Midway through a community meeting in Northeast Philadelphia on the opioid crisis Monday, a man stood up at the back of the room and yelled out a question to city Health Commissioner Thomas Farley: "Doctor, where do you live? Can we put a safe injection site next door to you?"
The crowd of 150 in the Fox Chase community center applauded and burst into shouts in a display that vividly showed the tough sales job the city is facing as it tries to fulfill a promise to allow a place where people in addiction can use drugs under medical supervision. As heroin has been adulterated with the deadlier opioid fentanyl, often without the user's knowledge, the overdose death rate has soared. Quick administration of a reversal medicine can save lives.
Health Department officials — who all said they live in Philadelphia — were in Fox Chase to talk about the overall plan to fight the epidemic, 18 recommendations that include expanding access to medication-assisted treatment and housing for people in addiction. But the only point anyone wanted to talk about was green-lighting a safe injection site.
"The hot one," said Mary Doherty, the director of government and strategic partnerships at CORA Services Inc., the community center that hosted the meeting.
Monday night's meeting was the first of eight that will be held around Philadelphia over the next month. But it was also the first time city officials held a sustained conversation with residents about safe injection sites since announcing in January they would allow one to open if a nonprofit offered to undertake the project without city funding.
The crowd was incensed about the site and frustrated that the city has taken so long to talk to residents about it. And they were alarmed by a false rumor that the city was putting a safe injection site nearby.
Advocates for boosting the city's response to the drug crisis said they were glad for the opportunity to set the record straight.
"It's about educating the community and dispelling stigma," said Brooke Feldman, a harm-reduction advocate who has been in recovery for 13 years and grew up in the Northeast. Drug use might not be as visible in her neighborhood as it is in Kensington, its neighbor to the south, which has long borne the brunt of drug epidemics. Still, she said: "I used drugs, I sold drugs, in Northeast Philadelphia, and I understand the concern about attracting people using drugs to the community. But people are using drugs and selling drugs and dying right here in Northeast Philadelphia."
After the meeting, she said she wasn't surprised her neighbors had not supported a safe injection site: a proposed methadone clinic several years ago faced a similar backlash, and Councilman Bobby Henon sued to keep it out of the district.
On Monday night, residents listened to a presentation explaining the city's opioids plan, residents lined up to speak to the crowd or submit questions on note cards. Some questions came from people in addiction living at an encampment on Emerald Street in Kensington, who watched the meeting on a live stream set up by advocates.
Some residents used the opportunity to ask questions about recovery and treatment. City officials fielded skeptical comments on the efficacy of medication-assisted treatment, explaining that the treatment keeps more people in recovery than counseling alone.
Others spoke of children and relatives who had died of overdoses or were struggling with addiction. One woman said she was frustrated that she scrimped to afford medications for her son, who has diabetes: "Where's the help for the people who work hard in this community?"
Still others said they felt a safe injection site would enable drug use, but some seemed more open to the idea — just not in a residential neighborhood, they said. "Why can't they go to a controlled environment in a hospital?" one woman suggested to Farley. "That's your best bet." Farley said her comment was "fair input."
Jeff Landsmann, a lineman from Fox Chase who attended the meeting after getting a text an hour earlier from a neighbor, said later that he was still opposed to a safe injection site, and hadn't heard anything that convinced him otherwise.
But Elise Schiller of Germantown took the microphone and said her daughter died of a heroin overdose in 2014. "I understand this very well. And I don't like the stigma. Please don't be judgmental," she said. "Rock bottom for opioid addiction is death. We can't wait until they hit rock bottom for treatment."