In the face of a projected 1,200 overdose deaths last year, Philadelphia officials are moving ahead with a plan to set up safe-injection sites in the city.
The city will actively encourage private organizations to establish places where people addicted to drugs can use under medical supervision. It would be the first such site in the country.
While District Attorney Larry Krasner expressed support for the idea earlier this month, an official announcement Tuesday opened the door for organizations interested in operating, funding or offering a location for the sites to approach the city. The city will not directly operate the so-called Comprehensive User Engagement Sites or CUES.
The sites, in operation around the world, offer a safe place to inject illegal drugs where health care workers provide monitoring and clean needles.
Thomas Farley, Philadelphia health commissioner, acknowledged that the notion of a space where drug users can bring their own drugs to safely use without penalty is controversial.
“No one here condones or supports illegal drug use in any way,” he said “But we recognize how difficult addiction is — the grip of addiction interferes with its own treatment.”
The most important criterion in developing a site will be accessibility for users, Farley said.
“We are talking about the people who are the most hard to reach, the most stigmatized,” he said. “We need to make it easy for them to come in so you can then engage them.”
The decision follows a task force study that found the sites reduce overdose deaths, instances of HIV, and neighborhood issues such as public drug injection and littered syringes. Each Philadelphia site could prevent up to 76 deaths from drug overdose each year, the report concluded.
More than 100 safe-injection sites operate internationally, many of them in Europe. A group of officials from Philadelphia recently visited a Vancouver site – and police Commissioner Richard Ross said learning more about a successful model helped him come around to the idea of CUES.
“I started completely, totally adamant against this,” Ross said. But after calling a colleague in Vancouver to discuss CUES, expecting to have his notions about the shortcomings of such an experiment reinforced, Ross said he was surprised. “I got everything opposite of that.”
Despite some unanswered questions, Ross said he recognized that an epidemic of historic proportions may necessitate unprecedented solutions.
“There’s a lot of lives being lost,” he said. “In the world of public safety, we cannot just throw our hands up and say, ‘That’s not our problem.’ ”
Not everyone on the local level is in favor of the idea. Councilwoman Maria Quiñones-Sánchez — who represents the city area where opioid use is at its highest — said she is worried that the CUES will not address the underlying health issues that have created the drug encampments throughout the 7th District.
“Opening an injection site without a real plan in place will further entrench the crisis in Kensington,” she said in a statement.
Whether the idea finds local support, opposition from the U.S. government remains a concern.
“Realistically, we’re not going to be able to protect from federal prosecution,” said First Deputy Managing Director Brian Abernathy. “I think we’re confident and hopeful that the federal government has more important things to do than to not save people’s lives.”
The federal government could seize the land where a site would be placed, he said, and liability insurance would pose another challenge.
While many advocates were surprised that the city was announcing its commitment so soon, the timeline for opening a site was also a concern. With so many overdose deaths, many indicated Philadelphia does not have much time to spare.
“My biggest concern moving forward with harm reduction is that government takes forever,” said Krasner. “When we have three or four people dying every day, no one can afford to wait.”
Eva Gladstein from the city’s Health and Human Services Department said officials anticipate the process would take months.