Nearly three decades after championing Philadelphia's first and only needle exchange for drug users, former Mayor and Gov. Ed Rendell is backing an even bolder idea to protect people in addiction from risk: He has joined the board of a nonprofit whose goal is to open a safe injection site where people can use drugs under medical supervision, and be revived if they overdose.
The incorporation of the nonprofit, called Safehouse, is Philadelphia's first concrete step toward opening a site since January, when city officials announced they would permit one to open, provided it was built and operated with private dollars.
Philadelphia has the highest overdose death rate of any major U.S. city and could become the first in the country to open a safe injection site. A handful of U.S. cities, from New York to Seattle, are working on plans, but none has yet succeeded in opening a site. California Gov. Jerry Brown just vetoed legislation that would have helped start a pilot program in San Francisco, which last year saw 200 overdose deaths, compared with Philadelphia's 1,217.
"Philadelphians are dying at an alarming rate," said Jose Benitez, the head of the needle exchange Prevention Point, who will serve as the new nonprofit's president and treasurer. "This is one response to that. It's just one of many responses that we need in the city."
In the early 1990s, AIDS activists had been operating Prevention Point unofficially and in secret, with the written support of Mayor Wilson W. Goode. Then, nearly half of the city's new HIV infections were caused by intravenous drug use. Rendell officially authorized the program in July 1992, and dared state officials who threatened legal action against the program to arrest him first. He said in January that the fight for needle exchanges reminded him of the fight for safe injection sites and commended the city for supporting them.
Rendell said his advocacy for safe injection sites is personal: In January 2016, John Decker, the son of his close friend, attorney Tad Decker, died of a heroin overdose at 30, alone in his parents' home while the couple was on vacation.
"I knew John Decker since he was five years old – he was good looking, charming, had a great sense of humor. He was friends with my son. The world was his oyster," Rendell said Tuesday night. "And he got injured playing college lacrosse, [and became addicted to opioids], and for that he had to die alone in a bed? If we save one John Decker, it will be worth it."
Safehouse has raised $200,000 for planning, board members said Tuesday night.
There's no time frame for Safehouse to open what it calls an overdose prevention site, and the group is still working with community members around the city to find the best location for the site, Benitez said. More money needs to be raised as well.
"We've had a lot of positive conversations toward private funding at this point," Benitez said. "We think there are some people who have lost family members [to opioid overdoses] who would like to contribute significantly to this project."
Rendell is a member of the corporation's board of directors; the two other board members are Benitez and Ronda Goldfein of the AIDS Law Project of Pennsylvania, who will serve as vice president and secretary.
The nonprofit will also receive guidance from an advisory committee that includes some of the city's most prominent health and philanthropic leaders, including Ana V. Diez Roux, dean of Drexel University's Dornsife School of Public Health; Larry R. Kaiser, CEO of Temple University's health system; Thomas Farley, the city health commissioner; David Jones, the commissioner of the city's Department of Behavioral Health and Intellectual disAbility Services; and Sister Mary Scullion, president and executive director of Project HOME, a housing, poverty and homelessness services organization.
The group describes Safehouse as a public health approach to the city's opioid crisis, part of a broader program of harm-reduction to help keep people in addiction safe from overdose, an ever more pressing problem as fentanyl, synthetic cannabinoids, and other contaminants have been making the city's heroin supply deadlier than ever.
Drugs will not be available at Safehouse, and staffers will not help participants inject drugs. Those interested in treatment will be able to start medication-assisted treatment on-site, the group said, and the site will also employ recovery specialists, social workers, and case managers to encourage treatment.
Back in January, city officials announced that they would allow a nonprofit to open a site to "meet [people in addiction] where they are, offer help getting treatment, and help them stay alive until they are ready to get treatment," said Farley at the time.
That announcement came after a full year of research and debate, including visiting a site in Vancouver and commissioning a report on evidence collected in Canada and Europe, where the sites have operated for decades. Its conclusion: A single site in Philadelphia would save 25 to 75 lives a year and millions of dollars in hospital costs and public funds, while reducing public injection of drugs and other neighborhood problems.
But the idea raised controversy immediately, ranging from Kensington residents tired of seeing their community bear the brunt of the city's drug crisis, to state and federal officials insisting that the concept — allowing people to use illicit drugs — would itself be illegal. Deputy Attorney General Rod Rosenstein told WHYY earlier this summer that city leaders should expect legal action if they permit a facility to open, he said. The announcement came just a week after U.S. Surgeon General Jerome M. Adams, in Philadelphia for a march against drug addiction stigma, said the Trump administration believes safe injection sites would violate federal law, and advocated for expanding needle exchanges.
Philadelphia Police Commissioner Richard Ross said in an interview Tuesday night that he has met with Safehouse representatives. He acknowledged the depths of the overdose crisis — "something has to be done" — but said he still has unanswered questions about how police will interact with the sites. Rosenstein's comments, he said, could make the site a hard sell. "The next step for us is just sitting back and waiting, if and when it will even take hold," he said. "By no means am I saying I'm a proponent."
Goldfein, who is married to David Lee Preston, an Inquirer/Daily News editor, said Safehouse leaders are aware of federal drug laws. "But we don't believe that this action is inconsistent with them," she said. "Our action is related to just saving lives, and we're not trying to be an affront to law enforcement. We are looking at an entity that has a very narrow purpose: preventing fatal overdoses."
Rendell said he is not worried about threats of legal action from the federal government.
"Federal prisons are much nicer than city prisons or state prisons," he said. "I'll be happy to go to Allenwood for a month and play tennis."
More seriously, he added: "I'm absolutely at peace that I'm doing the right thing. I have nothing to gain, and nothing to lose because I'm not running for election. I guess the majority of people might disagree with me, but I did this because I believe this is the right thing to do. I believe that as strongly as I can."