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Battling the Opioid War

· Healthcare,Health,Philadelphia

Battling the Opioid War

The overdose related death rate is on the rise in the United States. Despite mounting resources dedicated to confronting the growing crisis, more and more Americans are dying from opioid related deaths. Current procedures for battling addiction are clearly failing and new and more aggressive actions must be considered. One city that is trying to take a bold stance in the battle against deaths related to opioid addiction is Philadelphia.

Philadelphia has been on an urban rejuvenation path over the last 2 decades. However, the increase of a larger and wealthier urban population also comes with its downside. The opioid use in the city has skyrocketed, putting Philadelphia on the front lines of the opioid war. Philadelphia has been seeing increasing numbers of opioid related deaths in the past years with over 1,000 deaths just last year. In an attempt to see those numbers go down, Philadelphia is trying to open a medically supervised facility known as “Safehouse”. It is essentially and frequently referred to as a “safe injection site”, a place where addicts can come to use their illegal drugs under medical supervision and be provided with clean needles. While their intentions are to lower the rising death rate related to opioid overdoses, congress is having a hard time getting behind the legality of such a facility. In an editorial article published in the LA Times titled “Helping addicts stay alive shouldn’t be a crime”, the editorial board takes a positive view to the idea of such a site opening.

Safe injection program Insite's facilities in Vancouver, Ca which has been operating since 2003.

The main issue that is being debated in the LA Times article is whether or not the ‘safe injection site’ “Safehouse” should be legal. These medically supervised facilities already exist around the world, however none are in the United States. “There are dozens of drug consumption centers operating in Europe, some for more than 20 years. (LA Times)” The closest center to the United States is “Insite” located in Vancouver, Canada and has been open and operating since 2003. Vancouver has seen a substantial decrease in overdose fatalities since the opening of the safe injection facility. While Safehouse is a harm reduction site, it is also currently illegal to operate under the federal drug laws. There has been public communication on the issue of legality from congressmen to the non profit itself.

While the LA Times editorial board believes that it would be “worth trying every tool instead of criminalizing effort to save lives”, federal prosecutors in Pennsylvania have filed a lawsuit against the facility to prevent it from opening. The lawsuit was filed the day after President Trump’s State of the Union Speech where he made a vow to fight opioid use and HIV. “In political debates, critics describe these centers as nothing more than government-sanctioned opium dens, where addicts are encouraged to get high in comfort. (LA Times)”Deputy U.S. Attorney Rod Rosenstein also made a public statement over the summer (2018) “…that the federal government would take swift and aggressive legal action if cities open sites. (AP News)” Both the state and the federal laws are currently against Safehouse’s chances of operating and would need to change before the site could officially open to the public legally. The opening of Safehouse “…would violate a section added to the Controlled Substances Act in the 1980’s during the height of the crack epidemic. (NPR)”

Safehouse is still determined to open its doors despite the current legal questions. The law in the United States supports harm reduction programs. Safehouse maintains its claim to be a part of this program and claim to be “consistent with federal law…(LA Times)” in regards to this.The organization intends to be medically supervised and offer not only clean needles, but the drug naloxone, an overdose reversal medicine with the ultimate goal of saving lives. While Safehouse is still illegal, several congressmen have opted to support this non profit organization. Ed Rendell, the former Pennsylvania Governor is on board with supporting Safehouse as “…the nations first supervised drug injection site…(AP News)” He claims to continue his support, regarding any legal actions that may be thrown at him. “Philadelphia Mayor Jim Kenney and other city officials announced in January that they would support a private entity operating and funding safe injection sites. (AP News)” Philadelphia District Attorney Larry Krasner also seems to be on board with a statement that he will “…decline to prosecute workers or volunteer medical students who set up ‘a responsibly run harm reduction center’…(AP News)”


While there is no precedent for safe injection facilities in the United States, there are pre existing sites around the world. It will be interesting to see how the law will effect Safehouse’s efforts to legally operate in the upcoming months. Their goal of wanting to save lives and reduce the overdose death rate is admirable but the methods in which they are seeking to do so are not within the bounds of the United States state and federal laws.

Written by Ariel Silverstein & Edited by Alexander Fleiss

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