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Philadelphia May Become the First City to Open Safe Injection Sites

A Trump-appointed U.S. attorney is trying to stop the harm-reduction site from opening in Kensington, a Philly neighborhood that has been devastated by the opioid epidemic

PHILADELPHIA, PA - JANUARY 24:  A man uses heroin under a bridge where he lives with other addicts in the Kensington section which has become a hub for heroin use on January 24, 2018 in Philadelphia, Pennsylvania. Over 900 people died in 2016 in Philadelphia from opioid overdoses, a 30 percent increase from 2015. As the epidemic shows no signs of weakening, the number of fatalities this year is expected to surpass last year's numbers. Heroin use has doubled across the country since 2010, according to the U.S. Drug Enforcement Agency. Officials from Philadelphia recently announced that they will welcome private organizations to set up medically supervised drug injection sites as a way to combat the opioid epidemic.  (Photo by Spencer Platt/Getty Images)

A man uses heroin under a bridge in Kensington, the neighborhood where harm-reduction advocates are trying to open a safe-injection site.

Spencer Platt/Getty Images

After a lengthy battle involving numerous local lawmakers, soon, the city of Philadelphia will find out if a supervised, legal heroin injection site will open in the beleaguered Kensington neighborhood, which would make it the first city in the country to do so.

On Thursday afternoon, U.S. District Judge Gerald McHugh Jr. will hear oral arguments in USA vs. Safehouse, a suit filed by U.S. Attorney for the Eastern District of Pennsylvania William McSwain to halt plans to open a supervised injection site run by the nonprofit Safehouse. While McHugh is not expected to grant a final ruling today, the case will likely determine the future of supervised injection sites in the city, as well as serve as a litmus test for cities across the country also grappling with the opioid crisis.

Supervised injection sites are regulated establishments where drug users can inject heroin on premises. Although they do not provide drugs, they do provide free clean hypodermic needles and alcohol swabs to users to reduce the risk of infection, as well as addiction support and counseling services. Medically trained staff members at the site would also carry the drug naloxone, also known as Narcan, a treatment that reverses the effects of opioid overdose, which could potentially save countless lives. According to an article published in a Canadian medical journal, safe injection sites have been associated with lower mortality rates, as well as a decrease in OD-related ambulance calls and rates of HIV infection. Critics, however, have said there isn’t enough substantive research to determine whether these sites are actually beneficial for drug users.

Although such supervised injections have long been operating in major Canadian cities like Toronto and Vancouver, they have yet to make their way to the United States. While a number of major American cities, such as Denver and New York, have announced plans to open safe injection sites, none of these have come to fruition, largely due to opposition from lawmakers, who have argued that supervised injection sites violate what’s known as the “crack house statute.” A provision of the Controlled Substances Act (CSA), the statute makes it illegal for anyone to “knowingly open, lease, rent, use, or maintain any place for the purpose of manufacturing, distributing, or using any controlled substance.” In 2018, deputy attorney general Rod Rosenstein penned an op-ed for the New York Times reiterating this argument, writing that “cities and counties should expect the Department of Justice to meet the opening of any injection site with swift and aggressive action.”

Philadelphia Mayor Jim Kenney has expressed his approval for plans to build the site, even visiting Canada in July to tour legal injection facilities there. Yet many local lawmakers have expressed their opposition to the idea, most notably McSwain, a Trump appointee who filed a civil suit back in February attempting to prevent the Safehouse site from opening, on the grounds that it constituted a violation of the crack house statute. “This is in-your-face illegal activity using some of the most deadly, dangerous drugs that are on the streets. We have a responsibility to step in,” he told NPR at the time.

In response to the suit, Rhonda Goldfein, a board member of Safehouse, said that the crack house statute should not apply to supervised injection sites, which do not provide drugs and instead focus on harm reduction and overdose prevention. “We have a disagreement on the analysis and intention of the law,” Goldfein told NPR at the time. “We don’t think it was intended to prevent activities such as this, and perhaps it will take a court’s ruling to move the issue forward.” Lawyers for Safehouse have also argued that blocking the site from opening violates its religious freedoms, specifically Judeo-Christian tenets about the value of “preserving life.”

Philadelphia has the highest overdose rate of any major U.S. city, with nearly three people a day fatally overdosing on opioids in 2018. Kensington in particular, where the injection site would be built, is known as a hotbed for drug use, with the New York Times referring to it last year as “the largest open-air narcotics market for heroin on the East Coast.”

In 2017, Mayor Kenney assembled a task force to figure out how to solve the problem of opioid overdoses in the city. The task force recommended opening up a supervised injection site, leading Kenney to formally announce plans to open up such an establishment in early 2018. A Drexel University survey from early this year found that the vast majority of Kensington residents support plans for the site, with 90% of the 360 neighborhood residents they surveyed voicing their approval.

According to data from the National Institute of Drug Abuse (NIDA), nearly 130 people die of opioid overdoses every day, with 47,000 Americans dying in 2017 alone.

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