Jasper Katz, Law & Public Policy Scholar, JD Candidate May 2019
In 2016, 907 people died as a result of heroin overdoses in Philadelphia.
In 2017, that number is projected to hit 1,200.
As a response to these tragedies, Philadelphia recently decided to move forward in creating a safe injection site (SIF), a place where people who use drugs can do so under medical supervision in case of an overdose. Philadelphia has some of the cheapest and purest heroin available, and our response to this crisis must match the need. Harm reduction, and safe injection sites more specifically, allow us to respond effectively with kindness, care, and compassion.
The importance of this step cannot be overstated. Creating a safe injection site is one way to utilize the philosophy of harm reduction, a philosophy that prioritizes meeting people where they are and listening to them about where they want to go. Harm reduction says that people always deserve kindness, care, and compassion, no matter what.
Caring for and about someone unconditionally is a powerful thing, and it is this philosophy that has motivated Philadelphia to move forward with SIFs. These sites have been saving lives in Vancouver and across the globe for years. Vancouver actually has the longest-running safe injection site in North America, and in the 14 years since it opened, there have been 6,600 overdoses at the site, but not a single death.
Safe injections sites are also not, strictly speaking, illegal. As Temple Law Professor and Director of the Center for Public Health Law Research, Scott Burris, has said, they exist in a bit of a grey area, and the main thing lacking is political will. Harm reduction advocates have been promoting safe injection sites for years, but they often have to battle stigma surrounding drug use. SIFs, and the philosophy of harm reduction more broadly, call into question our opinions and beliefs about the people who use drugs. They make us think about what our responsibilities are to the people around us and how we want to and think we should fulfill those responsibilities; those are certainly not questions with easy answers.
However, we have seen the results of treating drug use with punishment instead of compassion. The war on drugs has only created a new drug crisis, and people are still dying every day. Our view of the demographics impacted by the current drug crisis has changed the response: during the crack-cocaine epidemic, we believed that the communities impacted were mostly communities of color, specifically low-income Black communities. Our response was swift and deadly, decimating communities that are still reeling today.
Now, in the midst of another drug crisis, we see the victims as young white kids from the suburbs, and the conversation has shifted to one about harm reduction. In the long term, this is a good thing. Harm reduction allows us to ask those impacted what they need right now; it allows us to respond to a crisis with compassion, patience, and an ability to meet someone where they are, instead of where we think they should be. It allows for programs like Philadelphia’s Prevention Point, which has distributed clean needles and life-saving drugs that reverse the effects of an overdose since the late 1990s. It gives the people who use drugs more time: using drugs and being alive has to be better than not using drugs because you’re dead.
I am relieved that the conversation is shifting from punishment to harm reduction, however slowly and imperceptibly that shift might be happening. I wish it had happened sooner and earlier; I wish we had listened to the people who thought to have this response in the 1980s; I still wish we were doing a better job of executing this response now, because people are still dying.
Philadelphia has made incredible progress over the past few weeks, and the announcement that we are moving forward in creating a safe injection site is an important step forward. I hope we continue to use this momentum to listen to the people most impacted, and create the programs and resources they say they need.