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US Excess Deaths Continued to Rise Even After the COVID-19 Pandemic

Erin Johnston
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Student Receives 2025 Pulitzer Center Reporting Fellowship

People at Risk of Overdose Willing to Use Safe Consumption Spaces.

June 13, 2019
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Woman disposing of syringe after self-injectionA majority of people who use heroin, fentanyl, and illicit opioid pills would be willing to use safe consumption spaces, according to a new study co-authored by a School of Public Health researcher. About 77 percent of the participants in the study, published in the Journal of Urban Health, reported their willingness to use such facilities, where they could receive sterile syringes and, in case of overdose, medical support.

“This study is an important first step in exploration of safe consumption spaces in these three cities,” says study senior author Traci Green, associate professor of community health sciences at SPH, associate professor of emergency medicine at the School of Medicine, and adjunct associate professor of emergency medicine at Brown University.

“Rigorous and measured scientific approaches to new innovations like safe consumption spaces can help inform policy and better equip public health responses to the opioid crisis.”

Safe consumption spaces, also called safe injection facilities and overdose prevention sites, are a proven method to reduce the harms stemming from opioid use disorders, according to the study. Countries outside the US have used them for more than 30 years. However, there are no legal safe consumption spaces in the US due in part to a federal law that creates a serious criminal liability for anyone knowingly connected with a property for illegal drug use. Policymakers in Massachusetts, Rhode Island, and a few other states are pursuing legislation to make safe consumption spaces viable options for stemming the ongoing opioid overdose epidemic.

The researchers surveyed 326 people in Providence, Boston, and Baltimore who said they had used opioids—including heroin, fentanyl, and opioid pills—non-medically in the past 30 days. Of those surveyed, 68 percent of the Providence participants, 84 percent of the Boston participants, and 78 percent of the Baltimore participants said they were willing to use a safe consumption space.

Willingness to use these spaces was even higher—84 percent—among people who primarily used opioids in public spaces such as streets, parks, and abandoned buildings, according to the study.

When asked what could hinder use of a safe space, 38 percent said fear of arrest and 36 percent pointed to privacy concerns.

Of the people surveyed, almost 70 percent were homeless, and 60 percent reported habitually using drugs in public or semi-public places. More than a third reported having experienced an overdose in the past six months, and 73 percent reported recent use of a drug they suspected had contained fentanyl, a synthetic opioid that is much more potent than heroin and implicated in an increasing number of fatal overdoses.

“On the whole, we found a strong willingness to use safe consumption spaces,” says study lead author Ju Nyeong Park, an assistant scientist at Johns Hopkins Bloomberg School of Public Health. “It’s encouraging because even though these are people engaging in very high-risk behaviors in very different contexts within these three cities, they were willing to use this harm-reduction intervention.”

The Bloomberg American Health Initiative and the National Institutes of Health supported the work. The other co-authors were: Michelle McKenzie and Brandon Marshall from Brown University; and Susan Sherman, Saba Rouhani, Kenneth Morales, and Sean Allen of the Johns Hopkins Bloomberg School of Public Health.

Explore Related Topics:

  • addiction
  • opioids
  • overdose
  • safe injection
  • substance use disorder
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