BOSTON (AP) — The idea may seem jarring at first: Creating safe spaces where drug users can shoot up under the watchful eye of staff trained in helping counter the effect of potentially fatal overdoses — all with the approval of public health officials.
But the terrible toll taken by the state's opioid battle in recent years have prompted some lawmakers, activists and medical groups to endorse the idea of "supervised injection sites" as another way to reduce overdose deaths.
Among those skeptical is Republican Gov. Charlie Baker, who said he doesn't see the sites as gateways to treatment.
At a public hearing Tuesday about a bill he filed to help ease the state's opioid abuse crisis, Baker was asked about the possibility of the sites — something not included in his legislation.
"As far as the data I've seen is concerned, it has not demonstrated any legitimate success in creating a pathway to treatment," Baker said. "The harm reduction argument I think is a much better one, but I'm kind of a hard sell on that one."
The Massachusetts Medical Society and the Massachusetts Hospital Association back the idea.
In a report released last year, the medical society found supervised injection sites can reduce overdose mortality and increase access to drug treatment. Much of the research is based on two sites in Canada and Australia.
The report called for the creation of a pilot supervised injection facility program in Massachusetts. The group said the state should seek an exemption from federal drug laws to pursue the pilot program and consider partnering with other states.
The American Medical Association said sites in other countries have helped reduce overdose deaths and curb transmission rates of infectious disease while getting more people into treatment without increasing drug trafficking or crime.
Aubri E., a 32-year-old Boston resident who declined to give her full name because she was admitting to illegal activity, said she would use such a facility.
Aubri said she began using drugs when she was 17. She said she's so concerned about overdosing that she calls or texts a friend before using and then texts every 2 minutes. If she stops texting, she has asked the friend to call 911 and leaves her home door open.
"I've lost a lot of very close friends due to overdosing, some of whom have died right in front of me," she said. "Another benefit for me would be being in a safe space and not having to hide and being able to talk openly about substance abuse and not having to inject alone."
There have been efforts to establish safe injection sites in a number of cities and states including New York, California and Vermont as well as Seattle, Denver, Philadelphia and San Francisco.
Injection sites are already legal in a number of countries including Australia, Canada, France and Spain.
In Massachusetts, legislation has been filed that would let state health officials permit injection sites. The bill, sponsored by Democratic state Sen. William Brownsberger, has just over a dozen co-sponsors out of a 200-member Legislature.
Brownsberger said the goal is to save lives and get people into treatment, provided supporters can find a welcoming city or town to locate the site and a group to run it.
"Whether or not it's a good idea depends on the whole context and whether it's actually set up in way that's going to work," he said.
Mayors of two of the state's largest cities — Boston's Marty Walsh and Springfield's Domenic Sarno, both Democrats — are opposed, saying the focus should instead be on treatment.
Baker's bill would let police officers and medical professionals bring high-risk individuals to substance abuse treatment centers, even against their will, for up to 72 hours. It would also set standards for addiction "recovery coaches" and make it easier to prescribe smaller amounts of opioid painkillers.
Some in the debate over supervised injection sites hear echoes of earlier debates over needle exchange programs, which supporters pushed to help stem the spread of diseases like AIDS.
Baker's Secretary of Health and Human Services Marylou Sudders noted the administration has worked to expand existing needle exchange programs but said there's one big obstacle to allowing injection sites.
"It is difficult for me to find that bridge given that it is completely illegal federally for medical professionals or others to actually be in the presence of someone injecting themselves with heroin," she said.
More than 2,000 people died from opioid-related overdoses in Massachusetts during 2016.