Safe consumption sites, where people can use pre-obtained drugs with medically trained personnel on hand to treat overdoses, garner higher public support when they are called "overdose prevention sites," according to a study led by researchers at Johns Hopkins Bloomberg School of Public Health.

The researchers, in a study published on August 8 in the American Journal of Public Health, surveyed representative national samples of Americans and found that only 29% of respondents were in favor of "safe consumption sites," but 45% supported them when the term "overdose prevention sites" was used instead.

Safe consumption sites are already legally operated in Canada, Europe and Australia, and have been found to reduce overdose deaths as well as HIV and hepatitis virus transmission.

These sites are being considered in some jurisdictions in the U.S. including San Francisco, Seattle, Philadelphia, New York City and Ithaca, New York, but so far, none have moved forward to establish them.

A shift to describe these sites as overdose prevention sites could make it easier to increase public support and eventually establish them, particularly in regions heavily affected by the opioid epidemic.

"The lack of support, despite strong evidence that these sites save lives, prompted us to wonder whether changing the language used to describe them might increase public acceptance," said lead study author Colleen L. Barry, Ph.D., Fred and Julie Soper Professor and Chair of the Department of Health Policy and Management at the Bloomberg School.

"Previous research suggests that how an issue is framed can matter when persuading the public to get behind evidence-based approaches, particularly controversial ones," she added. "In this case, we found that substituting just three words boosts public support by 16% points."

Centers for Disease Control and Prevention statistics indicate that about 50,000 Americans died from opioid overdoses in the U.S. in 2017, a substantial increase over the previous year. While the numbers of deaths due to prescription opioids are plateauing, overdose deaths due to heroin and fentanyl are rising rapidly.

To reduce overdose deaths and lessen other detrimental effects of the epidemic on individuals and communities, officials in hard-hit areas have increasingly turned to harm-reduction strategies.

Naloxone distribution programs

Harm-reduction approaches, such as syringe exchanges and naloxone distribution programs, aim to minimize negative health, social and economic consequences of harmful drug use for people who use drugs.

Syringe exchange programs allow people using drugs to obtain clean needles to prevent the transmission of HIV and other viruses. Distributing naloxone, a lifesaving medication to reverse the effects of an overdose through law enforcement, first responders, and friends and family members of individuals using opioids has also been shown to reduce overdose deaths.

"In addition to preventing overdose deaths, another important benefit," said study co-author Beth McGinty, Ph.D., the Bloomberg School's Department of Health Policy and Management, "is that these sites offer a range of health and social services to connect people using drugs to drug treatment, to primary health care services including wound care, in some cases, transition into successful treatment and recovery."