Last year, more Americans died of drug overdoses than ever before — more than 100,000 lives were lost. Philadelphia has been far from spared: More than 1,200 residents died in 2020 alone, and the city is home to the largest open-air drug market on the East Coast, if not the nation.

The big question is: What do we do about it?

Some have proposed setting up a safe injection site, where people can receive clean needles, with staff on hand to reverse overdoses and keep people alive. But the idea is deeply controversial.

We asked two residents: Is a safe injection site a good idea in Philadelphia?

Yes: Safe injection sites save lives.

By Brittany Salerno

Over the years, as someone who works with people struggling with opioid use disorder and has loved ones who are also affected, I have heard a lot of opinions about safe injection sites. I understand that the concept can be foreign to some people, and even those who support the idea of a safe injection site often don’t want it located in their neighborhood.

Well, I live in Northwest Philadelphia, and I would welcome a safe injection site in my neighborhood.

For one, the term “safe injection site” is misleading, because it is not just a place for people to inject drugs using clean needles. Rather, it should be called an overdose prevention center, because these facilities help keep people alive by providing a safe and sterile space to use drugs under medical supervision, with equipment to reverse an overdose in case one occurs.

Philadelphia is in desperate need of these services. In 2020 alone, the city experienced more than 1,200 unintentional overdose deaths.

» READ MORE: U.S. overdose deaths reached a record 107,000 last year, the CDC says

And yet, too many Philadelphia residents don’t feel like I do. Recently, residents in South Philly rallied against the opening of Safehouse, which attempted to open an overdose prevention center in Constitution Plaza.

I don’t blame them for being concerned — there hadn’t been nearly enough community engagement, and some neighbors felt blindsided. But amidst the bullhorns and parade of residents expressing their dismay that day, a young man died behind a closed door of an opioid overdose just a few blocks away.

A safe injection site is a medical facility. It doesn’t provide patrons with drugs, just tools to reduce harm and a place to dispose of needles safely to reduce both public waste and the potential spread of diseases. Sites also connect people to basic wound care, HIV testing, and supportive social services, and provide connections to treatment and peer specialists who are in recovery themselves. These centers reach people who are often not connected to resources, whether it’s due to lack of insurance, stigma, discrimination, or distrust of traditional services.

It’s not such an experimental concept, either, as these sites are effective and have been operational for decades. Almost 200 safe injection sites are operating around the world, and no fatal overdoses have occurred at any site. In the first six months of the first two facilities in the U.S. operating in New York City, 314 potential overdoses were reversed.

Safe injection sites keep surrounding grounds clear, and studies even show no increase in crime or public nuisance. Even if some neighbors don’t like the idea, a national poll of likely voters found that 64% would support a site.

“Our neighbors and loved ones are dying without this resource.”

Brittany Salerno

Not only would these sites promote individual and public health, but they would also save us millions of dollars — specifically, more than $1.5 million a year in health-care costs just in Philadelphia. A site would also alleviate overdose calls to both EMTs and local emergency departments, which lets them respond to other health emergencies.

Our neighbors and loved ones are dying without this resource. I hold the city accountable for the lack of action in addressing the overdose crisis — it is the one responsible, not the people struggling with addiction.

Let’s open a safe injection site to start saving lives, connecting people to resources, and cleaning up the surrounding community. We wouldn’t need to wait for the evidence to prove that a site is effective, because it begins as soon as the doors open. That’s enough for me.

Brittany Salerno is a master’s of public health candidate at the University of Pennsylvania and a founding member of the Philadelphia Overdose Prevention Network.

No: People need treatment, not another place to inject.

By Barbara Capozzi

In recent years, our beautiful city has experienced a frightening decline in quality of life. Neighbors and businesses watch in horror at mind-numbing and unchecked violence; ATVs and dirt bikes terrorize quiet communities and busy Center City streets, scaring away patrons and tourists; streets and sidewalks are filthy and riddled with potholes; city services have been reduced to “bare minimum” without even trash collection guaranteed; and wage taxes continue to be the highest in the nation.

If this hasn’t produced enough of an urban misery index, there is the legacy of the pandemic, riots, and unrest in the wake of the murder of George Floyd.

Amid all of this, the epidemic of opioid use disorder has resulted in people using drugs on transit, in concourses, and along commercial corridors.

» READ MORE: Business and bloodshed

None of these crises has been handled well — if at all — by our political leadership.

In this context of community exhaustion, Philadelphia residents are being asked to accept an experiment with safe injection sites. Can you blame us for being skeptical?

I know there are data showing that these sites in other cities have not been associated with an increase in crime or other issues. But can you blame us for being skeptical of that, too? Especially given how much crime in Philadelphia has skyrocketed in recent years.

I agree that the city is facing a crisis related to opioid use disorder. And I agree that we need to do more to help people and their families who are affected by it. But I don’t believe a safe injection site is the answer — and I certainly don’t trust the city to handle it properly.

“Can you blame us for being skeptical?”

Barbara Capozzi

Our citizens have lost faith in our elected leaders to do the fundamentals. Nothing illustrated this better than the shooting on South Street. The heavy police presence could have de-escalated the violence before it got worse, but our elected officials have handcuffed the police. In 2016, City Council passed a bill decriminalizing quality-of-life crimes, such as public drunkenness and disorderly conduct — these offenses are now code violations, not subject to criminal charges as they once were. Ever since, some business owners say things have gotten more dangerous.

With the administration’s prohibition on enforcing quality-of-life crimes in place, how can any community be asked to welcome a safe injection site? With the East Coast’s largest open-air drug market in Kensington (on YouTube for all the world to see), where is the city’s credibility in addressing the impacts of the opioid epidemic? When more than 1,000 people are dying in Philadelphia each year of overdose, how can we possibly explain to our children that it is OK to give people with opioid use disorder “safe” spots to get high?

People with opioid use disorder don’t need another place to get high — they need better options and access to treatment so they can reclaim their lives.

The last time a safe injection site was attempted in South Philadelphia, neighbors sprung into action and defeated the proposal. Since then, leaders and rowhouse citizens have started coming together to form new groups such as A Greater Philadelphia, Philly for Growth, and Philly Forward, which advocate for a new vision for Philadelphia and restoring our city to where we were five years ago.

As part of this effort, we need to do more to help people with opioid use disorder. But a safe injection site is not the answer.

Barbara Capozzi is a Realtor and community advocate who lives in South Philadelphia.