The Secret Safe Injection Facility That Is Saving American Lives

I have written herehere, and here about efforts by a nonprofit in Philadelphia named “Safehouse” to establish a Safe Injection Facility in the neighborhood of Kensington, where IV drug use is rampant and out in the open, and overdoses are soaring. That effort is being impeded by threats from the Department of Justice that it will enforce federal law prohibiting such sites. The specific law at issue is known as the “Crack House Statute,” passed in the 1980s. Leaders in other major US cities who also want to set up Safe Injection Facilities, including SeattleSan FranciscoNew York, and Boston, are closely monitoring the situation before proceeding with their own plans.

In my Policy Analysis on harm reduction I wrote of the impressive results that Safe Injection Facilities (also called “safe consumption sites” and “overdose prevention sites”) have had throughout much of the developed world since the 1980s. Now in operation in over 120 cities in Europe, Canada, and Australia, these facilities have dramatically reduced the spread of HIV, hepatitis, and other blood-borne diseases, dramatically reduced overdose deaths, and have brought many addicts into rehab programs. Darwin Fisher, the Program Coordinator of “Insite” in Vancouver, BC, the oldest Safe Injection Facility in North America (since 2003), gave an impressive presentation of how that facility has worked to save lives at Cato’s conference on harm reduction last March. You can see that presentation here.

The Policy Analysis also mentioned a Safe Injection Facility secretly operating in the US since 2014, notwithstanding the federal prohibition. A 2017 paper in the American Journal of Preventive Medicine that kept the name and location of the site confidential, reported it was well-accepted by the community, had at least four documented overdose reversals, and had no deaths associated with its operation. Dr. Barrot Lambdin, a senior epidemiologist with RTI International, an independent non-profit research institute in North Carolina, gave a data update on this secret Safe Injection Facility at an international conference on harm reduction held in Porto, Portugal on April 29, 2019. He did not disclose the name or location of the facility. 

One objection raised by residents of communities where these sites are proposed is that they don’t want to see IV drug users on the streets of their neighborhoods. But proponents respond that Safe Injection Facilities actually bring such people indoors, injecting their drugs out of the view of the community. Dr. Lambdin reported that since the facility’s opening in September 2014, nearly 8,400 public injections were prevented. 

Dr. Lambdin also reported the number of overdose reversals has now increased to 26.

Because the site is illegal, it is only able to operate part time—five or six days a week for eight or ten hours a day. And it accepts participants by invitation only. The surrounding community has cooperated by helping the facility maintain secrecy.

So here is an example of a Safe Injection Facility saving lives, and well-accepted by the surrounding neighborhood, in spite of federal impediments. Imagine how many more lives it could save if it could operate around the clock, out in the open, and advertise for walk-ins. Imagine how many hundreds or even thousands of lives would be saved if the “Crack House Statute’ was repealed.