Thank you for the opportunity to provide written testimony today.

My name is Jeffrey A. Singer. I am a Senior Fellow in Health Policy Studies at the Cato Institute. I am also a medical doctor specializing in general surgery and have been practicing that specialty in Phoenix, Arizona, for over 40 years. The Cato Institute is a 501(c)(3) non-partisan, non-profit, tax-exempt educational foundation dedicated to the principles of individual liberty, limited government, free markets, and peace. Cato scholars conduct independent research on a wide range of policy issues. To maintain its independence, the Cato Institute accepts no government funding. Cato receives approximately 80 percent of its funding through tax-deductible contributions from individuals. The remainder of its support comes from foundations, corporations, and the sale of books and other publications. The Cato Institute does not take positions on legislation.

I write to share my thoughts on SB 195, which would authorize a pilot program to establish overdose prevention centers (also known as supervised consumption sites) in four Connecticut municipalities.

In my 2023 Cato Institute briefing paper, Overdose Prevention Centers: A Successful Strategy for Preventing Death and Disease, I review the domestic and international evidence on supervised consumption facilities as a harm-reduction intervention. I explain that overdose prevention centers provide sterile equipment, drug-checking tools, medical monitoring, and rapid overdose reversal, while also linking participants to treatment, primary care, and social services. At the time I published the paper, there were 147 overdose prevention centers (OPCs) operating across 91 locations in 16 countries, with the longest continuously operating site located in Bern, Switzerland, which has been in operation since 1986. Drawing on more than three decades of experience across Europe, Canada, and Australia—as well as emerging U.S. programs—the evidence shows these centers prevent fatal overdoses, reduce HIV and hepatitis transmission, decrease public drug use and syringe litter, and increase entry into treatment without increasing crime or drug initiation. I situate overdose prevention centers within the broader context of a worsening overdose crisis driven by an increasingly toxic illicit drug supply and argue that harm-reduction strategies are a pragmatic public-health response focused on reducing death and disease rather than attempting to eliminate drug use altogether. I conclude that federal legal barriers—not evidence of ineffectiveness—remain the principal obstacle to broader implementation in the United States.1

Since the paper’s publication, Rhode Island lawmakers authorized an OPC pilot program, which opened in Providence last year.2 Vermont became the second state to sanction an OPC when lawmakers approved one for Burlington in 2024, and public health and community leaders are actively working to establish it.3

OnPointNYC, the harm reduction organization that New York City authorized to operate in Washington Heights and East Harlem in late 2021, reported reversing 1,600 overdoses by the end of 2024.4

Researchers from the University of Pennsylvania and Brown University reported in the Journal of the American Medical Association in November 2023, “[T]he first 2 government-sanctioned OPCs in the US were not associated with significant changes in measures of crime or disorder. These observations suggest the expansion of OPCs can be managed without negative crime or disorder outcomes.“5

In a study published in The Lancet in February 2024, researchers examined the overdose mortality rates in Toronto, Canada, between May 2017, when nine OPCs opened in the city, and December 2019. They found that overdose fatalities dropped significantly during that period in neighborhoods surrounding the OPCs but not in other neighborhoods.6

In April 2024, scholars at the New York City Department of Health and Mental Hygiene reported in NEJM Catalyst on the city’s two OPCs’ first full year of operation:

From November 30, 2021, to November 30, 2022, 2,841 individuals visited the two OPCs 48,533 times and staff intervened during 636 visits (1.3%) to prevent overdose-related injury and death. During this period, emergency medical services (EMS) were called only 23 times, and no overdose deaths occurred in the OPCs. Results suggest that the OPCs diverted up to 39,000 instances of public drug use and played a critical role in connecting participants to care, with 75% of participants accessing other harm-reduction, social, and medical services through OnPoint NYC.7

Besides saving lives and reducing public drug use, OPCs reduce the number of emergency medical services (EMS) calls and the costs associated with them.

OPCs also help the local community by moving non-medical drug use indoors, away from public view, including children. They collect used paraphernalia, reducing the risk of contaminating pedestrians and passersby.

The ongoing overdose crisis—driven increasingly by a volatile and toxic illicit drug supply—has caused policymakers around the world to explore pragmatic strategies aimed at reducing deaths and disease, even when drug use continues. SB 195 would enable Connecticut to evaluate this harm-reduction model through a time-limited, locally managed pilot program with built-in assessment. Importantly, the proposal does so without relying on state funds, instead allowing implementation through private and philanthropic support—an approach that enables policymakers to study real-world results while limiting budget risk. The legislation serves as a structured policy pilot, designed to gather evidence on health outcomes, treatment engagement, and community effects while maintaining legislative flexibility. It offers a framework that can guide future decisions with Connecticut-specific data, especially as policymakers seek practical solutions to a worsening overdose emergency.

Thank you for the opportunity to share my research and perspectives with the committee as you consider this important public health matter.

Respectfully submitted,

Jeffrey A. Singer, MD, FACS
Senior Fellow, Department of Health Policy Studies
Cato Institute