Philly’s journey to a supervised injection site spans years as overdose rates soar

In 2017, Philadelphia was on track to see a record-breaking overdose death toll. Calls were growing to open a supervised injection site, where people can use drugs under medical supervision and be revived if they overdose. By the end of the year, 1,217 people had died of an overdose, and city officials made the decision to sanction a site but not pay for it.

Five years later, the city still has no site, and the deaths go on. Still, advocates see renewed hope in the fact that the Justice Department under President Joe Biden signaled this week it is reconsidering the Trump administration’s long-held opposition to such efforts. Here’s a timeline of key moments in the process:

» READ MORE: Justice Department reevaluating supervised injection sites after its yearslong effort to block one in Philly

Philadelphia health officials announce they will support — but not fund — a supervised injection site.

Safehouse, a Philadelphia nonprofit, announces it wants to be the first supervised injection site in the country. Jose Benitez, the executive director of the long-running harm-reduction program Prevention Point; Ronda Goldfein, the executive director of the AIDS Law Project of Pennsylvania; and former Gov. Ed Rendell, who authorized the first syringe exchange in Philadelphia, are on the executive board.

Then-U.S. Attorney Bill McSwain, a Trump appointee, files a lawsuit to block Safehouse, citing a 1986 federal law colloquially known as the “crack house statute.” That law makes it a felony punishable by up to 20 years in prison to knowingly open or maintain any place for the purpose of using controlled substances.

Safehouse files a countersuit in federal court, arguing that the primary purpose of opening a supervised injection site is to save lives, not to provide a place for drug use, and therefore, such a site is not illegal under the crack house statute. The organization also argues that its founders are compelled by their religious beliefs to save lives in the overdose crisis.

» READ MORE: Supervised injection site supporters countersue feds

Philadelphia announces 1,116 fatal overdoses in 2018, only a slight drop from 2017′s record high.

Safehouse is granted tax-exempt status by the IRS.

The federal government’s lawsuit against Safehouse goes to court, with Safehouse officials testifying in the courtroom and supporters rallying outside.

In a first-of-its-kind ruling on the issue, U.S. District Judge Gerald A. McHugh says supervised injection sites do not violate federal law, clearing the path for Safehouse to open a site. McSwain vows to appeal and threatens to “use all enforcement tools” at his disposal to shut down any facility that opens before the Justice Department has exhausted its legal options.

» READ MORE: Judge: Philly supervised injection site proposal does not violate federal law

Safehouse announces it will open the first supervised injection site in the country, in an initially surprising location: South Philadelphia, where overdose deaths are high but where drug use is much less visible than in Kensington, the neighborhood hit hardest by the crisis. The proposal is met with immediate outcry from some community members and falls apart within days.

The Justice Department appeals McHugh’s ruling to the U.S. Court of Appeals for the Third Circuit in Philadelphia.

As Philadelphia enters the second month of the COVID-19 pandemic and ensuing lockdowns, city officials announce that 1,150 people died of overdoses in 2019, a 3% increase from 2018. The announcement dashes earlier hopes that deaths might continue to decline, and health officials warn that overdose deaths might increase even more during the pandemic.

McHugh grants the federal government’s request for a stay on his order that cleared the way for Safehouse to open until the Third Circuit can weigh in on the case. Amid the ongoing COVID-19 pandemic and protests over the police killing of George Floyd, McHugh says now “is the wrong moment for another change to the status quo.”

Biden is elected president. Biden, who, as a senator, was one of the cosponsors of the 1986 bill that instituted the “crack house statute,” later said that he regrets some of the tough-on-drugs legislation he championed during the period. During his presidential campaign, he pledged to decriminalize marijuana. His health and human services secretary, Xavier Becerra, supports supervised injection sites and signed onto a legal brief supporting Safehouse as California attorney general. But Biden’s attorney general, Merrick Garland, has largely remained silent on supervised injection sites.

Reversing McHugh’s initial findings, the Third Circuit rules that Safehouse’s plan does violate federal law. The appellate court returns the case to District Court, so it can rule on Safehouse’s other claims — including its argument that Safehouse founders’ religious faiths compel them to save lives amid an overdose crisis. Safehouse officials say they’re exploring their options, including an appeal to the Supreme Court.

Philadelphia health officials announce the number of overdose deaths in 2020: 1,214 fatalities, the second-highest overdose death toll on record. The staggering numbers were likely exacerbated by the pandemic, and health officials note with alarm that deaths in the Black and Hispanic communities are rising — the same groups hit hardest by the COVID-19 pandemic.

» READ MORE: Philadelphia drug deaths soared again in 2020, hitting Black residents hardest: ‘It’s a racial justice issue’

The Supreme Court declines to hear Safehouse’s appeal. Safehouse officials say that the organization still hopes to prevail in District Court — and that the ongoing litigation will force the Justice Department under newly elected President Biden to reconsider the Trump administration’s stance.

Two supervised injection sites open in New York City but unlike Safehouse four years earlier faced no threats from their U.S. Attorney’s Office. Meanwhile, in Philadelphia, health officials warn that 2021 could see even more fatal overdoses than the year before.

In a statement first obtained by the Associated Press, Justice Department officials say they are “evaluating” supervised injection sites and discussing “appropriate guardrails” with stakeholders — signifying a shift in thinking on the sites. Goldfein, Safehouse’s vice president, says the organization is in productive talks with the federal government.