“I think that this is going to be an experiment for a lot of people, to see if it’s going to work—which we know it will.”
Filter By Marilena Marilena,
Providence, Rhode Island became the first OPC sanctioned and operated by the State of Rhode Island in January. The site was opened by Project Weber/RENEW, a harm reduction provider, with the support of its clinical partner VICTA. It also includes a drop-in centre and offers substance abuse treatment.
Filter quoted Ashley Perry as saying, “I feel really proud about the work being done in Rhode Island.” Ashley Perry is PWR’s vice director and OPC Co-Director.
“None of this would have been possible without our strong peer workforce,” she continued, referring to their role in the advocacy coalition behind the OPC legislation—”a lot of people who are running recovery centers, a lot of people who are in recovery, but also a lot of harm reductionists. Some people have changed their work from being recovery focused to focusing on harm reduction. Without these [advocacy] “I’m not certain that there would be an overdose prevention centre in the forums.”
Near the Rhode Island Hospital is a site where people can bring their drugs and use them. There are also resources for overdose prevention, as well as trained staff, to make sure they stay safe. PWR offers harm reduction education and supplies, as well as a drug checking service. It also helps with basic necessities like food and clothes. VICTA (an opioid treatment provider) provides some medical and nursing services, as well as behavioral health. They can refer patients to Suboxone or methadone programs in a nearby location. The treatment of substance abuse is offered on request, but it’s not forced on anyone.
We are, I believe, the only OTP in Rhode Island who supports the Modernizing Opioid Treatment Access Act. This would allow any certified addiction medicine practitioner to write an a [methadone] VICTA CEO Lisa Peterson explained to Filter, “A prescription must be filled by a pharmacist.” “There’s a lot of backlash in the OTP community around that, but I think this is a lifesaving drug… And I think that we help perpetuate the discrimination that’s occurring by continuing to insist that we’re the only ones who should manage this.”
Even so soon after the OPC opened, PWR, VICTA and other advocates are working with lawmakers in hopes of removing a sunset clause in the Rhode Island legislation that authorized the sites—a ticking time bomb that could potentially end operations by March 2026.
Katelyn Berryhaume, Prevention Coordinator at AIDS Care Ocean State told Filter, “It will take a great deal of data to prove that this works”. “That is one aspect that I wish wasn’t as strict, because seeing change can take time.”
In 2021, more research is planned on the outcomes of two OPC sites sanctioned in New York City and Rhode Island.
Early February, I interviewed Ashley Perry, the co-director of Rhode Island OPC. In the video, you can watch a part of our conversation. The rest of our interview (which was edited to make it shorter and clearer) discussed the origins of the website, the early days of its operation and the users’ needs.
Marilena Marchetti (Filter): How did the first opening go?
Ashley Perry: I’d say it has been two and half crazy weeks. We took a long time to arrive. We have already served more than 70 people.
MM: How can people access the OPC as a user?
AP: There’s really not a process—it’s very low-barrier. Someone could come through the main door, tell someone they wanted to see the OPC and then go. [on the second floor]. They would be able come in, take an inventory and then do their job.
Our overdose center is staffed by six people. Hours are between 9 and 5. Our capacity is 16 participants. Eight booths are available for other methods of inhalation. We have two rooms for inhalation, with four people per room.
MM: Who does your new OPC serve?
AP: There’s a real mix in terms of ethnicity, race and gender. Project Weber/RENEW was originally a small group of sexworkers. Many sexworkers are seen here. The only male-only drop-in centre in the country is located here. There are a large number of LGBTQ people and trans individuals.
Right now it is still early to tell [how many participants the OPC will ultimately have]Project Weber/RENEW as a group serves about 6,000 people each year. We serve 3,000 clients a day in the Providence office.
MM: Soon, anyone can use the drug testing machine on your site. Are drug checks a high priority to your participants?
AP: Many harm reductionists believe that we have missed our mark with drug checks. As soon as we saw fentanyl or xylazine, it was time to start drug-checking people. People are now addicted and have a tolerance for these drugs.
So for some people, no. Yes, for some. Recreational users will often come to the store to get a test of whatever they plan to bring to a party, rave or other event. Rhode Island is a college town, so we’re used to seeing a large number of students come in for products like fentanyl testing strips. People are also looking for things such as psilocybin tests strips.
Our normal clientele is not the same as those who are looking to be drug tested. Drug checking will take place on the ground floor, making it easier for everyone. It will be optional for those who go up to OPC to use the OPC.
COBRE has partnered with us to supply us with an equipment, which they have been training staff in how to use. This is exciting news for us.
MM: What is the service that has the greatest demand, or growing demand?
AP: People always want safe places to go. Someone who can provide a warm meal for people. Our people really struggle on the streets. The number of homeless people in Washington has tripled over the last three years. There are more houses than ever before, but they’re not enough. Many of the drug-using people we work with are often left out.
You’ll see people on couches and cots if you come downstairs, as they probably haven’t been able to sleep all night. In our entire city, we see an ongoing war against homeless people. The people are going further and farther into the woods to ensure they don’t get kicked out. We often see people die after being kicked from encampments.
Despite the fact that we now have an overdose prevention centre, the goal is to get Narcan and education to those who are most in need. It has become very difficult in the last couple of years to provide this service. In some cities near us, ordinances have been passed to make it possible to arrest those who are homeless on public or municipal property. Then here in Providence we’re allowed to have an OPC. Our work in Pawtucket, however, is continually attacked by the law enforcement agencies out there. We find something new everywhere we travel.
MM: What is the relationship between you and the local police?
AP: Our former police chief was on the board. Because they aren’t, I won’t say the police officers here are perfect. Most of the time, however, police don’t like to arrest someone for minor offenses such as having crack in your pocket.
The police officers in Providence have taken our concerns into consideration. Maybe on other issues. Yesterday the chief of police and mayor gave a tour to mayors in New England. Some other police chiefs had asked him how the police felt. Our chief was like, “These people have a great reputation in the community…I’m proud that we’re able to support this work.” The relationship between us and them will hopefully continue to develop in this way, with them referring to our services instead of bringing them to prison.
I can’t believe that me as a person is saying this—I’ve been arrested by Providence police a number of times. However, they are trying something different and I really appreciate their willingness to be open-minded. We know that what we have been doing over the past decades is not working.
MM: What is the reason that Providence, the first Rhode Island City to have an OPC and Rhode Island as a state has just sanctioned it?
AP: We have a recovering mayor. Our mayor is a man who knows what he’s doing. We have councilors in this city who are committed to the work we do. We believe we are saving lives. It’s evident when visiting the encampments.
The following are some of the ways to get in touch with us: [PWR] I have now been in this place for thirteen years. If we were wearing backpacks [with harm reduction supplies] Drop-in Centers. Here in Providence, I feel that we have really established ourselves. Here, we have a good team of leaders who are committed to research and real results. This is critical to us.
Other places don’t share the same level of leadership. In almost any city in Rhode Island, I could never have imagined opening an overdose-prevention center with the approval of city council.
The mayor of Woonsocket proposed a ban on OPCs in his city when the OPC bill passed. They’re now the top overdose hotspots in Rhode Island. Leaders who are not committed to science and facts do not have a good leadership style.
MM: The site you have chosen is part of an integrated medical campus, which includes Rhode Island Hospital as well as Brown University Health. Which factors were considered when choosing the location?
AP: We need to get the City Council’s approval before we can move into any new location. Other locations were found that maybe didn’t make the most sense for our neighbors. It was important to us that the space we opened would not be a place that neighbors were likely to object to from day one.
Referrals are made by the hospital to us. Sometimes people come straight from emergency rooms for overdoses. Referrals can be made for frequent flyers who visit the ER to fall asleep.
Referrals are made to our office by the hospital, and people will be discharged in the morning after we have opened. Not only for our OPC, but also to wraparound services we offer, such as basic case management and HIV testing. We can connect people with housing and care. The majority of people in emergency departments who are homeless or who abuse drugs are doing so because they want to feel safe.
Just up the road was our original drop-in centre that only served male sexworkers. Many people believe that this area is not very busy, but it’s actually not true. It’s a few blocks away that you can find a great deal of nightlife. Our strip clubs can be found here. This is where you’ll find the male strip. That’s the place where most of our male sexual workers work.
On the other side of the street, we can see many female sexual workers. We are really in the middle of it all. You may not realize that if you don’t know the place. The public is expecting to see more panhandling on the streets. It’s a little discreet in Rhode Island. There are a number of people who engage in sexual work and other activities, but you wouldn’t be aware if they weren’t.
MM: VICTA runs methadone treatment clinics. What is the nature of that partnership?
AP: VICTA is a non-profit organization that has rented a space in the basement. A behavioral specialist is there to determine a patient’s health status. The full-time staff nurse is there. We’re partnering with them to provide the medical services that we as a team cannot provide, including basic wound care and antibiotics. The OTP is doing some amazing work in their methadone clinic at home on Elmwood Avenue. It’s an honor to have the opportunity to work with this OTP.
We’re trying to close the gaps in our knowledge of methadone. We can take someone to VICTA Elmwood today if they want to start methadone. This is the way harm reduction should look. They’re being flexible.
As of yet, we are not in a position where services must be billed. This amazing grant from the opioid settlement fund allows us to cover our provider’s time for this year without billing. The providers can spend more time building relationships within the community. This is something I am extremely proud of because it’s exactly what we are trying to achieve right now.
VICTA is treating hep C here. We haven’t yet enrolled any patients in this program because it’s so new. In the future, I hope to provide basic primary health care, however that might look, and whatever it is people may need. Our people often don’t have primary care.
MM: VICTA is a leader in opioid treatment, but it’s also a pioneer when it comes to harm reduction and respecting the autonomy of drug users.
AP: VICTA’s desire to change things has been a constant throughout its history. Their COO [Lisa Peterson] Was actually the one who pushed for it. [the OPC] She is really a harm-reductionist. She is interested in seeing harm reduction efforts. Not punishment, but holistic care is their main focus. The goal is not to have people stay on methadone for the rest of their lives.
There are a lot of methadone treatment centers here. However, two of them have high overdose rates. People are still taking drugs. You can also find out more about the following: We’re using methadone to help people stay away from fentanyl because we don’t give them a dose high enough. The clinics also have a strict policy on split dosage.
Methadone was supposed to be a gold standard in harm reduction, but it is not focused on what a patient needs. It’s something I see over and over: people will say “I take methadone but I am all over the map by two in the afternoon.”
You can give them an insane split doseKnow what? Two doses is enough! Outside methadone clinics, people are using and even dying. It’s a nationwide problem. The time has come to make a statement. Why not?? Why does this happen? It’s not something we discuss because methadone is the main source of income for many states.
MM: What lies ahead for Rhode Island Would the state be able to decriminalize drug use, as Oregon has?
AP: My team and I want to see total drug decriminalization. Perhaps not within the next two years but later on. I think that this is going to be an experiment for a lot of people, to see if it’s going to work—which we know it will. Our lawmakers are reassured that something like this could happen. It then says “Okay this is what you need to do for Providence and for Rhode Island as a whole.”
Also, we are making progress. The timing is important, I think.
It’s hard to reduce harm, I always tell people. The fight has never been an easy one. It’s important that we find someway to get past this. We just have to support each other this time. We will keep going.
This article originally appeared in Filter magazine, a website that covers drugs, drug policies, and human rights from a harm-reduction perspective. Sign up to receive Filter’s newsletter and follow them on Bluesky or Facebook.
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Jernej Fuman provided the photo.