Do overdose prevention centers work? First U.S. study seeks answers.

The federal government wants to learn the impact of the few U.S. facilities where people can use illegal drugs under the supervision of staffers trained to reverse overdoses, officials announced Monday.

The four-year, $5.8 million federally funded study could one day help government and community leaders decide whether to establish their own overdose prevention centers, which are aimed at curbing deaths but have also drawn concerns that they enable drug use and crime.

The study was announced as overdose prevention centers, also called “supervised injection” or “safe consumption” sites, have struggled to garner widespread support in U.S. communities in the face of a drug crisis killing over 100,000 each year. Nearly 200 sites operate in 14 countries, but efforts to establish U.S. sites have fizzled - critics say they are illegal under a federal law that prohibits knowingly maintaining a place “for the purpose of manufacturing, distributing, or using a controlled substance.”

“This research is urgently needed to inform policies that can best support public health, as more jurisdictions across the country consider” overdose prevention centers, Magdalena Cerdá, director of NYU Langone Health’s Center for Opioid Epidemiology and Policy, said in a statement. The center which will conduct the study with Brown University in Rhode Island.

The study, funded by National Institute on Drug Abuse (NIDA), will measure whether participants in government-approved overdose prevention centers in New York and Rhode Island experience fewer fatal and nonfatal overdoses and other health problems and are more likely to seek treatment for substance use disorder. The study will also assess potential savings to health-care and criminal justice systems, and even how the centers affect crime, litter and the opening and closing of local businesses.

“If you’re avoiding an overdose, then you’re saving money from not having to call an ambulance, saving money from that person not ending up in the emergency department,” Nora Volkow, NIDA’s director, said in an interview. “Without research, it’s very difficult to understand the cost effectiveness of these interventions.”

Last week, the Pennsylvania Senate overwhelmingly passed a bill that would ban overdose prevention sites in the state as a proposed Philadelphia program remains mired in litigation with the Justice Department. In Colorado, legislators last month killed a bill that would authorize such centers. Saying “worsening drug consumption” was too risky, California’s governor last year vetoed a bill that would have allowed sites in three cities.

The Biden administration embraces harm reduction efforts, including the widespread use of the overdose-reversal drug naloxone, but has not endorsed overdose prevention centers. None of the federal study money will go toward operating the sites.

Even though studies have shown overdose prevention facilities work in other countries, it’s unclear what the data will show in the United States, a diverse country with a drug supply dominated by the deadly synthetic opioid fentanyl. “The types of drugs people are being exposed to in the United States are much more dangerous,” Volkow said.

To analyze health outcomes, researchers hope to interview and follow 1,000 participants who use drugs - people who go to the sites and others who don’t.