Can 'safe injection sites' help curb opioid addiction? Philly and other cities say yes

Providing a safe, clean space for people addicted to illegal drugs to use them may seem illogical at best, particularly when the goal is to reduce addiction and opioid-related deaths. But city leaders and public health officials in cities like Philadelphia and Seattle, both experiencing increases in overdose deaths, see it as a way to intervene and reverse or at least mitigate an alarming trend. Yes, it's a controversial approach and unthinkable to its critics. But supporters of safe injection sites see them as a valuable intervention tool that can save lives. Yes, to many it's a radical concept for obvious reasons. But if your city is one of those facing the same crisis, it's worth taking the time to at least look into new intervention solutions.  — Doug Peeples


Philadelphia recorded 900 opioid deaths in 2016, 200 more than were recorded the previous year, and 1,200 last year — 80% of them from heroin and a similar but synthetic and far more potent drug, fentanyl. King County, Washington (which includes Seattle) saw a record 332 overdose deaths in 2016.

In 2016 the King County Heroin Task Force recommended two safe injection sites, a recommendation later endorsed by the county prosecutor and unanimously approved by the County Board of Health in January 2017. Later, the city included $2 million in its 2018 budget for a site to be located in Seattle.

City officials realize the name 'safe injection site' will be unpalatable to some people and it may be (officially anyway) referred to as a 'Community Health Engagement Location' instead.

But what exactly IS a safe injection site?
There are variations in services cities planning the sites will offer, but those differences seem to be very minor. Essentially, drug use would be permitted with no legal consequences. Professional medical assistance would be provided and could step in to administer naloxone to reverse an overdose, screening, referrals to primary medical care and housing programs and more. In Philadelphia's case, the program would be part of a larger effort to provide additional services, such as recovery housing and other services.

Philadelphia launched its task force in January 2017. And on Tuesday of this week city officials held a press conference Tuesday to formally announce the city's commitment to a safe injection site. Quoted in a Philly.com article, Health Commissioner Thomas Farley said "We are facing an epidemic of historic proportions. The people in the city of Philadelphia, our brothers, our sisters, our parents, our children, are dying. And they don't need to die. And we have an obligation to do everything we can to prevent those people from dying."

As part of their research, city officials visited a safe injection site in Vancouver, Canada and had a report prepared on data from Canada and European sites. The conclusion: one location in Philadelphia could save between 25 and 75 lives per year, help resolve issues related to drug use in public and reduce the use of public money and other related costs.

The city would not operate the sites (which it prefers to call 'Comprehensive User Engagement Sites'), but hopes to find private companies to manage them.

Anyone else?
San Francisco is working on plans for safe injection sites and a Vermont commission led by a top county prosecutor is advocating for them as well, although the state's Department of Public Safety Commissioner is strongly opposed.

Other benefits
In addition to saving lives and reducing neighborhood issues caused by public drug use, supporters of the sites say they could help reduce the number of potentially dangerous situations emergency medical personnel and police face when responding to an overdose call.

Doug Peeples is a Portland, Oregon-based writer specializing in technology and energy. Follow @smartccouncil on Twitter.