To reduce the impact of HIV among PWID, harm reduction models have proven their effectiveness. The provision of sterile syringes and other harm reduction services prevents HIV and creates pathways to substance use treatment. Yet there remain significant gaps in access to these services in many parts of the country.
Overdose prevention sites, also known as safe consumption sites, are a form of harm reduction. These sites provide a hygienic space for people to use illicit drugs under the supervision of trained staff and are designed to reduce the risk of HIV and Hepatitis C transmission, prevent overdose deaths, and connect people who use drugs with addiction treatment and other social services. Efforts to implement overdose prevention sites have been limited within the United States. Additionally, overdose prevention sites have faced legal challenge. In February 2019, the United States Attorney for the Eastern District of Pennsylvania filed a civil lawsuit against Safehouse, a Philadelphia-based nonprofit that plans on operating the country’s first ever overdose prevention site, and asked a federal court to declare overdose prevention sites to be illegal under a federal statute, 21 U.S.C. 856(a), also known as the “Crack House” Statute. On October 2, 2019, the federal district court ruled that “the ultimate goal of Safehouse’s proposed operation is to reduce drug use, not facilitate it, and accordingly, §856(a) does not prohibit Safehouse’s proposed conduct.” While this court decision is an important step forward, the legal process is not over.
More work is needed to implement overdose prevention sites, syringe services programs, and other harm reduction services throughout the United States. To be successful, we need continued legal and policy advocacy as well as leadership from elected officials and community stakeholders.
The views reflected in this expert column are those of the individual authors and do not necessarily represent those of the O’Neill Institute for National and Global Health Law or Georgetown University. This blog is solely informational in nature, and not intended as a substitute for competent legal advice from a licensed and retained attorney in your state or country.