What鈥檚 Next For 鈥楽afe Injection鈥� Sites In Philadelphia?
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Philadelphia is a step closer to opening what could be the nation鈥檚 first supervised site for safe drug injection. But turning the idea into reality won鈥檛 be easy.
City officials gave the proposition the green light Tuesday. They were armed with聽feasibility studies, harrowing聽聽and the backing of key leaders, including the mayor and a newly elected district attorney.
鈥淭here are many people who are hesitant to go into treatment, despite their addiction, and we don鈥檛 want them to die,鈥� said Dr. Thomas Farley, Philadelphia鈥檚 health commissioner and co-chair of the city鈥檚 opioid task force. Supervised safe-injection sites, he said, save lives by preventing overdose deaths and connecting people with treatment.
While one big hurdle is now cleared, the details of how safe-injection sites would actually work in Philadelphia have yet to be figured out. Who will actually fund and operate a site? Where will it be located? Will users really be safe there?
鈥淲e have a long way to go,鈥� said聽, first deputy managing director for the city.
Neither city council approval nor special zoning ordinances would be required to proceed, Abernathy said, but the city doesn鈥檛 plan to operate or pay for any sites. Instead, Philadelphia officials would play the roles of facilitator and connector with providers of addiction services.
In that way, Tuesday鈥檚 announcement by the city was more like an open call to potential investors and operators than it was the rollout of a specific plan.
鈥淲e took a really, really big first step,鈥� said Jose Benitez, executive director of聽, a large, nonprofit needle exchange. 鈥淚t鈥檚 early to talk about our involvement at this particular point. As the city officials said, there鈥檚 a lot to consider.鈥�
Broadly, the city envisions a place where people would be allowed to bring in drugs and inject them using clean equipment. If someone overdosed, trained staff would respond to prevent death. The sites could save lives and money otherwise lost to hospitalizations and emergency response efforts. Advocates say the sites also could reduce neighborhood problems associated with addiction, like people injecting in public and discarding needles.
A safe, supervised site wouldn鈥檛 just be about a spot to inject, Farley stressed, but also somewhere people could connect with other services and treatment.
Still, the effort to open a site will likely face additional hurdles and unknowns, from community buy-in to legal concerns.
For one, Councilwoman Maria Qui帽ones-S谩nchez, who聽聽in her district (one at the heart of the crisis), is wary of the city鈥檚 plan.
鈥淭his notion of letting a private developer or a private person come tell us how this could be done, we鈥檙e not paying for it, we鈥檒l do wrap-around services, so much of that is just up in the air,鈥� Qui帽ones-S谩nchez said. 鈥淪o why make an announcement with no answers?鈥�
Another question: Could such a site be immune from federal prosecution? Realistically no, said Philadelphia official Abernathy, though聽.
The city鈥檚 police commissioner, Richard Ross, has gone from 鈥渁damantly against鈥� any injection site to having an open mind. Whether police will take a hands-off approach remains to be seen. So would what the department鈥檚 role would be, what police officers would be asked to do, and how that would affect the policing of narcotics?
鈥淚 don鈥檛 have a lot of answers,鈥� he said.
One point of clarity: Philadelphia District Attorney Larry Krasner has no plans to prosecute.
鈥淲hat will we do? We will allow God鈥檚 work to go on,鈥� Krasner said, citing state laws as justification that allow the committing of minor violations in the interest of preventing greater harms. 鈥淲e will make sure that idealistic medical students don鈥檛 get busted for saving lives and that other people who are trying to stop the spread of disease don鈥檛 get busted.鈥�
After all this, it should come as no surprise that the timeline is really unclear, too. Rollout will take months, at least, leaders have said. Though if it were up to Krasner, one would have opened years ago.
鈥淢y biggest concern moving forward with harm reduction is that government takes forever,鈥� he said. 鈥淲hen we have three or four people dying every day, nobody can afford to wait.鈥�
This story is part of a partnership that includes , and Kaiser Health News.