From Student Proposal to Board of Health Endorsement: How a Decade of Advocacy May Bring Worcester's First Overdose Prevention Center

A new approach to addressing the opioid pandemic may soon be coming to Worcester. And along with it, an example of advocacy may be coming to fruition.

Supervised injection sites offer a location for people with opioid use disorder to use drugs with an added layer of safety – with a medical professional close by and ready to administer a lifesaving antidote if someone needs it – to reduce the risk of deadly overdose. For this reason, these sites are often called overdose prevention centers (OPCs).

In Massachusetts, the idea of OPCs has been percolating for over a decade in medical circles, even as public discourse began focusing on rising opioid use and overdose deaths. With examples of harm-reducing safe injection sites in Europe and in Canada, a group of medical students from across the Commonwealth, including UMass Chan, joined with leaders of the Massachusetts Medical Society (MMS) in 2016 to propose the policy that the MMS support supervised injection sites.

The MMS represents over 25,000 physician members and has a loud and strong voice on public health, healthcare delivery, and other issues related to doctors and medicine. Incorporated in 1781, the MMS has long supported medicine and public health through policy advocacy and medical education, including publishing the New England Journal of Medicine. In working through the MMS to support supervised injection sites, the students of UMass Chan and their colleagues were asking one of the oldest and most prominent medical societies in the country to support a progressive, patient-focused harm reduction strategy to help protect the lives of our patients and neighbors.

The proposal from UMass Chan students and their collaborators went before the members of the MMS House of Delegates, an assembly similar to Congress, which debated the merits and practicality of the proposal and, after a year of further debate and consideration, eventually adopted the group’s recommendation. The MMS now had a formal policy stating its support as a physician-led organization for the establishment of supervised injection sites in Massachusetts. It also promised to study how to make these sites legal and sustainable in the Commonwealth and to evaluate patient outcomes.

With the full weight of the Medical Society behind the idea, members of the MMS began advocating to the public, politicians, and policymakers. The President of the MMS wrote national articles. Prominent physicians advocated in local media through the Boston Globe, WBUR, and other outlets. With strong support from Massachusetts, the American Medical Association joined in the advocacy effort and also endorsed OPCs as a harm-reduction means to combat opioid overdose deaths.

Years of advocacy, starting with a resolution proposed by medical students nearly a decade ago, have led to the recent vote of the Worcester Board of Health which will now “support the reduction of overdose deaths in the city…[and] approve the creation of an overdose prevention center…” Local champions of this initiative have been working to reduce overdose deaths in Worcester for decades and now the City is poised to move forward with something that was once thought a radical approach. But with years of advocacy from students, physicians, community organizations, and physician groups like the MMS and the Worcester District Medical Society (WDMS), we will hopefully see a meaningful effort to prevent overdose deaths and bring treatment to a much-needed patient population.

The story of OPCs in Massachusetts is not complete, but it is inspiring. It shows how even “radical” ideas to improve patient care can come from anywhere – even from students nearly a decade ago. By collaborating with powerful stakeholders, such as local, state, and national medical societies (WDMS, MMS, AMA), an idea can gain the support it needs to become a reality. Many of those invested in preventing overdose deaths will be watching – and advocating – to see the Commonwealth’s first OPC come to reality in Worcester.

Patrick Lowe MD, PhD Chief Resident Department of Emergency MedicineMassachusetts General Hospital Brigham & Women’s Hospital PLowe1@bwh.harvard.edu