Will Philadelphia Host America's First Supervised Injection Site?

There are no supervised injection facilities openly operating in the United States. That might change soon.

A federal judge has ruled that a Philadelphia facility where intravenous drug users can get high under the watchful eye of medical professionals is not the same as the "crack houses" that are prohibited under federal law. Leaders in Philadelphia are now moving forward with a nonprofit "supervised injection facility" called Safehouse, with former Pennsylvania Gov. Ed Rendell (D) on the board.

When Safehouse first announced its plans, U.S. Attorney William McSwain of the Eastern District of Pennsylvania declared that such a facility would violate federal law. Rendell responded by challenging the Justice Department to arrest him.

Instead, McSwain filed a lawsuit in February asking a federal judge to rule that opening and operating Safehouse would contravene Section 856 of the Controlled Substances Act, which makes it a federal crime to open, lease, or operate a facility "for the purpose of manufacturing, distributing, or using any controlled substances." This amendment to federal drug laws was passed in 1986 as a tool to target so-called crack houses.

In Canada and across Europe, an estimated 100 supervised injection facilities operate openly and legally. Their purpose is to get drug users off the streets and into a place where they can be monitored rather than arrested. Bringing drug use into a safer setting reduces overdose deaths and the spread of disease while allowing social workers to help users find stable housing and transition into treatment if they want it.

There are no supervised injection facilities openly operating in the United States. That's partly because city and state officials fear reprisals from the Justice Department, which has threatened to arrest government workers and medical providers who operate them and to seize the associated properties and assets. But as the opioid crisis has escalated with no end in sight, more and more local leaders are calling to give these facilities a try.

Philadelphia has pushed the envelope the furthest. The Justice Department's attempt to stop Safehouse and send a message to other cities backfired when a federal judge ruled in October that Section 856 did not in fact apply. District Judge Gerald Austin McHugh, in a 56-page decision, concluded that "the ultimate goal of Safehouse's proposed operation is to reduce drug use, not facilitate it."

Yet the fight is far from over. McSwain immediately announced that he would appeal the decision, and U.S. Deputy Attorney General Jeffrey Rosen warned that any attempt to open a supervised injection facility would meet with immediate action from the Justice Department despite McHugh's decision.