Safe Consumption Site in Philly Has 90 Percent Support Among Locals

    Communities most impacted by the overdose crisis are more likely to back groundbreaking interventions like safe consumption sites (SCS) in order to mitigate problems and reduce deaths. That’s the message behind a first-of-its-kind study published this week in the Journal of Urban Health.

    Researchers asked residents of Philadelphia’s overdose-ravaged Kensington neighborhood to weigh in on a proposed SCS slated to open there this year, and they expressed overwhelming—90 percent—support.

    Safehouse, a nonprofit established last October to open the nation’s first sanctioned SCS, is currently locked in a legal battle with the Federal Government, in a case that many expect will ultimately decided by the Supreme Court.

    An SCS in Philly was first seriously considered in 2017, during District Attorney Larry Krasner’s pro-reform election campaign. His victory paved the way for city support. In January 2018following a fact-finding trip to InSite in VancouverMayor Jim Kenney and Police Commissioner Richard Ross said they would not interfere with good-faith efforts to save lives through an SCS.

    However the issue quickly became the subject of local controversy. A series of town hall meetings sponsored by a local radio personality who opposed the idea set the tonedespite the fact that most of the attendees lived outside Kensington, which has since been identified as the location for a proposed site. A small group of powerful City Council members also announced their intention to block an SCS.

    The NIMBY argument loses its teeth when your “backyard” is already littered with used syringes, and suffers high casualties linked with the ubiquity of fentanyl in the illicit drug supply.

    Harm reduction advocates found themselves losing control of the dialoguewhich notably excluded those most likely to benefit from an SCS. However, the closure of four homeless encampments this year, which displaced hundreds of injection drug users, has amplified what was already a critical public health crisis. Public injection is now at an all-time high along Kensington’s main thoroughfares.   

    The new study pokes a hole through the lens of NIMBY-ism (Not In My Backyard) through which many people still view this issue. There is a misconception in some quarters that an SCS will create the problems it promises to fix. But spend just a short time in the streets of Kensington and it’s evident those problems already existand are getting worse by the day. According to the study’s findings, this reality is apparent to local community members.

    The survey was conducted by members of Drexel’s University’s Dornsife School of Public Health and co-authored by noted harm reduction experts Alex H. Kral, and Peter Davidson of University of California San Diego.

    “We surveyed nearly 450 Kensington residents and business owners and staff about whether they were in favor of an overdose prevention site opening in the neighborhood,” lead author Alexis Roth explained to Filter. “We found the majority90 percent of residents and 63 percent of business owners and staffwere in favor of a Kensington-based overdose prevention site.”

    “Nine out of ten survey respondents indicated they frequently see drug litter,” she continued. “Moreover, 60 percent of the business respondents indicated they had called 911 or administered naloxone on someone they thought was overdosing on their premises. This indicates they are already engaging in efforts to curb harm associated with the opioid-related overdose crisis in their neighborhood. These experiences may explain, at least in part, why people are expressing support for another harm reduction initiative.”

    In other words, the NIMBY argument loses its teeth when your “backyard” is already littered with used syringes and spent naloxone cartridges, and suffers high casualties linked with the ubiquity of fentanyl in the illicit drug supply. Thanks to police efforts to shut down “shooting galleries” and less visible places where drug users gather, the streets of Kensington themselves have become a de facto consumption site—just not a safe one.   

    Federal legal efforts to prevent SCS on US soil continue. In March, US Attorney William McSwain filed a lawsuit against Safehouse, seeking an injunction to prevent the facility from opening on the grounds it violates the co-called “crack house” statute of the Controlled Substances Act. (Filter’s Sessi Kuwabara Blanchard wrote an excellent summary of the legal arguments expected to play out in the case.)

    In a countersuit, Safehouse (which includes two theologians among its board) invoked religious liberty in its defense of SCS, arguing that blocking one would violate the Religious Freedom Restoration Act.

    “Safehouse’s model will include medically supervised consumption and observation. Those who are at high risk of overdose death would stay,” the counterclaim asserts, adding that these measures are “an exercise of the religious beliefs of its Board of Directors, who hold as core tenets preserving life, providing shelter to neighbors, and ministering to those most in need of physical and spiritual care.”

    Skeptics remain. This speaks to harm reductionists’ continued need for effective messaging.

    While local support for supervised consumption is overwhelming, according to the Drexel study, skeptics remain, including some people who use drugs themselves. This speaks to harm reductionists’ continued need for effective messaging.

    Homeless people who use heroin have expressed a range of pro- and anti-SCS views during my time reporting in Kensingtonincluding one man who argued emphatically that a SCS would only “enable” his drug use. Others worry about privacy, saying they would be less likely to use a facility that requires them to give their name or other identifying information. Others still have trouble injecting themselves and rely on another person to do so for them; Safehouse has not yet said whether its site would permit that.

    And injection drug users who say they would use an SCS may still struggle to comprehend its practicalities. “I just don’t understand it,” said one local woman who uses drugs during a street interview in May. “I mean, I think it’s great but if you’re telling me it’s going to be, like, okay for us to have drugs on us and use them there, well I mean, you’re gonna see a tent city pop up around that place.”  

    So clear communication is still needed. But “tent cities,” as my reporting for Filter has shown, are far preferable to the alternative of cracking down and not allowing street-based drug users to gather anywhere. In one of the communities hit hardest by the overdose crisis, when it comes to the Russian roulette of fentanyl-adulterated drugs, there is safety in numbers.

    The advent of an SCS in Kensington would exponentially increase that safety.


    Photograph (by Christopher Moraff): A young woman prepares a “speedball” of heroin and cocaine along the edge of a busy street in West Kensington.

    • Christopher Moraff

      DISPATCHES is Christopher Moraff’s weekly column for Filter, featuring analysis and beat reporting. Christopher has spent over a decade reporting on the intersection of policing, criminal justice and civil liberties. His immersion reporting from Kensington, Philadelphia, has earned him a reputation as an expert on injection drug culture and the fentanyl crisis. His work has appeared in publications including the Daily Beast, the Washington Post and Al Jazeera America. He is co-host of the podcast Narcotica, and curator of the stock photo site StashHouse.org.

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