A demonstration of the supplies that would be available at a safe, or supervised, injection site. Photo : AP

On Wednesday, a federal judge struck down the U.S. government’s attempt to stop the development of the country’s first supervised injection site in Philadelphia—a move heralded by many public health experts worried about the opioid and drug overdose crisis.


Supervised, or safe, injection sites are public spaces where people are given the opportunity to use illicit drugs safely without the fear of arrest. That means they have access to sterile needles and other paraphernalia, along with immediate medical attention if they experience an overdose (the drugs themselves are not provided). Though controversial, research has shown that these sites reduce the risk of fatal overdoses as well as encourage people to take advantage of social and rehabilitation services that are often available nearby, which then lessen their chances of continued, unsafe substance use.

“As we are in the midst of one of the nation’s worst public health crises, today’s ruling is a significant victory in the fight to save lives.”


A relatively new idea, more than 100 safe injection sites operate legally in nearly a dozen countries, including Canada, Denmark, France, Germany, and the Netherlands. But they haven’t been sanctioned in the U.S., and there is no precedent for whether they would be permitted to exist (though that hasn’t stopped underground sites from popping up).

While several cities have explored approving sites, the Department of Justice under Donald Trump fiercely warned in 2018 that it would pursue legal action against anyone who tried. Soon after the non-profit organization Safehouse announced it would create a site in Philadelphia this year, the government joined forces with U.S. Attorney for the Eastern District of Pennsylvania William McSwain to do just that, filing a civil lawsuit against Safehouse this February.

The government’s case argued that the Safehouse site would violate the Anti-Drug Abuse Act of 1986, specifically a “crack house” statute that holds someone criminally liable if their owned, leased, or rented properties are used “for the purpose of manufacturing, distributing or using any controlled substance.”

Famously, the statute was used in the early 2000s to go after rave promoters. At the time, current presidential candidate and co-author of the legislation, Joe Biden, endorsed the use of the law in that fashion; he later sponsored a bill that explicitly expanded the statute to cover “temporarily” operated buildings as well. Nearly 20 years later, federal prosecutors cited Biden in arguing that the Safehouse site ran afoul of the statute as well.


Following months of hearings, motions, and a counter-lawsuit by Safehouse alleging the government was violating its freedom of religion, however, U.S. District Judge Gerald McHugh ruled against the U.S. government . In his judgement, he ruled that the original law was never intended to account for the existence of these sites. And importantly, because the ultimate goal of Safehouse’s “proposed operation is to reduce drug use, not facilitate it,” it did not violate the statute.


The legal decision is already being praised by many experts in the drug policy and public health field, specifically those who advocate harm- reduction policies that mitigate the negative consequences of drug use, rather than simply trying to force people to stop using drugs.

“As we are in the midst of one of the nation’s worst public health crises, today’s ruling is a significant victory in the fight to save lives,” said Lindsay LaSalle, managing director of Public Health Law and Policy for the Drug Policy Alliance, in a statement provided to Gizmodo. “Though legal questions remain, this decision—that the federal ‘crack house’ statute does not apply to supervised consumption sites like Safehouse—sets an important legal precedent in the fight to establish evidence-based interventions to address drug use and related harms.”


During the lawsuit, amicus briefs on behalf of Safehouse were filed by more than a dozen public health and advocacy organizations, including the Drug Policy Alliance, HIV activism group ACT-UP, and the American Civil Liberties Union. Philadelphia District Attorney Larry Krasner also endorsed the Safehouse site, as did former Pennsylvania governor Ed Rendell. The court decision today was also praised by the Manhattan District Attorney Cy Vance, who explicitly called for sites to be created in the city.


At this point, it’s unclear whether U.S. Attorney William McSwain will pursue further legal action against Safehouse. The ruling doesn’t preclude the possibility that the federal or state government will try to stop these sites in court by arguing on different legal grounds, and an appeal could still presumably prevent Safehouse from going ahead with its plans to have a site up by the end of the year. But for now, at least, the news is good.

“We hope this decision sends a signal to the Trump Administration that criminalization is not the right response to overdose deaths and that the administration will rethink efforts to interfere with state-level drug policy that prioritizes individual and community health,” Lasalle said.