Somerville Supervised Consumption Site
The City of Somerville is currently exploring the possibility of opening a local supervised consumption site (SCS) to address the ongoing impacts of the overdose crisis. In 2021, the City conducted a needs assessment and feasibility study, which recommended the establishment of at least one SCS in Somerville that includes harm reduction and support services for people who use drugs.
In 2022, the City contracted with Fenway Health to develop a conceptual design, explore location options, and engage the community in the process. Fenway Health is a community health center that provides harm reduction, overdose prevention, and health services to people who use drugs.
What is a supervised consumption site?
SCSs are harm reduction interventions that have been implemented in more than 10 countries, including Canada, Australia, and across Europe, to prevent fatal overdoses and connect people to services. People who use drugs are allowed to consume substances in the SCS under the supervision of staff who can intervene in the event of an overdose or other medical emergency.
Often, additional services like basic health care, housing support, and recovery resources are also offered at an SCS. To date, there have been no reported drug overdose deaths in an SCS anywhere in the world.
Community Meeting Videos
June 1, 2022 (Community forum with Fenway Health)
July 22, 2021
July 13, 2021
June 10, 2021
Questions & Answers
Questions that could not be addressed during the events above due to time constraints are answered in the links below. Please note that some questions have been reworded to use de-stigmatizing and person-centered language.
Harm Reduction and Outcomes
1) Would you consider the site effective if people who use drugs were not interested in further treatment?
The aims of SCS are to reduce the risk of fatal overdose and connect individuals to needed health and social supports. While some of these supports include treatment, it is not required that individuals accessing the SCS engage in treatment. Ongoing monitoring and evaluating of the site should include a range of metrics to assess effectiveness, including topics focused on the accessibility and usefulness of the site for people who use drugs (e.g., meeting needs, hours of operation accessible, services needed are offered), health outcomes (e.g. impact on overdose, HIV and hepatitis C infections, linkages to treatment), and community impacts (e.g. impact on publicly discarded paraphernalia, impact on public drug consumption).
2) What is different about SCS than what harm reduction agencies are already doing?
Currently, there are no harm reduction agencies operating out of permanent facilities (i.e. brick and mortar) in Somerville. While there are some services offering medications for opioid use disorder, access to harm reduction supplies and supports for people who use drugs are variable and often conducted through street outreach. An SCS would provide a permanent space where people could access harm reduction supports, as well as a range of wraparound services that meet their needs. It would also provide a space where drug consumption would be monitored under the supervision of trained staff who could intervene in the event of an emergency like an overdose. No services currently offer these types of supports.
3) If people want to know why people who use drugs don’t engage in treatment, does the task force make clear that not all people who use drugs are ready for treatment, but this can be a way to make contact?
As part of phase two of this work, the Task Force will lead community engagement and education events. Part of that work will include discussions related to harm reduction and the needs of people who use drugs, and how SCS can facilitate connections to care.
4) Why are we doing this when overdose deaths are falling statewide, and are low in Somerville?
While fatal overdoses have decreased in Somerville since 2018, fatal overdose surveillance data for 2020 is provisional and subject to change. Moreover, the Somerville police and fire departments respond to more than 100 overdose-related calls each year. These data suggest that overdose remains a major public health crisis in Somerville, and the city currently lacks supports for people who use drugs. SCS are one public health intervention being considered by the city as critical for minimizing fatal overdose rates.
5) The study draws a correlation between increased HIV cases and illicit drug use, and identifies that within the Commonwealth, large outbreaks have been observed in Lowell and Lawrence. Further, Somerville has been identified as a preferred location for SCS, given public access to transportation, however there are no direct commutes using public transportation from either of these locations. In viewing the broader social benefit to the Commonwealth, would another location within the State provide better accessibility?
While Lowell and Lawrence have faced significant upticks in HIV cases recently, this needs assessment and feasibility study was conducted only to look at Somerville specifically, with recommended siting of an SCS in Somerville being guided by access to public transit. However, research has shown that people do not tend to travel more than 20 minutes (or approximately one mile) to use an SCS and therefore it is unlikely people would travel from these other cities. It is important for other cities and towns across Massachusetts to consider a range of public health interventions to address the health needs of people who use drugs, including SCS, where appropriate.
6) The study presents data reflecting East Somerville to be the preferred location to establish the SCS, yet historically this area has been underdeveloped for residential and commercial economic benefit. Have, or will, considerations be taken to ensure economic equity in terms of the location of the site(s) relative to other Somerville locations?
As part of the recommendations in the report, it has been advised that the City undertake a transparent site selection process to identify potential locations for an SCS in Somerville that is inclusive of a range of stakeholders. During the site selection process, as well as ongoing dialogue opportunities related to the SCS, this would be a critical point to highlight.
7) Are the cities where the sites are located comparable to Somerville: population density, racial diversity, types of businesses?
SCSs can be found in a variety of communities from large cities like Amsterdam and Vancouver to small rural communities that are served by mobile units.<
8) Please discuss the concept of 'safe zones'. Will public drug use be allowed in safe zones?
Communities tend to see a decrease in public drug use when an SCS opens. Public drug use would still not be allowed when an SCS opens.
9) What is the average number of visits per day per location?
It varies widely by location, but one study looking at SCS in Europe found they could see anywhere from 25 to 400 clients depending on the site.
10) What are our plans for dealing with the violence and property destruction that will result from a greater number of people who use drugs and people who sell drugs being drawn to Somerville?
Existing research on SCS have not shown an increase in violence nor any impact to property following the implementation of an SCS. In fact, research has shown that SCS enhance public order and public safety in the neighborhoods in which they are located. Further, research has shown that individuals do not generally travel further than 20 minutes (approximately one mile) to access SCS, so it is unlikely that Somerville would experience an increase in the number of individuals coming to the city to use the site.
11) Is the impact of a freestanding site on local business/neighborhoods the same as a site embedded in an existing health care or resource center?
Most supervised consumption sites are not part of existing health care or resource centers, but rather house some of those services themselves. Part of what we've learned from talking to potential users of the site is that they'd feel more comfortable using a stand-alone SCS. That being said, we imagine the effects would be the same as have been found with other SCS - reductions in crime, public drug use, and discarded needles in the area, reduction of loss of life, and an increase in people accessing treatment and other services.
12) What conversations, if any, have you had with local and state prosecutors and other members of law enforcement?
No specific outreach was conducted with law enforcement as part of this needs assessment and feasibility study. However, these conversations may have been undertaken by the City outside of these study efforts. Next phases of this work will include outreach to a range of stakeholder groups in Somerville, including prosecutors and law enforcement, that will be led by the City and the Somerville SCS Task Force.
Fenway Health Report
In December 2021, the City of Somerville hired Fenway Health to further explore key questions raised in the 2021 Needs Assessment and Feasibility Study. The final report is available below.
Somerville Supervised Consumption Site - Needs and Feasibility Final Report
A summary of the 2021 needs and feasibility study results is shown below. The full report is also available for review.
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