Supervised injection site project director wants ‘respect, dignity, love and life’ for people in addiction
The new director of Safehouse spoke with the Inquirer and Daily News about her passion for harm reduction, her advocacy for people with addiction and why she chose to take the job.
Last week, the nonprofit Safehouse hired an executive director to lead the organization as it works to open a supervised injection site for people in addiction, a first for Philadelphia and possibly the entire nation.
Jeannette “Jen” Bowles, who has a doctorate in public health from Drexel University, was one of the most vocal advocates for a supervised injection site on Mayor Jim Kenney’s opioid task force, convened in 2017 as the opioid epidemic hit crisis levels in Philadelphia.
Bowles, 36, recently returned to Philadelphia from a postdoctorate position at the University of California at San Diego. She has begun her work with Safehouse, which is in the process of raising funds and finding a site where people can use drugs they bring in with them under medical supervision. She spoke with the Inquirer and Daily News about her passion for helping people in addiction. Here is a portion of that conversation.
How did you land in Philadelphia?
I grew up between Puerto Rico and New Jersey. I moved to Philly when I was 20; I’m 36 now. I have a bachelor’s degree in psychology from [Temple University]. I sought out a master’s of social work degree at the University of Pennsylvania, and that led to a pursuit of a doctoral degree at [Drexel University].
I’ve also interned at Prevention Point [the city’s only needle exchange]. I had worked with Project SAFE [a local advocacy organization for sex workers], particularly working with women who were using and injecting drugs.
What have you found is the best way to build trust with people who use drugs?
I just found that the opportunity to sit and develop relationships with folks in a nonjudgmental way led to ... true relationship-building that was sometimes transformative.
Someone would say they were ready to seek treatment, and I was the person who developed a relationship with them because I hadn’t judged them for their drug use. And I was the one they called. And they would be, like, “Jen, I want to go to detox,” and I was, like, “I’ll move mountains to get you to detox.”
What is “harm reduction”?
The basis of harm reduction is about meeting folks where they’re at.
It’s a framework that doesn’t require the abstinence of drugs in order to receive services. When you meet folks in a nonjudgmental space, they may be more likely to use other services because they’re being offered [in a space] that’s showing them care -- that they’re worthy of respect, dignity, love, and life.
Something like a syringe exchange is an example of harm reduction. And there are many people who have stopped using drugs, and are free of HIV and hepatitis C, because they used needle exchange services and because Prevention Point linked them to [treatment].
How does a supervised injection site fit these principles?
The time needed for rescue in the event of an overdose has dramatically shortened in the time of fentanyl [the deadly synthetic opioid that has contaminated almost all of Philadelphia’s heroin supply].
[A supervised injection site] enables us to react and respond [to an overdose] almost immediately, while simultaneously providing other services. This isn’t about walk in, consume drugs, and leave. There’s a host of other social and medical services afforded to people within this intervention.
[Overdose deaths] are happening to family members, to community members -- that’s pain that’s just immense. To me, if we can prevent that, that’s a success.
How are drug users preventing overdoses now?
For my dissertation [at Drexel], I investigated opioid overdoses in Kensington, specifically.
What we found, a lot, is that there are folks who were going to Prevention Point and getting Narcan [the overdose-reversing drug]. And when they were using together, they were able to reverse overdoses among peers, which is incredible.
When I was collecting data, people were still living down on the tracks [at the Gurney Street encampment]. They were using communally, and telling me stories about how they always had Narcan on the tracks. And they were seeing overdose reversals all the time.
On the other hand, other people were using drugs somewhat hastily because they didn’t have somewhere to go, and maybe didn’t have the adequate time, and space, and equipment needed for [injections] to be done in a manner that could reduce the harms [including dangerous infections] associated with drug use.
An academic job in San Diego sounds nice. Why did you want the job at Safehouse?
I’ve known Jose Benitez [Prevention Point executive director and Safehouse president] for a long time, through harm reduction work, and we had been in touch since I left for San Diego. At first he kind of suggested, would you consider [this position] if it was asked of you. I was on an academic track -- a post-doc is to set you up to stay within academia. But my gut reaction, having done advocacy in Philadelphia before, was, like, of course I would consider it.
If we can get this off the ground, it would be the first of its kind in the U.S. And that’s really public health history-making, and that’s something that Philadelphia could be incredibly proud of down the road. We had a number of talks about it, and then it came to an official offer, which I accepted, and then I drove 3,000 miles home in a little car with my two dogs.
The role is partially administrative, which would mean I’ll be responsible for seeing what staffing would look like, involved in where appropriate siting may be, and certain aspects around the public-health end of this.
How do you answer community concerns that a supervised injection site would increase drug use and dealing?
Folks who walk through the door of Safehouse are not coming in to learn how to inject. These are folks who will have been using for some time. [The aim is that] they feel that they’re treated ... with more respect than in other spaces.
There are community benefits, as well -- when we think about harm reduction, we don’t want to just think about benefits to drug users. [Supervised injection sites are associated with] reductions in public drug use and paraphernalia.
And some of that research has been done in the U.S. [A supervised injection site] does exist in the U.S., it’s just in a secret location. And they’ve found they’ve had the same positive outcomes in the community as they’ve found in other communities [internationally] where sites exist.
I want to attend as many town halls as possible to hear from the community what their concerns are about this. [I want to learn] how do we find consensus and work together so this program can be beneficial for the community overall?
Don’t Safehouse and the people who run it face threats of legal action from the U.S. Justice Department?
I don’t think there’s progress in public health without some controversy, and in our case we have some legal controversy. I joined the team that respectfully disagrees with the Justice Department’s stance that this is illegal.
What we can hope is that there’s an understanding among the community and among law enforcement that we’re facing a fatal opioid crisis [and] that we have evidence to show that we can address this with intervention. And we want science to be the cornerstone of policy changes.
Ideally, we’ll have the opportunity to pilot this and show it can work in Philly as it has in other [countries].