Philadelphia, and the nation, is facing three deadly epidemics: the opioid overdose crisis, COVID-19, and the systemic assault on Black lives. And as we collectively seek to envision a more humane and equitable response to substance use, overdose prevention sites (OPS) are an important place to start.
Reform-minded prosecutors and law enforcement leaders agree.
On Monday, 85 criminal justice leaders joined in an amicus brief filed in the Third Circuit arguing that Safehouse, a Philadelphia nonprofit organization seeking to open our nation’s first overdose prevention site, doesn’t violate the Controlled Substance Act, and provides a lifesaving service critical to public safety.
As the brief notes, the need for OPS is especially important in the context of COVID-19. Medical experts caution that these epidemics are “intersecting in ways that are additively deadly” and predict “an overdose surge will compound the COVID-19 pandemic if urgent action is not taken.” The brief comes after a federal judge put Safehouse’s plans on hold on June 24, citing the pandemic and ongoing protests surrounding the death of George Floyd at the hands of Minneapolis police as evidence that Philly was “too frayed” for an overdose prevention site.
Overdose prevention sites, also called supervised injection sites, provide a location to use drugs under the supervision of people trained to immediately reverse overdoses. They are also harm reduction outreach centers where people can receive medical care and access social services, including recovery services.
In the context of the pandemic, harm reduction strategies — including OPS and needle exchanges — are even more important. They can provide access to COVID-19 testing for the most marginalized people who otherwise have little interaction with the health-care system. Further, they can provide a conduit to opioid substitution therapies like buprenorphine and methadone, which are essential for ensuring those who use drugs and test COVID positive can successfully quarantine. But most importantly, they save lives. In Canada, where OPS is legal, harm reduction workers reported seeing an immediate spike in overdoses when some OPS were temporarily closed in the name of social distancing.
Now with the increasing public support for a reimagining of our public safety systems, OPS also offers a way to reduce police contact with the community. Too often, police officers are the first to respond to overdoses, creating the potential for escalation and incarceration. OPS offers a path where people can access care rather than risk incarceration and police violence.
Addressing opioid use disorder is more important than ever, given that people who use opioids are at greater risk of incarceration and homelessness — conditions that inherently preclude proper social distancing measures and frequent handwashing. The criminalization, rather than treatment, of substance use disorder continues to contribute to massive COVID-19 outbreaks in overcrowded prisons and jails.
Addressing the overdose crisis is also a racial justice issue. Despite the perception of the overdose epidemic as a white rural crisis, overdose rates have skyrocketed in the Black community, which has been left behind and historically criminalized by national efforts to reduce opioid use and fatalities. From 2016-2017, the mortality rate among Black people rose by 25%, compared with the 11% increase among white individuals. And by 2017 in several states, opioid overdose death rates were already higher among Black communities — including in West Virginia, the so-called epicenter of the crisis. Those disparities play out in cities as well. In Chicago, Black individuals make up a third of the population, but almost half of opioid-related deaths.
It is time to leave the War on Drugs in the past. Let’s seize the opportunity to provide public health responses that reduce harm and save lives, rather than criminal justice responses that punish. Failure to do so will put even more lives needlessly at risk.
Larry Krasner is Philadelphia’s district attorney. Miriam Krinsky is the executive director of Fair and Just Prosecution.