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.

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  1. There are no supervised injection facilities openly operating in the United States.

    I’m pretty sure most states that still have a death penalty have a supervised injection site, just not the kind you’re thinking of.

  2. Don’t worry, I’m sure a higher court will laugh this sudden outbreak of common sense right out of the courtroom.

    Also can’t wait for the Republicans who make up this comment section find a way to oppose the whole idea even though it’s not even public money. Well assuming Dipshit Donny opposes it, since that’s what really matters; we know his personal attorney “AG” Barr does.

    “There are no supervised injection facilities openly operating in the United States.”
    That’s not *quite* true… there are no authorized/acknowledged ones. There is in fact at least one.

    1. “…even though it’s not even public money.”

      Aw isn’t that cute! Care to cite for that?
      In SF, there are very few non-profits which don’t have a hand in the public pocket, and look how hard it is to do so:

      “Government Grants for Non-Profit Organizations”

    2. Oh, and:
      “..Dipshit Donny…”
      Why do fucking lefty ignoramuses spend half their lives coming up with nick-names that would embarrass a 1st-grade kid?

  3. Just legalize all drugs and be done with it.

    Sorry, McSwine or McSwain, whatever you call yourself. People don’t want to be bullied by mental midgets like you. Go get a real, productive job instead of spending your days looking for ways to persecute and harass others.

    1. This. The entire law sucks. A court choosing to conveniently ignore obvious language – “for the purpose of manufacturing, distributing, or using any controlled substances.” – because it interferes with a desired outcome is not libertarian nor is it justice.

      These are baby steps on the road to rule by men, and against the fundamental notion of rule by law.

      Bad law is like that, but the solution is not to sort of ignore some of it, the solution is to eliminate it.

  4. I certainly wouldn’t stand in the way of this, but it’s a stepping stone that doesn’t really go in the direction we want. Ideally we’d like drug reform to show people that narcotics, etc. can be safely used non-therapeutically and society won’t fall apart from it. That would serve to lessen the objections of non-libertarians to prohibition repeal.

    However, this shows, what? That you can get junkies to come in to your place to get lessons on how not to hit an artery, while being propagandized to give up their habits? It works only in the context of there still being a public policy against non-therapeutic drug use. So its only benefit is temporarily reducing morbidity and mortality in a population that’s already prone to same, and not getting them into jail.

  5. The language of the law is crystal clear. Obama-appointed Judge McHugh is just another federal judge making shit up as they go along to get the result that they want. No different than federal judges who make shit up to, say, curtail the RTKBA.

    The Safehouse people need to open the Safe Injection site up and let the Feds raid it (will be the lead story on the “news”) and shut it down. Now the have standing to take the entire federal drug prohibition scam right to the Supremes if they argue on the grounds that drug prohibition is unconstitutional. If drug prohibition is not unconstitutional, why did the Temperance movement go to all that trouble to get the Vostead Act (17th Amendment) passed?

    1. Good idea. Need a crowdsourced site to defray the legal costs.

  6. arrest government workers and medical providers who operate them.

    But we were assured by the therapeutic-statists that there would be no government-run shooting galleries.

  7. One should point out that the enthusiasm for a safe injection site in Penna. is reversely proportionate to the distance it is located from posh neighborhoods. That is, it won’t be next door to Ed Rendell’s house or Rittenhouse Square or on the Parkway.

    1. There is a lot of NIMBY going on however fact is those are not locations where the users are. To have any impact you need to be within walking distance of where the IV street drug users are located.

  8. I don’t want to reduce overdose death. I want people to suffer the consequences of their actions. Government has no business in this.

    1. It’s not the overdosers this would help as much as their families and friends. For every person who overdoses there are dozens of innocent people affected.

      1. “It’s not the overdosers this would help as much as their families and friends. For every person who overdoses there are dozens of innocent people affected.”

        Still no business of the government.

      2. A free climber recently fell to his death in Yosemite. I’m sure that affected dozens of innocent people.

        Doesn’t mean we need to put free climbers on government subsidized belay.

    2. You neglect that much of the overdose deaths are BECAUSE of government involvement. Most deaths are because the user doesn’t know the purity or what it has been cut with. If drugs were allowed to be legally sold then they would be able to know what they are putting in their body and dose it out accordingly

      1. If they don’t know, don’t do it.

      2. “Most deaths are because the user doesn’t know the purity or what it has been cut with. ”

        And yet are still stupid, or reckless enough to use it.

        Either they are free to choose, and therefore accept all potential consequences. Or they are somehow so in the thrall of their activity that they have lost the ability to reason, and therefore lack agency.

        If only we had a term for the latter….

        1. And, to be perfectly clear, I’m in favor of legalizing all of it. I just wont advocate it out of any silly misguided belief that it will in any way make junkies less likely to off themselves. Nor would I advocate it even if it would. I advocate legalization for the sole reason that the government has no business involving itself in such choices.

          It is about liberty not about saving anyone from themselves.

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  10. The proposal only addresses IV drug use as harm reduction not drug prohibition in general. Even them only a subset of the most dysfunctional.

    The argument for such a center is a public health issue. IV drug users especially those likely to use such a facility have very high risk of infectious disease including HIV, hepatitis, TB, bacterial infections from pneumonia to spinal or brain abscess. The cost for which is indirectly already paid by everyone in the form of law enforcement, EMS and hospital care.

    Then the homeless part of the equation which really cannot be ignored.

    I think of such facilities as an experiment. A clinical trial. The proposal should include the stipulation that the facility must collect data to be published and shared. If you have multiple centers pooled data can be used in risk/benefit and cost/benefit analysis.

    Clearly the law enforcement approach does not work. A rational more science based approach is where we should be.

    1. I think of such facilities as an experiment.

      Like in Tuskeegee or Birkenau?

      1. Were Tuskeegee or Birkenau voluntary? Not similar in the slightest.

    2. It’s all moral hazard. Trying to protect people from their own risky behaviors inevitably leads to worse outcomes.

  11. I’m actually kind of disappointed in Reason regarding their coverage of Safehouse because it’s distinctly lacking in local knowledge. They aren’t trying to open this place in Rittenhouse or East Falls; they want in in Kensington near McPherson Square (this is the Narcan library and is affectionately called Needle Park). Kensington already has crime problems and the residents do not want even more drugs and junkies in the neighborhood. Supporting this site as is is peak NIMBYism from elites who know that these sorts of facilities have adverse effects on communities.

    1. Well why would you place such a facility in needle park?

      You know where the people are who might show up.

      Perhaps they can get in the Subaru SUV and drive out or get an Uber out to East Falls.

      A NIMBY would very much like to do nothing. Leave them in Kensington. That is your proposal. Problem solved.

      You state that such facilities have adverse affects on local communities. Show me data. I am open to that.

      Here is a report from researchers at Thomas Jefferson in Philadelphia.


      What do you think of it?

      1. The point is that you’re going to have even more there than before. People in Kensington are very strongly opposed to the proposal. Whenever private organizations or the city tries something, NIMBYism is the reason it ends up in places like Kensington. For instance, the city was going to start a homeless shelter in the concourse at Suburban station. The wealthy residents of Center City complained and that’s why it’s not there. Complaining that shit always gets dumped on your neighborhood due to NIMBYism isn’t NIMBYism.

        Also, big flaw of that study; Vancouver is not Philadelphia. It’s not even remotely comparable. It would be like monitoring a safe injection site in Tokyo and claiming its results can be replicated in Detroit.

        1. As for studies, I’ll look for some. I really don’t think there will be many because people don’t do much research on Kensington, but anyone who has been there (or worked for the city like I did) knows how bad it can be. All the city rec facilities are littered with needles. It’s bad for real estate, bad for kids, bad for business…who the hell does this serve? Certainly not the lower income families of Kensington who would leave if they could afford to do so. I did inspections of their pool facilities and every single one had police stationed there in broad daylight. You’ll see “vegetable” salesmen on street corners dealing drugs. It’s an awful place.


          1. I can add caveats here.

            What I linked to is a white paper, not a peer reviewed article. That is one limitation.

            Second there is possible bias as the authors are epidemiologists and the paper was funded by the Robert Wood Johnson Foundation.

            Third this population is very difficult to study there are many confounding factors not easily controlled for.

            In addition the impact on the neighborhood while addressed in the paper needs to be looked at with additional studies and local concerns.

            Still there is a strong possibility that such a facility can improve outcomes. The idea should not be dismissed out of hand.

        2. True. That is why multi center data needs to be collected.

          It is also true that one center could be a failure and another be a success. You are never going to know anything without trying.

          Should the citizens of Philadelphia not even try then so be it.

          Then you are where you started.

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