Amid a Growing Substance Abuse Epidemic, Massachusetts Lawmakers Stall on Overdose Prevention Legislation

A wall at the overdose prevention center. Image sourced from OnPoint NYC.

In May 2025, Boston’s Live Long and Well Agenda, a public health initiative aimed at eliminating race-based health disparities, found that one of the leading causes of premature mortality in Boston is unintentional drug overdoses. 12% of tested cocaine samples were found to contain fentanyl, and Boston public health advisories warned against a tranquilizer known as xylazine. A sedative, xylazine can cause unresponsiveness and reduced breathing, especially when combined with heroin and fentanyl. Opioid-related deaths in particular have increased by 36% since 2019.

The establishment of Overdose Prevention Centers (also referred to as supervised consumption sites) has gained large bipartisan support in recent years to combat substance abuse and drug-related deaths. Overdose Prevention Centers (OPCs) are places where individuals may use previously attained illicit substances with supervision and medical assistance on standby. Despite a 2023 Fenway Health poll that shows 70% of Massachusetts voters are in favor of instituting OPCs, progress in getting state and federal governments to sanction these institutions has encountered significant roadblocks. 

Following the establishment of the first facility in Switzerland in 1986, 130 additional locations soon followed, now spanning fourteen countries. While OPCs have seen immense success in Europe and Canada, the U.S. has shown more reluctance. While a few New York City OPCs have operated since 2021 without authorization from the state or federal government, the first legal OPC in the United States was implemented in Providence, Rhode Island, in December of last year. Ongoing collaborative research from Brown University, New York University Langone Health, and Project Weber/RENEW, the nonprofit that operates the Providence OPCs, is currently evaluating how the new Providence OPC, as well as two New York City OPCs, address overdose crises in their respective cities. The study is also focused on the impact each OPC has on its surrounding community. The results of this research are expected to be released over the next three years.

In Massachusetts, the legalization of Overdose Prevention Centers has thus far been a difficult endeavor, regardless of widespread public support. The President’s July 2025 executive order stated that grants issued by the Substance Abuse and Mental Health Services Administration (SAMHSA) must not fund programs that allow safe and supervised consumption, describing them as “efforts that only facilitate illegal drug use.” Rhetoric from the current administration further condemns similar public health efforts aimed at reducing overdose deaths and substance abuse. 

In the same month that OPCs were established in Rhode Island, Massachusetts lawmakers removed OPC proposals from Bill H.5143 during negotiations with the Massachusetts House of Representatives. The bill is intended to expand coverage for substance use disorder and increase access to opioid reversal drugs, yet many advocates were displeased with the omission of what they believed to be one of the key provisions of the bill— the approval and implementation of OPCs.

On the other hand, bills H.2196 and S.1393, introduced earlier in 2025, propose an act to prevent overdose deaths and increase treatment accessibility via Overdose Prevention Centers. According to the Massachusetts for Overdose Prevention Coalition, just one OPC established in Boston could save $4 million because it would significantly reduce the number of ambulance rides and Emergency Department and hospital visits that would otherwise occur. The bills would also grant regulatory authority to the Massachusetts Department of Public Health and require data collection, as well as provide legal protections for staff involved in public health efforts. Organizations such as the Massachusetts Medical Society have strongly voiced their support for these bills.

When it comes to Massachusetts residents, perceptions of the OPCs’ success are less controversial. Public opinion polls show that 76% of voters consider drug abuse to be a major problem in their state. The same percentage want Massachusetts to treat the problem as a public health crisis above all else, and further, 73% believe the government should be doing more about the issue in general. Regardless, legislative leaders have either spoken critically about OPCs or voiced general support, but have not prioritized their development. 

Those opposed to OPCs argue that rather than minimizing death and harmful effects, these facilities encourage drug use and illicit activity. In fact, under 21 U.S.C. Section 856, it is a federal crime to open an institution that knowingly allows drug use—hence why it has been so difficult for OPCs to receive state approval. Repealing this federal statute could therefore complicate the ethics of the war on drugs.   

Substance use and overdose deaths continue to be a prominent problem in Boston and Massachusetts, especially for minorities. Drug overdose mortality rates increased by 27.9% for Black residents, and for Latine residents 5.6%. For opioids in particular, the mortality rate increased by 15.7%. In short, substance abuse problems are not getting any better, and they are disproportionately harming already vulnerable populations. 

Currently, Rhode Island and New York are the only states where OPCs are in operation, and Rhode Island is the only state with state government approval. Massachusetts is among the nine states that have introduced legislation. Somerville and Cambridge began looking into supervised injection sites after citizens urged the cities to take action against their substance abuse and overdose issues, but many have noted a delay in progress in recent years. Whether Massachusetts lawmakers will adhere to the desires of their constituents and combat the growing drug crisis with OPCs or turn to another solution is uncertain.