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Commentary COVID-19 in Maryland

Opinion: Prevention Sites Can Help Reduce Overdose Deaths

A fentanyl test kit distributed for free by an organization in Baltimore. Photo by Ian Round/Capital News Service.

Over more than half a decade, Maryland has lost more than 10,000 lives to overdose. Like so much else, the COVID-19 epidemic has exacerbated this crisis. In Maryland, drug- and alcohol-related deaths spiked over 12% since the onset of the pandemic. This is not surprising. For many of us, the pandemic has increased stress, anxiety, isolation and loneliness – all of which are risk factors for experiencing overdose.

This is our reality now, but it doesn’t have to be our future.

One crucial step we can take is to pass a bill currently before the Maryland General Assembly.

HB396/SB279, introduced by Del. Joseline Pena-Melnyk and Sen. Shelly Hettleman, authorizes the creation of overdose prevention sites in Maryland, a sensible and heavily researched approach to reduce overdose deaths and to help people get connected to health care. We often say that every overdose death is a policy decision, so we need a policy solution.

We have worked with people who use drugs and in various stages of recovery – defined by the individual – for more than 15 years combined. People are more likely to overdose when they use alone – and no one deserves to die of an overdose. Allowing community groups to open spaces, where we can make sure no one uses alone, will reduce overdose in our neighborhoods. Overdose prevention sites are essential for accomplishing the goal of healthier communities, which is a goal all of us share.

There are more than 150 OPS currently operating in 12 countries, and many have been operating for decades. These sites are low-barrier facilities that provide people who already use drugs a safe place to use. They provide access to clean supplies and treatment services, and trained staff are on hand to offer life-saving interventions in case of an overdose.

By meeting people who use drugs with kindness and understanding, we can build mutual trust which is a necessary ingredient for any caring relationship. Through relationships we can offer a safer experience and connections to the other resources someone might need, such as housing and health care services.

These sites are not only helpful to people who use drugs and their loved ones, there is also a positive impact on the entire community. Rather than using drugs on street corners, vacant lots or alleys, people would be able to consume them inside, in a place that is warm and welcoming while also being safe for the surrounding neighborhood.

If this is hard to imagine, consider the experience of receiving a COVID-19 vaccination.

When we had the opportunity to receive the first dose of the vaccine, we were greeted warmly at the site and checked in. We then received our vaccine in a sterile environment and proceeded to a supervised waiting area where staff helped make sure we didn’t experience any adverse reactions. This setup is very similar to what you would experience in an overdose prevention site: a registration and welcome area, a clean and comfortable environment, and staff on hand to offer observation and support.

Overdose prevention sites can help us prevent avoidable deaths.

Since Barcelona improved its system of care for people who use drugs, including opening overdose prevention sites, the city’s overdose deaths decreased by more than 60%. The sites in Maryland will have naloxone – the opioid overdose reversal medication – as well as clean syringes and test strips to gauge if fentanyl, a powerful synthetic opioid, is present. The sites will also offer access to HIV and hepatitis C counseling, testing and treatment. The sites will have case managers and referral networks to make the connection to medication assisted treatment, recovery coaching and other specialized services for people who use drugs.

Baltimore Mayor Brandon Scott expressed his full support for this bill during a hearing at the Senate Finance Committee, noting that we experience more overdose deaths than gun violence fatalities each year.

“Think about the gravity of that pain and trauma that each one of these people [who dies of overdose] leaves behind for their family and community,” he stated in his testimony. “We have to accept that the way that we’ve dealt with people who use drugs and the ways that we’ve attempted to address the issue are not only wrong but have not worked to save lives.”

We urge the General Assembly to pass HB396/SB279. It is clear that overdose prevention sites can save lives, save money, improve communities and help people who use drugs gain access to other life-saving resources.

All residents of Maryland deserve nothing less.


The writers are, respectively, director of education and a member of the community outreach team at Baltimore Harm Reduction Coalition. Smith can be reached at [email protected]; Kerr can be reached at [email protected]. Both are members of BRIDGES, which advocates for policies to help end overdose and the criminalization of people who use drugs.


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Opinion: Prevention Sites Can Help Reduce Overdose Deaths