaces in the areas surrounding the program decreased by roughly 90%.
If you are someone who considers themself an advocate for public safety and for protecting children in particular, this is your intervention. I'll close with, at the end of the day, every single fatal21412 overdose is preventable. We have a proven approach that has continuously worked in countries around the world and now here in the United States, yet we choose to allow overdose to continue. We choose to sit back and allow our family members, friends, neighbors, patients, and constituents to die unnecessarily. For those of you who remain skeptical or opposed, I promise that you're not saving lives with an action on this legislation. On the contrary, you're an obstacle to saving lives, and I beg you to please get out the way. Thank you. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER3 - Thank you very much. Questions, members21452 of the committee? Seeing none, thank you very much for your testimony.
SPEAKER32 - Time, and thank you to everyone here in attendance participating.
SPEAKER3 - Alrighty. Next We have James Evans and Jacqueline Gott.
JACQUELINE GOTT - THE DIMOCK CENTER - HB 1981 - SB 1242 - We made it. My name is Jackie Gott, and I stand before you as a nurse specializing in addiction. I think I'm one of the few nurses who has presented here today. I'm also a concerned mother of three small children and a resident of the commonwealth. I would like to express my wholehearted support for bill H.1981 sponsored by representative Fernandes and bill S.1242 sponsored by senator Cyr. I'm currently the director of at The Dimock Center For Behavioral Health and Addiction Services. But I spent most of my nursing career as a nurse at Boston Medical Center working in the Med Surg Float Pool, where I was21524 working in the epicenter of the opioid epidemic.
This experience gave me a front row seat to the struggles, the stigma, and the resilience of people living with substance use disorder. I can tell you as a nurse, stigma is real. It's encountered frequently in21541 the hospital, and it is counterproductive to patient care. Before I embarked on my center and pursued advanced training as an addictions nurse. I admit that I might not have been in support of such legislation. However, my experiences, research, and education have shaped My have reshaped my perspectives entirely. Prior to assuming my current position at the Dimock Center, I had the privilege of being the nurse manager of the roundhouse, where I oversaw the transitional and stabilizational care centers.
There, we implemented an innovative, low barrier care model for patients with substance use disorder who are also experiencing housing insecurity. Our approach was straightforward but transformative. Meet patients where they are, provide care in a welcoming, nonjudgmental, and compassionate environment. Over time, as we walked with patients at their own pace, they began to trust us and knew where to go when they were ready to seek help. The results were astounding. We witnessed a significant increase in patient engagement while helping to reduce the burden of ED visits on an already overtaxed health care system.
We implemented a program with Boston EMS where they were able to actually divert patients post overdose to the roundhouse, rather than bringing them to the emergency department. Because they were able to seek care immediately when they arrived to the Brown House, we were able to implement innovative treatment models, Immediately inducing the Mont Suboxone and then following it up with a 28 day supply of lifesaving medications for addiction treatment, Sublocade. In my current role, I oversee a detox in a full continuum of care for patients with substance use disorder. Through this work, I'm able to see firsthand that recovery is possible. However, to assist people along this path, we must first focus on keeping them alive.
The establishment of an OPC in Massachusetts is an important first step in reducing overdose deaths and engaging a population who is reluctant to engage with the traditional medical model due to stigma and shame. As a state with a history of being a leader in health care reform and supporting the most vulnerable in society, who better than us to enact this model? The good news is we're not the 1st to do it. And as you have heard, there's an abundance of re abundance of research and data to support the successes of these programs. Clearly, the approach we're taking21681 is not enough, so I urge you to consider the overwhelming evidence, the success stories from around the world, and the urgent need for change. Thank you.
JIMMY EVANS - CONCERNED CITIZEN - HB 1981 - SB 1242 - Good call. Hi. Thank you for hearing me. My name is Jimmy Evans. I am also a nurse. I think one of the only nurses that I spoke today. I'm also a person in long term recovery and an overdose survivor. I have a thing written out here. I feel like I've Everybody said what I wanted to say. I think, hearing the stories really got me today. In June of 2016, my brother died of an overdose alone in a bathroom somewhere. The pain, the emptiness, the tragedy that My family feels every Thanksgiving, every Christmas,21735 every birthday with21737 my kids. You know, two what is it? 2,357?
I mean, it's a club that nobody wants to be a part of, and more and more people are joining every21748 day. I mean, I don't know. I can cite all the fancy numbers, but really, it's zero overdose deaths. I mean, I'm not sure what else we need to talk about, as a nurse, as a person in recovery, as a person who's lost someone to opioid overdose. It doesn't seem that that complicated. I think we need to do this. I think it's a pilot program. I think we need to try something. I worked at BMC with21778 Jackie, on Mass21780 and Cass. I was there long before it was Mass and Cass. And, you21786 know, I think anything that we can21788 do, to make it better, we need to do now. That's it. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER3 - Members of the committee, questions? Thank you both very much. Appreciate that person experience.
James Veggie.
JAMES VAHEY - CONCERNED CITIZEN - HB 1981 - SB 1242 - Thanks so much for taking the time and being here still at this hour, to hear my testimony. My first name's, my name is James Vahey, and I'm a 1st year medical student, but for the last five years have worked in harm reduction in the Mass Cass area. I speak today in support of bill S.1242 for the high school classmates I have lost to opiates, my family members continuing to battle with substance use, the patients I have the privilege of working with and my coworkers who provide services to people who use drugs day in and day out and shoulder so much of the pain that accompanies this work.
I'd like to paint you a picture of my experience. On my favorite days, I'd walk around the streets engaging with people in the Mass Cass area. Many of my days, we'd spent building relationships. We would just chat about the dismal red sox season, relive our best high school sports moments, or debated the best Ben and Jerry's ice cream flavors. At times, we talked about HIV prevention and housing resources as well. I truly saw the best of community out there. On the hard days, we'd be called to respond to someone overdosing in a porta potty. We'd have to carefully pull them out to apply Narcan and rescue breaths until they were revived.
Day in and day out on the bone chilling days in the summer, the freezing rains of spring and the festering hot of summer, we'd respond to people who cared about overdosing in the dirt, in gutters, and behind dumpsters. We'd find them in unsafe, undignified places where they were forced to use Drugs to make sure they wouldn't go through the sick sickness of the withdrawal. On the21912 hardest days, I've commiserated with patients and21914 coworkers After hearing about another one of our patients overdosing and dying in the back of a U Haul or an ATM booth the night before alone and suffering.
What hurts the most about losing these people are we care so much about is knowing how preventable their deaths are. I've not seen a silver bullet solution for people with substance use disorder. Strongly believe in a spectrum of supports for people who use drugs, some who stop, some who cut down their use, some who continue using more safely. But I've also seen the power of showing unconditional love for people using drugs. That is the purpose of overdose prevention centers, and we have seen a documented success. They provide a dignified space to people who are otherwise pushed into the margins of our communities.
Each needle they give out is one more case of HIV or Hep C prevented, each overdose reversed, a life saved. Most importantly, they represent a space for people using to know they are nondominantly welcomed in love. To end, I'll invoke a quote from my inspiration, doctor Paul Farmer, who said the idea that some lives matter less is the root of all that is wrong with the world. I hope you vote21975 to support measure s.1242 to provide21977 dignified spaces for people who use drugs and expanding harm reduction services in order to demonstrate how much we value the lives of our family, Friends and community members who use drugs. Thank you. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER3 - Thank you very much. Questions, member of the committee? Seeing none. Appreciate you. Thank you very much. Laura Karian?
Laura Carrion here remotely.
Alright. Moving on.
SPEAKER9 - Bill Frio.
WILLIAM FRIO - CONCERNED CITIZEN - HB 1981 - SB 1242 - Hello. My name is Bill Frio, and I will be extremely brief. I came to this issue by working for about 10 or so years at the law enforcement, Action Partnership. I was a nonlaw enforcement person staff for that organization, which was run by drug warriors from every level up to former, commissioners, international commissioners, drug czars, what they're called. And they talked about what they had done because of the stigma and the hysteria about the drugs. They could do anything. They were completely ruthless. It's well documented what's happened, but they all turned against that. And part of that, what happened was we went to22079 visit, inside in Vancouver, and also the rainbow room in, up in, Amsterdam.
And, what happened, of course, in in insight as advertised, and it's a place that's warm, welcoming, supportive. And, it's a stigma free place, and, that's exactly what's being asked for here, and it's I can testify firsthand that it actually does work. I just wanted to say very quickly, I'm not an expert on these things about hospitals, but I know the frustration that you feel that where everyone feels that when somebody goes through and they save them in the operating room and they come out and they go out and they, again, may come back. But, also, that is true of people who are morbidly obese, who have heart attacks, and people who eat bad diets and, have diabetic shock or coma. And people who smoke too many cigarettes and have COPD.
Or people who drink too much and damage their liver, you heal them and you send them out again, but we would not think in any of those cases of saying let's lock them up for six months until they stop drinking, until they stop eating too many cheeseburgers and stuff like that. And the reason we might do that22160 with a drug related Disease is because of the stigma. So I I fear that some of the stigma still remains even with the best of intentions and concern and heartbreaking concern the people who you see being released. So I would hope that anyhow, my wife and I bought our house in Somerville, Davis Square, 45 so years ago, raised our children there and hope to live another 45 years there. And I completely support having one of these sites in our neighborhood, and I look forward to it. Thank you. SHOW NON-ESSENTIAL DIALOGUE
SPEAKER3 - Thank you very much, sir. Questions? Seeing none, thank you very much.
Alright. We're just going to quickly go back To some of the folks who were not here the 1st time around, see if they're here now. Kim Powers?
Mia p,
Rayna Hill,
Coriam?
Anybody else here in attendance who wants to speak, who has not spoken yet?
Going once, going twice, going three times at this point, and motion to adjourn.
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