In Providence’s West End, behavioral health care agency CODAC Inc. serves one of the city’s hardest-hit neighborhoods in the opioid crisis. From 2016 to 2018, between 13 and 17 people died of overdoses in this area while emergency medical services responded to 98 to 133 overdose-related calls.
These numbers, compiled by the Rhode Island Public Health Institute, qualify the neighborhood as one of Providence’s three “overdose hot spots,” along with downtown and Olneyville.
But as overdose numbers rise in the West End and throughout the state, Project Weber/RENEW, a nonprofit offering harm reduction and recovery resources to people with substance use disorders, plans to bring a first-of-its-kind facility to the neighborhood: Project Weber, with CODAC as its clinical partner, is working to establish Rhode Island’s first harm reduction center in early 2024.
Harm reduction centers, also known as safe injection sites or overdose prevention centers, provide a supervised space for people to use illegal drugs, with trained staff on-site to provide medical assistance in the event of an overdose.
The harm reduction center has long been in the works at Project Weber/RENEW, says Executive Director Colleen Daley Ndoye.
“The overdose crisis in Rhode Island is taking away our family members, our friends and our loved ones,” Daley Ndoye said. With the center’s planned opening at 349 Huntington Ave., she said, “the goal is that people’s lives will be saved.”
Getting to this point has involved a lengthy legislative process and funding search. In July 2021, Rhode Island became the first state in the U.S. to legalize harm reduction centers, with legislation authorizing a pilot program originally approved to run through March 2024.
New York City opened two centers in December 2021.
Meanwhile, in Rhode Island it has taken nearly two years to develop a concrete proposal and the pilot program deadline has been extended to March 2026. And although the R.I. Executive Office of Health and Human Services has approved Project Weber/RENEW and CODAC for funding, no finished applications have made it to the R.I. Department of Health as of late April, said spokesperson Joseph Wendelken.
But securing funding from the EOHHS marks one of the most prominent steps forward. The harm reduction center’s allocation will draw from Rhode Island’s January 2022 national settlement with three major opioid distributors, which allocated $90 million to fund state and local efforts to combat the opioid crisis.
While New York has authorized the facilities at the municipal level, Rhode Island’s harm reduction center will be the first state-regulated resource of its kind in the U.S., Daley Ndoye says.
The facilities have attracted opposition in some communities. In California, for example, Gov. Gavin Newsom last year vetoed a bill that would allow safe injection sites in the state, citing a need for more planning.
But Daley Ndoye and other harm reduction advocates point to the existing overdose prevention centers in New York and outside of the U.S. as evidence that the concept saves lives.
In New York City, 613 individuals visited the centers nearly 6,000 times in their first two months of operation, according to a report by the Journal of the American Medical Association Network. Staff members responded to 125 possible overdoses in that time, and so far no one has died at the centers.
Overdoses in Rhode Island have surged in recent years. Confirmed accidental drug overdoses in the Ocean State rose from 308 in 2019 to 435 in 2021, according to R.I. Department of Health data.
In rolling out Rhode Island’s pilot program, the Brown University-based People, Place and Health Collective will collaborate with the New York University public health experts who operate the existing centers to conduct “a rigorous and comprehensive evaluation” of the upcoming center and its outcomes, said People, Place and Health Collective Executive Director Brandon Marshall.
Organizers see potential in the CODAC site for several reasons: in addition to bringing harm reduction services to a critically impacted neighborhood, “it’s currently being operated at a site serving folks who have substance use disorders,” Daley Ndoye said. “It’s a known site, it’s been open for decades, and it is in an overdose hot spot – that’s incredibly important, so it will have an impact on that direct area.”
Additionally, Daley Ndoye says, it has no direct residential neighbors who could raise objections.
Marshall also said the site makes “a lot of public health sense,” adding that the existing CODAC clinic means that the facility is already equipped to provide harm reduction and recovery services.
The extended pilot program, approved in late March, will provide essential time for the Project Weber/RENEW and CODAC facility’s launch and evaluation, Marshall says, and he’s optimistic it will leave time for other applicants to open centers as well.
“The regulations allow for different types of overdose prevention centers, such as mobile facilities, for example,” Marshall said. “So I think it would be possible for other organizations to go through the regulatory and municipal process in that timeline.
“If and when another organization opens another overdose prevention center in Rhode Island,” he said, “we will be ready to evaluate it.”