How do sites for supervised drug use work? A primer.
The sites have been controversial in the U.S. Philadelphia advocates have been working to open one here since 2018, while New York City launched two in 2021.
A Philadelphia nonprofit’s efforts to open a site where people can use drugs under medical supervision to prevent overdoses has slogged through court for years, with the federal government asking for another extension in the case Monday.
These sites go by a variety of names: In New York City, which hosts the nation’s only two openly operating sites, they’re termed “overdose prevention sites” as a nod to their ultimate goal: preventing people from dying of overdoses.
“Supervised injection site” is another commonly used term, although many sites, such as New York’s, do not limit participants to people who only inject their drugs.
» READ MORE: Feds ask for another extension in a suit to open a supervised injection site in Philadelphia
The term “supervised consumption site,” or SCS, more accurately describes the spectrum of drug use allowed at many sites.
New York’s ‘overdose prevention sites’
In New York, the Associated Press reported, clients can bring drugs of whatever kind to overdose prevention sites, where they can access “syringes, alcohol wipes, straws for snorting, other paraphernalia and, crucially, oxygen and the opioid-overdose-reversing drug naloxone.”
Clients bring their own drugs to the site, and staffers at New York’s consumption spaces can help them use drug-checking machines to test for contaminants such as fentanyl — a powerful synthetic opioid much stronger than heroin.
In Philadelphia, fentanyl has replaced much of the city’s heroin supply and is now involved in most overdose deaths.
Controversial in other places, including Philly
The sites have operated for decades internationally, but have been controversial in the United States. Philadelphia advocates, including the nonprofit Safehouse, have been working to open one here since 2018, embroiled in a years-long legal battle launched when the Trump administration’s Department of Justice sued to stop Safehouse from establishing a site.
» READ MORE: How a Horsham lab is helping Philly learn about its contaminated drug supply
Some residents in neighborhoods proposed as potential site locations have pushed back: Kensington residents have demanded a say in the process if a site opens in their neighborhood, one of the hardest-hit by the overdose crisis, and South Philadelphia residents successfully blocked Safehouse from opening a site in a medical facility on South Broad Street in early 2020.
Other cities and states have attempted to open sites as overdoses have skyrocketed across the country, but those efforts have mostly either fizzled or been blocked by legislators or governors. California Gov. Gavin Newsom vetoed a bill that would have legalized supervised injection sites in the state this April. Rhode Island’s legislature legalized supervised injection sites in 2021 and is currently setting up rules for how they will operate.
An unauthorized supervised injection site has been operating at an undisclosed location in the United States for years, and reversed 26 overdoses between 2014 and 2019. Staff at New York City’s sites have reversed more than 600 potentially fatal overdoses since they opened last November.