In Providence, Rhode Island workers spent months renovating a historic, three-story brick building just off Interstate 95 to create the nation’s first state-sanctioned safe-consumption site for people who use drugs. It received its state license — No. 0001 — and held a “soft opening” in January.

The work involved adding a high-powered ventilation system to clear the fumes from people smoking crack cocaine inside a room in a once nondescript office suite on the second floor. Stainless steel booths in the main space offer a sanitary spot for people who inhale or inject illicit drugs, all of which must be obtained elsewhere.

At the center of the room is a nursing station for staff from Weber/RENEW, the harm-reduction organization that owns the building and runs the program, who are trained to quickly revive someone experiencing an overdose. A drop-in center on the first floor provides laundry, showers, hot food and space to rest and charge phones, as well as connections to services ranging from mental health treatment to housing assistance.

Funded in part with money from Rhode Island’s share of a national opioid lawsuit settlement, the program reversed a handful of potentially fatal overdoses in its first few weeks, organizers said. “If they were out in public, who knows what would have happened,” Dennis Bailer, Weber/RENEW’s program director, told NJ Spotlight News in May. “And it’s more than just [safe drug] consumption,” he said. “It’s connecting people to support and these wraparound services.”

“I think it will save so many lives and it would keep people safe,” said Cheryl Robinson, a senior peer outreach specialist with Weber/RENEW who is in recovery herself. “You won’t get found behind a building where nobody cares, where no one even knows you’re back there.”

Video Editor: Laura Galarza

Safe-consumption sites, sometimes known as overdose-prevention centers, are considered one form of harm reduction, a strategy that also includes distributing test kits to determine drug potency, clean syringes and pipes to curb infection spread and the opioid-reversal agent naloxone, or Narcan. The harm-reduction model — now endorsed by multiple medical organizations — has for decades been successful in saving lives and reducing the spread of infection in Europe, Canada, Australia and elsewhere. No drug-related deaths have been reported at staffed safe-consumption sites, according to reports.     

Weber/RENEW’s safe-consumption facility is just the second to open in the United States. It follows a program launched in late 2021 by harm-reduction experts at OnPoint in East Harlem, New York City, who have since reversed nearly 1,700 overdoses. OnPoint’s work is sanctioned by city government and law enforcement and supported by the community but is not codified in state law. Rhode Island was the first to pass a state law permitting safe-consumption sites; several other states have since followed suit, including Minnesota and Vermont.

As part of our Change Project series, NJ Spotlight News examined the safe-consumption model and its potential benefits to New Jersey, which has embraced other aspects of harm reduction in recent years. Drug-related deaths here are now declining, but there were still more than 2,500 fatal overdoses in 2023. State officials have not officially endorsed safe consumption but Health Department leaders indicate they are open to all options to save lives.

Making the argument

Despite the convincing data, harm-reduction advocates say making the case for safe-consumption sites is far from easy. Philadelphia launched an effort to open what would have been the nation’s first program in 2017, following recommendations from experts empaneled by then-Mayor James Kenney. Several advocacy organizations joined forces to form Safehouse Philly, which the city tapped to open multiple sites, according to Safehouse Philly’s vice president Ronda Goldfein, an AIDS advocacy lawyer.

But before a location was identified, the U.S. Justice Department intervened and sought to block the effort during President Donald Trump’s first term. In a 2019 filing, it claimed that a safe-consumption site would violate the federal “crack house” statute, which makes it illegal to own or operate a location “for the purpose of unlawfully consuming controlled substances.” 

‘The biggest thing to emphasize is saving lives. People are dying. They’re dying in your backyard, or they’re dying at the mall, behind dumpsters, or by McDonalds or Dunkin’ Donuts.’

Dennis Bailer, program director, Weber/RENEW

Safehouse argued that the statute related to buying, selling or storing illegal drugs — things it never intended to do — and that safe-consumption sites exist “for the exclusive purpose of providing urgent, lifesaving medical care to those at risk of drug overdose.” In February 2020 the judge agreed. 

Safehouse identified a preliminary location, but as the COVID-19 pandemic emerged, the site’s landlord grew concerned about possible community opposition and backed out, Goldfein recalled. The Justice Department intervened again in May 2020, urging the U.S. Court of Appeals for the Third Circuit — which includes Pennsylvania and New Jersey — to block the project based on neighborhood opposition. In January 2021 the court agreed and efforts to appeal this ruling failed, Goldfein said.

Interest in the project continued to grow, however. In the fall of 2021, Safehouse shifted legal gears and claimed the government was infringing on the religious rights of its leaders and staff by limiting their ability to save lives in keeping with their Judeo-Christian beliefs. The Justice Department argued that, as a nonreligious entity, Safehouse had no standing to make this claim. Several years and motions later, a judge dismissed the case in April.

In September, Safehouse appealed this ruling to the Third Circuit, insisting the District Court was wrong, an argument that has attracted plenty of support. It is not clear what will happen now that Trump is back in office.

Safehouse leaders “believe, based on their deeply held religious convictions, that they have a duty to do everything possible to keep [people who use drugs] alive, even for one more day,” according to their legal claim. Since 2019 — when the government first challenged the project — 7,200 people have died of preventable overdoses in Philadelphia, it notes.  

Building support

In Rhode Island, harm-reduction advocates worked to build support for safe consumption at the local and state levels. Bailer, Weber/RENEW’s program director, said the state’s small size enabled advocates to meet directly with most lawmakers to make a case for the program. Personal experience also came into play.

“Many of our lawmakers have family members or close friends who have gone through the struggle. So that adds some compassion in their minds,” Bailer said. And in that state — unlike New Jersey — public health is largely controlled at the state level, he and others said.

Rhode Island lawmakers passed legislation to create a two-year safe-consumption pilot program in the spring of 2021 and Gov. Dan McKee signed it into law that September. But securing a site to run the program proved to be a greater challenge, Bailer said, and community opposition helped scuttle the first two potential locations. 

“We’ve done so much advocating, going into the community, talking to the neighborhood associations, canvassing, every time we found a spot,” Bailer said. “The biggest thing to emphasize is saving lives. People are dying. They’re dying in your backyard, or they’re dying at the mall, behind dumpsters, or by McDonalds or Dunkin’ Donuts.”

Eventually Weber/RENEW secured the brick building near the highway, which is adjacent to the state’s largest hospital complex. The Providence City Council voted unanimously in favor of the site last winter. Bailer said they now operate a shuttle bus to transport clients from their original drop-in center in South Providence to the safe-consumption site downtown. Robinson, the peer specialist, encourages people who are unsure to make the trip.

Bailer, in recovery himself, said the safe-consumption center can be a bridge to treatment, stable housing and other services. Clients of these programs are 30% more likely to enter treatment than other people who use drugs on the street, he said. The key is to welcome them with love.

“Just because you brought them into the fold, you show that you care. They see their peers living by example,” Bailer said. “Our goal is to keep people alive. And our hope is that maybe they’ll find recovery. But the goal is life. And the hope is that people think there’s a better life in recovery.”

Even in the depths of his addiction, Bailer said he still cherished moments with his family, career advances and life milestones. “Let’s keep a person alive so that we can catch them in those moments of clarity, in those moments when they want to change, and be there for them in those moments,” he said.

This resonates with Robert Budsock, president and CEO of Integrity House in Newark, which has been offering addiction treatment for nearly 60 years and, more recently, harm-reduction services. “It’s important to be open to all the different ways that will lead people to being the best version of themselves and living their best life possible,” he told NJ Spotlight News in June.

“If people remain in dark corners, isolated, that leads to death,” Budsock said. “If they’re surrounded by folks that want to help them lead their best life, there’s a better chance they are going to survive.”

Bailer also hopes his organization’s work in Rhode Island will be a model for other states — just as OnPoint in New York City helped lead the way for them. “I know there are so many other states that can benefit, if we can prove — which I know we will — a benefit to the city, to the state, to the community, to the clientele, to the neighborhoods, to law enforcement, to the emergency rooms, to EMS. We can prove all that,” Bailer said. Trump’s election doesn’t change that goal, he added.

Having the program backed in Rhode Island state law is also important, Bailer said. “I think we opened the door to other locations to do the same,” he added. “And again, it’s about saving lives and giving people dignity. And that’s a great, great fight to be in and a great battle to win.”

Cover photo: Weber/RENEW’s new facility in Providence, location of its safe-consumption center (Lilo H. Stainton/NJ Spotlight News)

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About this project

The Change Project is a part of the Chasing the Dream multiplatform public media initiative from The WNET Group. We are reporting on challenges facing New Jersey in a variety of areas involving social justice and equity, as well as showcasing promising remedies. Our reporting focuses on inequality in many aspects of life, from birth through school to finding an affordable place to live. We are also focusing on what has worked elsewhere to make life better for people, and what lessons we can learn for the future. 

Major funding for The Change Project and Chasing the Dream is provided by The JPB Foundation

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