Addiction advocates in Philadelphia are gearing up for a fight with federal law enforcement over a so-called supervised injection site, where drug use can take place in the presence of medical professionals.

Fatal overdoses from opioids in the United States have increased by about 250 percent since 2007. The problem is particularly acute in a handful of states, including Pennsylvania, which has the nation's third highest overdose death rate.

In the city of Philadelphia, overdose deaths are concentrated in the neighborhood of Kensington, where a supervised injection site known as Safehouse is slated to open.

At Safehouse, drug users will be invited to drop in and inject themselves with drugs like heroin. If they overdose, supervising staff will administer the overdose reversal drug Naloxone, often known by the brand name Narcan. The facility will also provide clean needles and a sanitary environment.

But Safehouse is technically in violation of the so-called "crack house" statute, which was part of the federal Anti-Drug Abuse Act of 1986. In early 2019, the DOJ preemptively sued Safe House and its executive director, Jeanette Bowles, a move that will make it easier to begin making arrests if the project moves forward.

"We don't supply anybody with drugs, we don't touch drugs, [and] none of our personnel do," says former Pennsylvania Governor and former Mayor of Philadelphia Ed Rendell. "If you're an addict and you want to use the safe house, you have to bring whatever drug it is you're using to the site."

Rendell sits on the board of the nonprofit that's behind Safehouse, and he's been instrumental in building support for the project.

"The senators and congressmen who developed the crack house statute never in a million years thought about volunteer medical personnel standing by while someone injecting themselves ready to… reverse the effects of the overdose," says Rendell. "Do you think they thought for a minute that that activity should be criminal?"

Safehouse would be the first supervised injection site in the U.S. operating out in the open. In 2014, a social service agency opened a covert facility in an undisclosed urban neighborhood in the U.S.

According to a 2017 study in the American Journal of Preventive Medicine, over two years, 2,574 injections were performed at the site, 90 percent of which would have otherwise occurred in a "public restroom, street, park, or parking lot," according to participants. Two overdoses were treated immediately with Narcan.

There are over 120 supervised injection sites across the globe. Safehouse is modeled after Insite, a supervised injection site in Vancouver Canada.

"We're asking the federal government to use their prosecutorial discretion and not make an arrest for violation of a statute that never meant to cover this type of activity," Rendell told Reason. "We'll go ahead with it and maybe…[we'll] wind up in federal prison."

It's not the first time Rendell has squared off with authorities for policies intended to help addicts. In 1992, when he was mayor of Philly, a group of activists opened a needle exchange called Prevention Point to combat the AIDs epidemic.

When Rendell signed an order allowing it to proceed, he received a call from the state health commissioner, who said he would be arresting anyone involved with the program.

"I said 'Mr. Secretary, come to 212 City Hall, that's my office, and arrest me first because I'm the one who sent those people out and told them they would be left alone,'" says Rendell.

Rendell issued an executive order directing the city attorneys not to prosecute the activists involved in Prevention Point.

"Prevention point went on to be a great success, accepted universally, and, in Philadelphia, our model was used in 30 other American cities," he says.

Rendell sees Safe House as a continuation of that mission.

"I don't think the government should be wasting resources arresting doctors and nurses who are volunteering their time. I don't think they should do that," says Rendell. "And all we want to do is save some young people from dying needlessly. That's all we want to do."

Produced, edited, and narrated by Mark McDaniel.

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