Residual Questions from Town Hall 6_10_2021 — File 212153

Community Meeting - additional questions Below are questions from the Community Meeting held June 10th, 2021 discussing the release of a needs assessment and feasibility study on supervised consumption sites (SCS) in Somerville that were unable to be answered due to time constraints. 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.

Location 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 under developed 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. Community impact 7. 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. Outreach 8. 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.