Opioids

These People Are Risking Prison To Help Philadelphia's Drug Users

"All we want to do is save some young people from dying needlessly," says former Gov. Ed Rendell, who's on the board of Safehouse, the nation's first supervised injection site to operate out in the open.

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Addiction advocates in Philadelphia are gearing up for a fight with federal law enforcement over a so-called supervised injection site, where drug use can take place in the presence of medical professionals.

Fatal overdoses from opioids in the United States have increased by about 250 percent since 2007. The problem is particularly acute in a handful of states, including Pennsylvania, which has the nation's third highest overdose death rate.

In the city of Philadelphia, overdose deaths are concentrated in the neighborhood of Kensington, where a supervised injection site known as Safehouse is slated to open.

At Safehouse, drug users will be invited to drop in and inject themselves with drugs like heroin. If they overdose, supervising staff will administer the overdose reversal drug Naloxone, often known by the brand name Narcan. The facility will also provide clean needles and a sanitary environment.

But Safehouse is technically in violation of the so-called "crack house" statute, which was part of the federal Anti-Drug Abuse Act of 1986. In early 2019, the DOJ preemptively sued Safe House and its executive director, Jeanette Bowles, a move that will make it easier to begin making arrests if the project moves forward.

"We don't supply anybody with drugs, we don't touch drugs, [and] none of our personnel do," says former Pennsylvania Governor and former Mayor of Philadelphia Ed Rendell. "If you're an addict and you want to use the safe house, you have to bring whatever drug it is you're using to the site."

Rendell sits on the board of the nonprofit that's behind Safehouse, and he's been instrumental in building support for the project.

"The senators and congressmen who developed the crack house statute never in a million years thought about volunteer medical personnel standing by while someone injecting themselves ready to… reverse the effects of the overdose," says Rendell. "Do you think they thought for a minute that that activity should be criminal?"

Safehouse would be the first supervised injection site in the U.S. operating out in the open. In 2014, a social service agency opened a covert facility in an undisclosed urban neighborhood in the U.S.

According to a 2017 study in the American Journal of Preventive Medicine, over two years, 2,574 injections were performed at the site, 90 percent of which would have otherwise occurred in a "public restroom, street, park, or parking lot," according to participants. Two overdoses were treated immediately with Narcan.

There are over 120 supervised injection sites across the globe. Safehouse is modeled after Insite, a supervised injection site in Vancouver Canada.

"We're asking the federal government to use their prosecutorial discretion and not make an arrest for violation of a statute that never meant to cover this type of activity," Rendell told Reason. "We'll go ahead with it and maybe…[we'll] wind up in federal prison."

It's not the first time Rendell has squared off with authorities for policies intended to help addicts. In 1992, when he was mayor of Philly, a group of activists opened a needle exchange called Prevention Point to combat the AIDs epidemic.

When Rendell signed an order allowing it to proceed, he received a call from the state health commissioner, who said he would be arresting anyone involved with the program.

"I said 'Mr. Secretary, come to 212 City Hall, that's my office, and arrest me first because I'm the one who sent those people out and told them they would be left alone,'" says Rendell.

Rendell issued an executive order directing the city attorneys not to prosecute the activists involved in Prevention Point.

"Prevention point went on to be a great success, accepted universally, and, in Philadelphia, our model was used in 30 other American cities," he says.

Rendell sees Safe House as a continuation of that mission.

"I don't think the government should be wasting resources arresting doctors and nurses who are volunteering their time. I don't think they should do that," says Rendell. "And all we want to do is save some young people from dying needlessly. That's all we want to do."

Produced, edited, and narrated by Mark McDaniel.

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  1. These People Are Risking Prison To Help Philadelphia’s Drug Users

    First off, I don’t think you have convinced people that giving addicts clean needles “helps drug users”. All they are really doing is helping drug users get high with clean needles. This is potentially lowering needle sharing and OD related injury. Many Addicts at this level are still engaging in very high risk behavior, including but not limited to unprotected sex while high and stealing property to get money for the next fix.

    Second, as we have learned from decades of serious addiction disorders, enabling Addicts to use usually leads to longer periods before they hit bottom and get clean or die. It would almost appear that by “helping” you are actually lengthening the suffering of the Addict.

    With that being said, I think some drug users who inject have the money to do it at home and use a needle just for them. This completely avoids the high risk of shared needles. This does not avoid the OD issue but even doctors prescribe medicines in excessive doses.

    1. I am also one who advocates for the repeal of the Controlled Substances Act, thereby making all drugs legal again and ending most of this War on Drugs nonsense.

      I think Americans still dont want to see people suffer and having their lives spiral into drug addiction but it’s supposed to be a free country. Decisions have consequences that people have to live with.

      Boomers as a Generation have high incidences of hepatitis C likely because of high risk sex, high risk drug use, and medical facilities spreading the disease from the infected to the uninfected. This Generation made choices and has to live with the consequences but many want young Americans to pay for their poor choices.

    2. Addiction is a symptom of PTSD.

      Post USA Civil War alcoholism was called “the soldiers disease”

  2. If drugs were legal this would be seen for the horrible idea it is, and the operators would rightly face civil action over the public nuisance they are creating.

  3. Rendell may have deluded himself into thinking he’s just saving lives, but he’s also making a shitload of money from it.

    If he wants safe injection sites, put them in Rittenhouse Square. Kensington is already a shithole and the people there don’t need more junkies showing up for free needles.

    Drug addiction isn’t curable. Let these people die already and stop wasting resources on them.

    1. “Drug addiction isn’t curable.”

      Rush Limbaugh would like a word with you.

      1. The damage to your body is permanent and you never really are “cured.”

    2. They are not trying to cure anything. What they are trying to do is harm reduction.

      And drug addiction is curable, or rather can be in lifelong remission, the semantics are debatable.

      1. You don’t reduce harm by creating market forces that bring more junkies, needles and dealers into an already struggling neighborhood.

        1. If it was such a good thing, you’d see these places put in nice parts of town. But you never will. Best to make sure the junkies die where the hoi polloi are less likely to see them.

          1. The junkies in the nice part of town have nice clean needles and shoot up at home.

            These junkies are already in the crappy neighborhoods shooting up in public bathrooms, hallways and alleyways.

            So how is that better?

            Nobody knows if it will improve things or not because there is not enough data. To get that you need to have a fair number of these places in different locations and pool the data.

            So it is an experiment, a pilot project. If it doesn’t work out then don’t do it. All of these objections are projections based on emotion as are most attitudes about addiction and drug addicts.

            If we don’t bring this out in the light of day and look at it in an objective non judgmental manner it will just go on.

        2. projection without evidence. I think part of having one of these should be that you have to collect data including impact on the neighborhood. That should be published in scientific revised journals.

    3. Addiction is a symptom of PTSD.

      Dr. Lonny Shavelson found that 70% of female heroin addicts were sexually abused in childhood.

  4. WIH this has to do with free minds or free markets is a mystery to me.
    The drug laws are deplorable; end them. Helping idiots shoot up is another issue entirely, and one which is of doubtful value.

    1. Yeah, it’s pretty blatant rent-seeking being glossed over with hand waving. The majority of the benefit from such a facility is from clean needles, which don’t need a facility to see their effects/benefits. Additionally, the exchange between costs of lives saved vs. exposure/shielding to liability isn’t clear and minimally explored. Not to mention that, again, there’s no reason why you couldn’t simply sanction and shield in-home or at large caregivers unless you’re going to say that only doctors can work in these clinics and only doctors are capable of preventing OD deaths and only in these clinics. Otherwise, you can grant the immunity to any given nurse, EMT, and social worker already on the payroll in any building they choose to walk into.

  5. Nothing in politics is more bizarre than the people who stick to positions long after they know that the position is a failure and will accomplish the exact opposite of the outcome that the person is trying to accomplish.

  6. Liberal Governor of California, Jerry Brown’s Veto Message for “safe” injection sites

    gov.ca.gov/wp-content/uploads/2018/09/AB-186-veto-9.30.pdf

    cbc.ca/news/canada/toronto/mother-opposes-safe-injection-sites-1.3496502
    Radio interview with a young woman battling addiction about “safe” injection sites. Starting at 3:14

    She insisted that such sites would have exactly the opposite effect as intended. “ I don’t think it’s harm reduction anymore. It just goes into enabling and harm. When I was an addict,” she said, “I didn’t have anywhere to go. I’d be in stairwells, I’d be in bathrooms, I’d be in the malls. Having somewhere to go, where everybody is shooting up, it’s almost like a dream come true.”

    Addict shares how to help addicts:
    cbc.ca/news/canada/toronto/mother-opposes-safe-injection-sites-1.349650

  7. Hilariously if, instead of injection sites, these were sports facilities aimed at getting kids off the streets or promising to attract business, Reason would be highlighting what a sham they are and how the benefits are between marginal and illusory.

    1. No the organization is a privately funded non profit. The libertarian objection here is that there is a law which may prevent them from opening. The law clearly should not be applied to this sort of facility.

    2. Wow. An argument from prophesy, divination and necromancy. Have you heard the word of Jesus today?

  8. Back when the Haight was like modern Portugal, you couldn’t give away opiates except to arthritic geezers and curious teenyboppers. With choices available, everyone spent money on psychedelics, hashish and, if truly benighted, uppers and downers. The cure for opiates (at least among youth) is a decriminalized market. For elders, maybe a reliable supply of affordable chondroitin?

  9. It appears Reason has confused “help” with “enable”…again.

  10. http://www.huffingtonpost.ca/mark-hasiuk/insite-vancouver_b_3949237.html

    “Ten years later, despite any lofty claims, for most addicts, InSite’s just another place to get high.”

    The 100% positive studies on Vancouver’s Insite (Safe Injection Facility) was done “Early last decade, Montaner and Kerr lobbied for an injection site. In 2003, the Chretien Liberals acquiesced, gave the greenlight to B.C.’s Ministry of Health, which, through Vancouver Coastal Health, gave nearly $1.5 million to the BC Centre (that’s Montaner and Kerr, you remember them) to evaluate a three-year injection site trial in Vancouver.

    I asked him about the potential conflict of interest (lobbyists conducting research) and he ended the interview with a warning. “If you took that one step further you’d be accusing me of scientific misconduct, which I would take great offense to. And any allegation of that has been generally met with a letter from my lawyer.”

    Was I being unfair? InSite is a radical experiment, new to North America and paid for by taxpayers. Kerr and company are obligated to explain their methods and defend their philosophy without issuing veiled threats of legal action.”

    In the media, Kerr frequently mentions the “peer review” status of his studies, implying that studies published in medical journals are unassailable. Rubbish. Journals often publish controversial studies to attract readers — publication does not necessarily equal endorsement. The InSite study published in the New England Journal of Medicine, a favourite reference of InSite champions, appeared as a “letter to the editor” sandwiched between a letter about “crush injuries” in earthquakes and another on celiac disease.”

    Really? What kind of “science” produces dozens of studies, within the realm of public health, a notoriously volatile research field, with positive outcomes 100 per cent of the time? Those results should raise the eyebrows of any first-year stats student.”

    And who’s more likely to be swayed by personal bias? InSite opponents, questioning government-sanctioned hard drug abuse? Or Montaner, Kerr and their handful of acolytes who’ve staked their careers on InSite’s survival? From 2003 to 2011, the BC Centre received $2,610,000 from B.C. taxpayers to “study” InSite. How much money have InSite critics received?”

    There has never been an independent analysis of InSite, yet, if you base your knowledge on Vancouver media reports, the case is closed. InSite is a success and should be copied nationwide for the benefit of humanity. Tangential links to declining overdose rates are swallowed whole. Kerr’s claims of reduced “public disorder” in the neighbourhood go unchallenged, despite other mitigating factors such as police activity and community initiative. Journalists note Onsite, the so-called “treatment program” above the injection site, ignoring Onsite’s reputation among neighbourhood residents as a spit-shined flophouse of momentary sobriety.”

  11. There are a significant minority of socons which want to outlaw many types of birth control too because it’s “abortion”. That’s right, pills or IUDs might cause a fertilized egg not to implant so that’s “killing the baby”. Not even scientifically accurate – but having no birth control might keep the sluts from having sex or create more babies that will immediately get adopted (yea!).

  12. Retarded. Drugs should be legal, but this kind of shit is insane. Most of these people need to be forced into treatment, not given tax payer funded spots to chill out and get high. If shit was legal and this was privately funded I’d be less peeved… But it would still be a dumb idea vs trying to convince people they need rehab.

    Also, if you want to be a dick about it, we’re pretty much better off if these people just OD and die quick if they’re not going to get themselves off of drugs.

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