Philadelphia’s supervised injection site has faced a long legal battle: How we got here

A federal court cleared the way for Philadelphia to become the nation’s first city to open a supervised injection site for intravenous drug users, but plans for the site remain in flux. The U.S. Attorney’s Office in Philadelphia says it will appeal, and Safehouse, the nonprofit formed to operate the site, said it would open a site in South Philadelphia, but those plans quickly collapsed.

The court ruling was the latest step of a two-year battle to open a place where people in addiction can use drugs under medical supervision, be revived if they overdose, and access treatment.

Here’s a look of how we got here.

With the city experiencing a record number of drug-overdose deaths, a task force appointed by Mayor Jim Kenney suggests the city open supervised injection sites, in the most controversial of its 18 recommendations. “We have seen the costs of inaction on epidemics in the past and cannot let that happen again,” Kenney says at a City Hall news conference.

» READ MORE: Supervised injection sites worth considering, says Philly mayor’s opioid task force

Larry Krasner, then the front-running candidate for district attorney, says he supports opening supervised injection sites. The city, for its part, calls planning in the “exploration” stage. Krasner, who represented the needle-exchange program Prevention Point in the early 1990s, says a site is just one tactic in combating an addiction crisis that must be treated as a medical issue.

The city formally announces support of supervised injection sites to be run by private organizations. “We are facing an epidemic of historic proportions,” Health Commissioner Thomas Farley says. “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.”

» READ MORE: Supervised injection sites to fight opioid overdose deaths get green light from Philadelphia officials

Then-Deputy Attorney General Rod Rosenstein vows that the Justice Department will fight any attempts to open a supervised injection site, saying people in addiction need treatment, not access to drugs: “If local governments get in the business of facilitating drug use … they’re actually inviting people to bring these illegal drugs into their places of business. If you start down that road, you’re really going to undermine the deterrent message that I think is so important in order to prevent people from becoming addicted in the future.”

Safehouse is incorporated with the aim of opening supervised injection sites in Philadelphia, with former Mayor and Gov. Ed Rendell on its board. Jose Benitez, head of the needle exchange Prevention Point, serves as the new nonprofit’s president and treasurer. Ronda Goldfein of the AIDS Law Project of Pennsylvania will serve as vice president and secretary. Benitez and Goldfein (who is married to David Lee Preston, an editor at The Inquirer who is not involved in coverage of this story), had approached Rendell about launching the project two months earlier.

» READ MORE: Former Gov. Ed Rendell is leading nonprofit to open a supervised injection site in Philadelphia

Later in the month, U.S. Surgeon General Jerome Adams says he remains unconvinced that Philadelphia should open supervised injection sites.

U.S. Attorney William M. McSwain files suit in federal court to block the opening of a supervised injection site, citing a 1986 law — known colloquially as the “crack-house statute” — that makes it a felony to knowingly open or maintain any place for the purpose of manufacturing, distributing, or using controlled substances. “Normalizing the use of deadly drugs like heroin and fentanyl is not the answer to solving the opioid epidemic,” he says.

» READ MORE: U.S. attorney sues to stop supervised injection sites in Philadelphia

Safehouse files a countersuit arguing that the supervised injection sites are a legitimate medical intervention, not illicit drug dens. The suit also states that the organizers’ religious beliefs compel them to save lives at the heart of the overdose crisis.

» READ MORE: Supervised injection site supporters say their Philly mission comes from religious and medical imperatives

Safehouse asks the judge to give it a chance to explain in court how such a facility can help stop fatal drug overdoses.

U.S. District Judge Gerald A. McHugh holds a hearing during which McSwain grills Safehouse president Benitez on how he plans to open a facility for people to use illegal drugs without breaking federal law. Benitez counters that the primary goals of the operation are to prevent and treat overdoses and provide access to addiction treatment.

» READ MORE: Philadelphia’s supervised injection site plan faces a contentious day in federal court

McHugh holds a second hearing to give both sides a chance to argue whether a supervised injection site would violate federal drug laws.

McHugh rules that Safehouse’s plan for a facility where people could use drugs under medical supervision does not violate the so-called crack-house statute. “The ultimate goal of Safehouse’s proposed operation is to reduce drug use, not facilitate it,” the judge writes.

McSwain later vows to “use all enforcement tools” at his disposal, including drug seizures, arrests, and criminal forfeiture proceedings, to shut down any facility that opens before the Justice Department has exhausted its options in court.

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

Safehouse says it would not let an expected appeal by the Justice Department — or threats from McSwain — stop it from opening soon and asks McHugh to enter a final order cementing his October decision.

» READ MORE: Philly’s supervised injection site backers say they won’t delay opening while Justice Dept. appeals

Safehouse vows to open the first supervised injection site in the nation within a week after McHugh enters a final ruling that the proposed facility would not violate federal law. Plans for the opening collapse within days.