“It is one additional tool that we could employ to build trust among users and provide services to save lives.”
By Logan Hullinger, Filter
Urged on by the mayor at the epicenter of the nation’s overdose crisis, a Maryland lawmaker has launched a renewed bid to legalize overdose prevention centers (OPCs) statewide.
On January 8, state Sen. Shelly Hettleman (D-Baltimore County) reintroduced a bill that would permit six OPCs in places with high rates of overdose deaths. Although OPCs have been proven to prevent deaths and bring many other public health benefits, previous iterations of the bill have repeatedly died in committee over the years.
“I really believe what we are doing with regard to substance use disorder is not enough,” Hettleman told Filter. “It is one additional tool that we could employ to build trust among users and provide services to save lives. Bottom line for me, this is about saving lives.”
The bill will soon be scheduled for a hearing in the Senate Finance Committee, and a companion bill will be introduced in the House.
Maryland has seen a long battle over OPCs. Activists and public health experts have fought hard to get the legislature to act over the years, but OPC bills haven’t gained support as easily as other harm reduction efforts. For example, legislation to decriminalize drug “paraphernalia” cleared both chambers in the General Assembly, though it was vetoed by former Gov. Larry Hogan (R) in 2021. (A new bill is back on the table this legislative session.)
The OPC bill does not mandate the creation of the sites, which Hettleman said could be a source of misunderstanding. Rather, it permits municipalities to work with community partners to introduce them, subject to approval from the state health department.
What may be most important this time around, Hettleman said, is that Baltimore Mayor Brandon Scott (D), recently sworn in for his second term, named OPCs as a “legislative priority” on the same day the bill was introduced.
Scott has voiced support for OPCs for years. But his recent comments may signify a more urgent wish to bring them to Baltimore, which has the highest fatal overdose rate of any major city in the United States.
OPCs “are associated with reduced overdoses, decreased public drug use, reduced syringe litter, increased access to addiction treatment, increased engagement in health services and reduced strain on emergency medical services,” Scott said. “As Maryland sees an influx of opioid restitution funds, we have an unprecedented opportunity to address substance use disorder and the overdose crisis—I’m calling on our state legislators to take bold, evidence-based action.”
Scott’s office did not respond to Filter’s requests for comment on why Baltimore has not followed the lead of New York City in establishing OPCs without state authorization. Researchers have suggested that Baltimore could accomplish this by issuing an emergency declaration.
Despite overdose deaths reaching unprecedented levels in recent years, only three states have legalized the sites. Rhode Island opened the first state-sanctioned OPC in December. New York City’s two sites opened in 2021; they have averted almost 1,700 overdoses since then and have been visited by local lawmakers.
OPCs in Maryland would not only save lives but address the racist impact of the drug war, said Candy Kerr, spokesperson for the Baltimore Harm Reduction Coalition. The nonprofit is part of the Bridges Coalition, a group of more than 30 Maryland organizations advocating for OPC.
“Baltimore City has a long history of predominantly Black communities being hit the hardest by drugs and criminalization of [drug use], and opening OPCs in said communities [is] one small piece to combatting this continued harm,” Kerr told Filter.
Research has found that a majority of business owners in Baltimore City and Baltimore County support the idea of having OPCs in their neighborhoods. One study found that OPCs in Baltimore could save the city $6 million in annual health care costs.
State lawmakers, however, have other financial concerns on their minds.
Maryland is currently reckoning with an anticipated $2.7 billion budget deficit, and lawmakers are focused on hashing out deals to fill the gap. Advocates fear this could dominate the legislature’s attention, leaving the OPC bill sidelined once again.
In 2020, Scott, then serving as city council president, announced a resolution to hold informational hearings on OPC. “There’s nothing that says we can’t do it,” he told Filter at the time.
The resolution passed and gave hope to advocates, yet years went by without any legislative action to implement OPCs in the city. Any prospect of opening the sites could also hinge on a landmark trial in which the city is seeking $5.2 billion from opioid distributors McKesson and Cencora to combat the overdose crisis. In the second phase of the trial in December, the city’s expert witnesses testified that investments in OPCs, in addition to a myriad of other harm reduction initiatives, are crucial to the city’s 15-year abatement plan.
Susan Sherman, a professor at the Johns Hopkins School of Public Health who created the city’s abatement plan, has studied and advocated for OPCs for years. She views the sites as a holistic, evidence-based approach to public health, but she recognizes the roadblocks.
“It’s hard to stomach the fact that it flies in the face of what people think helps people who use drugs, period,” Sherman told Filter. “It challenges you on a deep level.”
While Baltimore’s power to implement the sites unilaterally may be up for debate, she added, authorization through state law is preferable because it would provide stronger legal protections.
Leadership of Maryland’s Democrat-controlled House and Senate leadership did not respond to Filter’s requests for comment. The office of Gov.r Wes Moore (D) declined to comment on specific legislation.
“I think politicians are concerned that their constituents won’t support them if they vote for something so controversial,” Kerr said. “So our job should be easy, right? OPCs actively save lives in the short term and give people access to supplies and resources that can help them in the long term, and we have scientific evidence to prove it, so why wouldn’t people be on board?”
“Because we still see drug use as a moral issue in this country, and a lot of people have experiences with drug use or people who use drugs that may be less desirable,” she concluded. “Does that mean we’ll stop educating? No. But it does mean it takes time.”
This article was originally published by Filter, an online magazine covering drug use, drug policy and human rights through a harm reduction lens. Follow Filter on Facebook or Twitter, or sign up for its newsletter.
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Photo courtesy of Flickr/Marco Verch.
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