Close the bathroom door at Supportive Place for Observation and Treatment (SPOT), and you have two minutes and 50 seconds. Then the alarm sounds, warning staff to check on the person inside. People sometimes inject drugs in SPOT’s bathroom, just as they do in the bathrooms of Starbucks or McDonald’s. The longer you wait to reverse an overdose, the harder it gets. SPOT, run by Boston Health Care for the Homeless, has had to shorten that window, from five minutes, to four, to three, and now, to two minutes and 50 seconds — even a 10-second margin means life or death.
Many people use drugs far from the clinicians who could save their lives if they overdose. And the drugs they use have become more lethal — fentanyl, a synthetic opioid many times more potent than heroin, is now common throughout Massachusetts. People die within minutes after injection. SPOT cares for people who’ve already used. But, it would be better to have clinicians present during the life-threatening moments of and right after drug use.
Supervised injection facilities (SIFs) would provide people more support and clinical care in those most vulnerable moments. SIFs are facilities where people can use drugs under clinical supervision. None currently exist in the United States (with the exception of one underground SIF), but they’ve operated for years in Canada, Europe and Australia. Advocates and lawmakers in the U.S. want to establish SIFs here, too. They meet a need that facilities like SPOT can’t.