CHAPTER 1

Introduction

Background

Since the start of the COVID-19 pandemic in early 2020, observation and reporting of open and visible drug use on transit vehicles and in stations has become increasingly commonplace in major cities in the United States. For instance, concerns raised by transit operators in the Pacific Northwest regarding widespread drug use on their vehicles led to a research study aimed at assessing exposure levels and recommending protective measures that transit agencies can implement to minimize exposure to secondhand drug residues. This study (to be discussed in more detail in the literature review [Chapter 2]), highlights how drug use on transit poses significant concerns for the health and well-being of transit users, operators, and employees. The long-term health effects of secondhand drug exposure, particularly for transit operators who spend 8 to 12 hours in the vehicles they operate, remain largely unknown.

A related crisis occurring on transit systems is the prevalence of overdose deaths and concerns about an individual experiencing an overdose on transit vehicles or in a transit station. For example, an investigation conducted by The Reader in Chicago using data from the Cook County Medical Examiner’s Office reported that 158 individuals died from an opioid-related overdose on Chicago Transit Authority (CTA) property between 2018 and 2022, with 60 of these deaths occurring in 2022—a sharp spike from the 31 overdoses in 2021 (Prout 2023). Similarly, analysis from Cambridge, MA, indicates that 10% of all overdose calls within the city originated from five Massachusetts Bay Transit Authority (MBTA) stations (Kholi et al. 2023). These data highlight how the significant rise in overdoses in the United States has specifically adversely affected transit environments.

Understanding the complexity and range of circumstances surrounding drug use within transit vehicles and stations is beyond the intent of this project. This synthesis aims to explore the scope and scale of the issue through available data and agency interviews and to better understand how transit agencies are responding to this situation. Reporting on these programs and sharing this knowledge within the transit industry are essential to addressing this critical issue that affects transit users and transit employees and operators alike. Transit agencies are facing a crisis—as agencies try to rebuild ridership to pre-pandemic levels, drug use negatively affects perceptions of rider safety, leading riders to make alternative transportation choices, avoid transit, or change how they use transit by avoiding travel at certain times or along certain routes.

This first part of this synthesis effort focused on gathering, synthesizing, and reporting on the academic and non-academic literature to understand how transit agencies are addressing drug use on transit property. These broader findings are complemented by case example interviews and site visits involving five large transit agencies across the United States in order to identify the state of the practice and gaps in creating safer, more supportive, and healthier transit environments for all.

Objectives

The primary goal of this synthesis project is to document current practices used by transit agencies in addressing observed and reported incidents of drug use on public transit property, including vehicles, stations, and bus stops. The project is guided by the following objectives:

1. To determine if and which transit systems have seen and documented an increase in drug use within their transit systems;
2. To investigate and document how transit systems respond to drug use on transit;
3. To identify existing data collection methods and sources specific to drug use on transit and understand how data are used for reporting, operational planning and program design, and monitoring and evaluation.

This synthesis can be used by policymakers to inform outreach or other programs addressing drug use on transit, by agency staff who wish to improve their operational responses, by advocates who wish to understand the effectiveness of various programs and approaches, and by researchers who want to identify and close gaps in knowledge in the field.

Method

This synthesis consists of two distinct parts. First, a literature review presents the current level of discourse and study on the topic of drug use and transit and the publicly documented ways in which transit agencies are responding to the issue. Second, in-person field visits with five selected transit agencies were conducted to gain in-depth knowledge of the programmatic responses to drug use, data monitoring and evaluation programs, and the severity of the problem.

The decision to conduct five in-depth case examples rather than the typical survey approach of a TCRP Synthesis Project was guided by the subject matter and the judgment of the contractors and panel members. First, responsibility and working awareness of the issue of drug use on transit is distributed across several working groups at each agency along with community service partners, public health officials, and law enforcement, making survey dissemination a challenge. Second, the topic is sensitive and complex, requiring a thorough approach to ensure a deeper understanding.

Organization

Chapter 2 presents the literature review which summarizes an examination of relevant academic sources as well as news articles, reports, and transit agency websites. Chapter 3 outlines the agency case example selection approach, interview and field visit process, and the findings from these visits. Chapter 4 summarizes the findings, discusses challenges and opportunities, and provides suggestions for future areas of study.