Few places in the United States have been as hard hit by the opioid crisis as Philadelphia, where about 1,150 people died from overdoses last year. So it is fitting that this is where the nation’s first “safe injection facility,” where addicts can use drugs under medical supervision without fear of arrest, is likely to open its doors.
At least, it was going to open. Now its future, and that of the addicts it would serve, is less certain.
Last week, federal prosecutors in Pennsylvania filed a lawsuit to stop the nonprofit facility, Safehouse, from opening. The lawsuit seeks a broad ruling under the “crack house” statute in the Controlled Substances Act that would declare it illegal to provide a safe space for people to use illicit drugs. This reaction by the federal government should not come as a surprise; Deputy U.S. Atty. Gen. Rod Rosenstein threatened “swift and aggressive action” in a New York Times op-ed last year, the same day the California Legislature approved a bill that would have established a safe injection pilot program in San Francisco. (No doubt that threat was on then-Gov. Jerry Brown’s mind when he vetoed the measure.)
Safe injection sites are medical facilities.
It’s strange and unfortunate that the Trump administration is attacking a program that could help lower the number of opioid overdose deaths and fight HIV transmissions too. (These facilities provide clean needles, which are key to reducing infection rates among drug users.) The timing is even stranger. The lawsuit was filed the day after President Trump vowed to fight both opioid use and HIV in his State of the Union speech. Does he know that his Department of Justice is undermining these efforts?
The organizers of Safehouse have not given up; in fact, they say the lawsuit could actually be a good thing if the judge rules in their favor, settling the question of legality. Their argument is that safe injection sites are consistent with federal law, which explicitly allows harm reduction programs such as those that provide clean needles and naloxone, an overdose reversal medicine.
Safe injection sites, also known as drug consumption facilities, provide both those things to addicts as well a safe and clean location to self-administer illicitly obtained drugs under medical supervision. The goal is to save lives by reducing overdoses.
In political debates, critics describe these centers as nothing more than government-sanctioned opium dens, where addicts are encouraged to get high in comfort. In fact, these are medical facilities. They are staffed by healthcare professionals and serve sick people whose addictions are so deeply entrenched, they risk death to get high.
The staff members at such centers don’t help the addicts take drugs, but can intervene if someone gets ill or overdoses, which is an ever likelier prospect due to the flood of fentanyl, an incredibly potent synthetic opioid, into the market. One study of Canada’s first safe injection space, which has been open since 2003 in Vancouver, found that drug overdoses decreased by 35% in the surrounding community after the facility opened. As a bonus, data show that the facility helps direct addicts into treatment. There are dozens of drug consumption centers operating in Europe, some for more than 20 years.
It would be good to have the legal questions cleared up because the threat of a crackdown has certainly chilled interest in facilities across the nation. The authors of last year’s vetoed bill, Assemblywoman Susan Talamantes Eggman (D-Stockton) and state Sen. Scott Wiener (D-San Francisco) are trying again this year. Gov. Gavin Newsom said last fall that he is “very, very open” to the idea of a pilot project. Good, then perhaps he won’t be cowed by threats from Washington.
No one is saying that safe injection facilities will solve the opioid crisis; we don’t even know yet, without pilot programs to test them, how effective these programs will be in the United States. But with overdoses still killing thousands of people every year in a crisis that some think will get worse before it gets better, it’s worth trying every tool available instead of criminalizing efforts to save lives.