As Massachusetts moves towards permitting overdose prevention centers or supervised consumption sites, based on John’s observations, he offers the following recommendations for communities considering a facility: - Facilities should establish close working relationships with local law enforcement, government officials, business owners, educators, neighborhood groups, health care providers, and community service providers, and facilities should have advisory committees that include all the above, as well as people who use drugs and use the facilities. - There must be a robust public engagement process that includes, at a minimum, comprehensive education about the public health benefits of such sites, showing their effectiveness in preventing overdose deaths and the spread of diseases such as HIV and Hepatitis C. - The public should also be educated about the role such facilities play in reducing the strain on first responders and hospitals and in reducing health insurance costs by avoiding costly responses to emergency calls. - The latest data on community impacts available from other places where sites are located should be shared openly and completely. - Law enforcement and other first responder leaders should be informed and educated about the sites, with the education to include visits to nearby sites in New York and Montreal and meetings with law enforcement, medical responders, and members of those communities. - Communities considering sites should be aware that initially the sites will draw new people to the communities and that the use of the facilities will then become regular and predictable. - Facility exterior design should fit with the look and character of the communities where they will be located. - Facility operators should have regular community litter pick-up and needle retrieval programs. - Facility operators, local business owners, municipal officials, and law enforcement should have plans to discourage loitering in the areas of the facilities. - Communities and local law enforcement should have zero tolerance for open and obvious drug sales and purchases in the areas of the facilities. - Facilities should be staffed with appropriate medical personnel as well as trained peer-to-peer counselors and licensed recovery coaches. - Facilities should have separate spaces for women or LGBTQ community members who do not feel safe in a communal use setting. - Facilities should provide testing of drugs. - Facilities should have formalized relationships with treatment providers, including those providing medication for opioid use disorders and all other treatments for opioids and other drugs used in the facilities. - Facilities should work with local public health departments and the Massachusetts Department of Public Health to establish robust data collection while respecting the privacy of individuals who use the facilities.