Commentary: Overdose prevention centers will save lives in New Hampshire

Needles on the pavement
Overdose prevention centers are safe locations where drug users can use pre-obtained substances under medical supervision. (Jeff J Mitchell | Getty Images)

Based on the Centers for Disease Control and Prevention’s latest provisional data on drug poisoning deaths, it is projected that the United States may be losing 90,000 American lives to drug poisoning every 12 months.

The disproportionate impact of the COVID-19 pandemic on marginalized populations is not new news. The impacts of isolation and economic hardship only added to the existing struggles of people living with a substance-use disorder over the past 14 months. There are many factors involved in such drastic spikes in overdose rates. But what we know with certainty is that with a comprehensive harm-reduction strategy, all drug-related death and disease is preventable.

After being hit early and hard by the overdose crisis, in the face of increasing drug deaths, Gov. Chris Sununu signed Senate Bill 234 into law in 2017. This bill legalized syringe services programs, otherwise known as needle exchanges, or harm-reduction programs. For the past three years, the Granite State has seen overdose rates decrease while the rest of the nation has faced alarming increases. This trend is aligned with over 30 years of research demonstrating the efficacy of harm-reduction programs.

While the nation’s overdose rates may have increased by as much as 27 percent in one year during the COVID-19 pandemic, New Hampshire responded by expanding essential harm-reduction services, reducing barriers to substance-use treatments like buprenorphine through telemedicine, increased the supply of cost-free naloxone, and affirmed that drug use is a health issue, not a criminal issue.

The New Hampshire Senate recently rejected a proposal for a new program that we believe is critical to the state’s fight against the ongoing syndemic of overdose, homelessness, addiction, viral hepatitis, and COVID-19: a harm-reduction and overdose-prevention program in the state Department of Health and Human Services.

The New Hampshire Providers Association, representing alcohol and other drug service providers, strongly supports this section of Senate Bill 149 and urges the House of Representatives to reconsider the Senate amendment that removed it. At the very least, SB 149 should keep Part 3 of the bill to allow for a study commission or academic pilot program to better understand the impacts of bringing a legal overdose prevention center to New Hampshire, similar to the work that led up to legalized syringe services programs in 2017.

Our association and our members believe that a harm-reduction program would help us make measurable progress in reducing overdose deaths in New Hampshire.

Overdose prevention centers are safe locations where drug users can use pre-obtained substances under medical supervision. Staff are present to provide first aid, administer naloxone, and sometimes oxygen if an overdose occurs. More than 120 of these facilities operate in 10 countries, many of which have been in operation for decades and supervised millions of injections. No one has ever died in one of these programs. Evidence shows that participants in harm-reduction programs are three times more likely to stop injecting and five times more likely to enter substance-use treatment.

In the past three years, nine U.S. states have considered legislation to authorize and implement overdose prevention centers and at least nine major cities are considering such models to help address the overdose crisis at the local level.

There is no universal roadmap for implementing harm reduction, which means that local communities and states can adapt the model to meet their own needs. The harm-reduction model saves local governments significant amounts of taxpayer dollars when overdose deaths and infectious disease transmission are removed from health care costs. It also helps to reduce crime. A study focused on San Francisco found that one overdose prevention center in that city would result in a net savings of $3.5 million per year; a similar study focused on Baltimore estimated an annual net savings of $7.8 million.

The philosophy behind the harm-reduction model is that it makes more ethical and economic sense to acknowledge the dignity and humanity of people who use drugs and bring them into a community of care. Moving away from a punitive approach to drug use reduces stigma and focuses on the health care, behavioral, and societal issues that need to be addressed in our communities.

We are losing at least 80,000 Americans every 12 months to drug poisoning: 80,000 people whose needs were not met; 80,000 policy failures and casualties of the war on drugs. These deaths could have been prevented if there was a comprehensive harm reduction approach.

New Hampshire needs to be forward thinking and authorize this proven and realistic strategy. It is possible to have zero overdose deaths in New Hampshire, and that strategy includes legal overdose prevention centers.