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Mistake to close Kensington encampments before Philly has a safe injection site | Opinion

When opioid users are forced to turn to remote places to use drugs, the likelihood increases that they could overdose without access to life-saving naloxone.

Outreach workers check on homeless people living under the Tulip Street bridge in Philadelphia, PA on April 30, 2018. The city posted signs advising people they must leave from under the bridge by May 30.
Outreach workers check on homeless people living under the Tulip Street bridge in Philadelphia, PA on April 30, 2018. The city posted signs advising people they must leave from under the bridge by May 30.Read moreDAVID MAIALETTI / Staff Photographer

On May 30, the city will evict the residents of two of the four Kensington encampments of homeless people in addiction. The announcement of the evacuation plan argues that the encampments "pose a health and safety threat to those who stay there, as well as to the neighbors."

There is no argument that the encampments are not ideal. "I guess you can't really have this," Kensington Avenue encampment resident Michael Jones told the Inquirer. "But I don't know where all these people are going to go."

The encampments, however, are not just a problem. They are an improvised solution.

As Philadelphia grapples with opening a safe injection site, the encampments function as informal ones. Before Vancouver opened its safe  injection site, activists opened an unauthorized harm-reduction tent. The tent eventually shut down because of lack of funding, but it never once saw an overdose death. The Kensington encampments, between the community that has developed there and the ability to conduct geographically focused outreach, are an informal, spontaneous, and open-air version of that tent.

It is a mistake for the city to shut down the encampments right now.

You would think that the city would've learned from their previous efforts here. This is not the first time that the city evacuated an area that is inhibited by homeless people who use drugs. There was "El Campamento," the McPherson Library lawn, and the Cathedral. The people residing in those places didn't find homes, they just moved under the bridges.

Liz Hersh, the director of Homeless Services in the city, says that the mistake in previous evacuations was that the only option was treatment. "For people who aren't ready or wanting to have treatment, we have to start where people are," she explains.

In the city's defense, they are making efforts there: They're opening two shelters and the new shelter beds don't have any abstinence requirements attached to them, a positive step toward harm reduction and away from coercing people into treatment. But it is important to remember that a bed in a shelter does not equal a stable home.

It's also important to remember that addiction is a chronic relapsing disease and people who are not ready for treatment will still need to use. Without the encampments or safe injection sites, and while wanting to spare children from seeing the use of drugs, the alternative is using in abandoned homes and remote places. That is extremely risky. When opioid users are forced to turn to remote places to use drugs, the likelihood increases that they could overdose without access to life-saving naloxone, that reverses an overdose in a matter of minutes.

The encampments allow outreach groups such as SOL Collective to provide naloxone to those who are most likely to use it, and it is saving lives. In 2017, "75 percent of opioid-related overdose deaths occurred in a personal residence, often the decedents' homes," according to a report of the Department of Health. One reason for that is that in the encampments, unlike in people's homes, there is always someone from the community ready to administer naloxone

The community of the encampments goes beyond administering life-saving naloxone. "There is a young woman that I see every week [in the encampment] and she always collects extra wound care kits from me, menstrual supplies, lip balm, whatever we may have. She always collects a little bit extra," said Adrienne Standley, a member of SOL Collective. "She wants to always make sure that all the other women under the bridge have what they need.

Evacuating the encampments should be a part of the city's comprehensive drug and homelessness plan. It should be the last step, not the first. Until the city is willing to take action in the form opening safe injection sites and providing stable housing, it shouldn't shut down the closest alternative.

Abraham Gutman is a writer and economist based in Philadelphia.  He currently works as a senior data and policy analyst at the Center for Public Health Law Research at Temple University. @abgutman