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Philadelphia Was Supposed To Open The First U.S. Safe Injection Site. Residents And Officials Are Pushing Back.

Less than a month ago, a federal judge cleared the way for Philadelphia nonprofit Safehouse to open the nation’s first facility where drug addicts would be able to inject themselves with clean needles under medical supervision with otherwise-illegal drugs.

Now, it is unclear whether any “safe injection site” will open in the City of Brotherly Love, given the firestorm of opposition from local residents and city and state officials.

Philadelphia City Hall

A district judge ruled on Feb. 25 that safe injection sites don't violate federal drug laws, and that Safehouse could open the country's first such facility in South Philadelphia.

The decision could set a national legal precedent since officials in San Francisco, Seattle, Minneapolis and several Massachusetts cities are reportedly interested in setting up safe injection sites.

Attorneys general in seven states and the District of Columbia filed amicus curiae, or "friend of the court" briefs, backing Safehouse's position. In a highly unusual move, local U.S. Attorney William McSwain, who opposes these facilities, is handling the case personally. U.S. Attorneys usually leave the work of arguing cases to their staff.

McSwain said he would appeal the District Court's ruling.

Safehouse unveiled plans the next day to open a safe injection site at a medical building called Constitution Health Plaza, located in a residential neighborhood in South Philadelphia. It had not engaged with the community before the announcement, and people were furious.

“You blindsided us, you blindsided South Philly,” resident Leighanne Savlof is quoted by local NPR affiliate WHYY as saying. “You never came into our community. You never talked to us. You don’t come to our meetings. When we had a meeting about crime, where were you?” 

Safehouse declined to comment for this story.

The owner of Constitution Health, recorded as St Agnes MOB LLC, canceled its lease with Safehouse and issued a public apology.

“We believe in the good intentions of all involved — on both sides of this issue — and want to thank you for your honest communications with us over the past few days,” the property owner said in a statement. “We want you to know that we have listened. We apologize. And we want to ensure open lines of communication moving forward.”

While McSwain plans his appeal, members of local and state government are working to put up roadblocks against safe injection site operators.

The Philadelphia City Council may pass safe injection site restrictions as soon as this week that would require an operator to get support from at least 80% of residents and businesses in a half-mile radius, according to Councilman David Oh, the bill’s sponsor. He estimates that he has the support of between nine and 13 of his colleagues on the 17-member legislative body. The legislation would need nine votes to pass. 

Mayor Jim Kenney has publicly said he supports Safehouse and estimates that the initiative could save between 25 and 76 lives annually. Philadelphia Health Commissioner Tom Farley, who is on the Safehouse board, told city council last week that Oh’s proposal would create “insurmountable” obstacles for any future safe injection sites.

Similar restrictions are being considered by state lawmakers in Harrisburg. Companion bills introduced March 2 by Sen. Anthony Williams (D-Philadelphia) and Rep. Maria Donatucci, (D-Philadelphia) would require a local government to pass an ordinance to hold three public hearings before an ordinance authorizing an organization to open a supervised injection site is passed.

Insite, a safe injection facility in Vancouver. Insite opened in 2003 and is North America's oldest supervised injection location.

No other property owner has publicly stepped up to offer Safehouse a new home since its earlier deal collapsed, and no new leases have been announced, although no legal restrictions are preventing them.

“They can go into a medical office building that’s zoned that way (for medical uses) and open a safe injection site,” Oh told Bisnow in an interview. “The problem that they face is that it enrages the community ... There’s probably not a neighborhood in Philadelphia that wants it.”

Commercial real estate property owners have found themselves on the front line in the battle against opioid abuse, whether they want to be or not.  

According to Oh, safe injection sites do more harm than good because, unlike methadone clinics, the people who frequent them aren’t trying to kick their addictions.  

Safehouse and its backers argue that safe injection sites are needed to combat the epidemic of opioid overdoses, which the Centers for Disease Control and Prevention estimates killed about 70,000 people in the U.S. in 2018.

According to the Drug Policy Alliance, more than 100 peer-reviewed studies have proven the positive benefits of safe injection sites, including reducing costs thanks to a reduction in disease, overdose deaths and the need for emergency services. 

The nonprofit further argues that fears about the facilities triggering an increase in crime and drug use that have surfaced in Philadelphia and in other cities where they are being considered are groundless.

Vancouver is a case in point. North America's first safe injection site, Insite, opened there in 2003, and is still in operation. There are now eight sites in a 2-mile radius in Vancouver. In Insite's more than a decade of operation, there have been more than 3.6 million visits. Roughly 1,500 overdoses a year are treated, and no one has died there. The surrounding Downtown Eastside area still has one of Vancouver's highest crime rates, though the police chief said in 2008 that crime had dropped, perhaps because uniformed officers patrol the site. 

It isn't clear whether the facilities have hurt property values in their immediate vicinity, but values in Downtown Eastside neighborhood have been skyrocketing, despite the presence of eight safe injection sites.

The opioid crisis has hit Philadelphia especially hard. According to the Pew Charitable Trusts, the city has one of the highest U.S. death rates from unintentional drug overdoses, with 1,116 dying in 2018. That is roughly three times as many people who died from homicide.