Could the nation's stance on supervised consumption sites be shifting?

Asked for his views on supervised consumption sites, long contemplated and controversial as a potential intervention in San Francisco, where users bring their own drugs to take under the supervision of trained workers in case they overdose Gupta’s eyes lit up. Then he paused, catching himself, and said he could not weigh in yet.

“It’s late by, I don’t know, a few decades,” Alex Kral, a public health resarcher and drug policy expert at RTI International, a nonprofit research organization, said of the White House support for the approach. He now says the closure of the Charleston program was a significant mistake; in an interview, he emphasized that he had supported more than a dozen harm reduction programs in West Virginia when he was overseeing public health there.

Naloxone is now fundamental to the nation’s efforts to curb overdose deaths. Observing a naloxone training session at an architecture firm in New Hampshire that keeps the medication on-site, Gupta observed that he had grown familiar with the dummies used for such demonstrations. Dan Ciccarone, a professor of family and community medicine at the University of California, San Francisco, said that Gupta’s arrival at the White House was the culmination of the shift from the moralistic debate around drugs, blaming suppliers and users, to an approach treating the issue as a health crisis, with acceptance of drug use.

There are now more than 80 such programs statewide, said Van Ingram, director of Kentucky’s drug control policy office, pointing to it an example of bipartisanship in harm reduction policymaking. Local health officials, he added, “had to take the uncomfortable positions with the same people they stand in line with at Kroger.”

A Justice Department decision on supervised consumption — tied to the Philadelphia case — could allow sites to function without fear of interruption by federal authorities. The resolution could also give the White House an opening to publicly endorse the option.

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