The current debate about the need for the nation’s first safe injection site encompasses several important trends in our society. The war on drugs, criminal justice reform and of course the opioid crisis; are all involved in this debate. The question is whether we should allow such a site in Kensington, ground zero of the opioid crisis. The site would allow addicts to come with their drugs into a clinical setting and use clean needles, have opioid antidotes available and treatment options for the users. Our own Ronda Goldfein, executive director of the AIDS Law Project is leading the charge. Former governor and Mayor Ed Rendell is on the board of the Site Committee of Safehouse Inc. and is a strong supporter. U.S. Attorney William McSwain is leading the opposition. McSwain has filed a civil action on July 17, to stop the site. The matter has been assigned to Judge Gerald McHugh in the U.S. District Court for the Eastern District of Pennsylvania. The Controlled Substance Act (CSA) also known as the crack house laws are being used to sanctify the legal action. He notes that criminal penalties are not at issue as it is a civil matter. They contend that the law prohibits drug use in such abodes.

I contend that such a site should be permitted and it is a step in the right direction when dealing with the national health emergency that the opioids have created. It is one of the most devastating public health crises in our history. Last year, there were 75,000 opioid-related deaths in the United States. This represents a 16% increase from 2016. In 2017, there were 5,456 deaths in Pennsylvania and 1,217 in Philadelphia. Sadly Philadelphia is the epicenter of the epidemic where opioid deaths outnumber homicides by three to one. Of those deaths, more than half were fentanyl related. Fentanyl, also readily available on the street, was first synthesized around 1960 by Janssen Pharmaceuticals of Belgium. Today’s version is usually illicitly manufactured, often in China and available in white powder form. It can be 100 times more powerful than morphine. It is often mixed with heroin to increase the effect, often with deadly consequences.

The Drug War began in the 1970s under the Richard Nixon presidency. It criminalized what was previously considered a medical problem. Soon the prisons and jails were overflowing with drug dealers and users. The mass incarceration phenomena took hold largely fueled by this so-called war. Prison populations skyrocketed. In Pennsylvania, the state prison population increased from 8,000 in 1980 with eight prisons and a budget of $200 million to 48,000 with 28 prisons and a budget of $2.7 billion today. Similar increases occurred in other states and on the federal level. Sadly we incarcerated 25% of the world’s incarcerated population despite being only 5% of the overall population. With the recession of 2008, the marginal results in stopping the use of drugs and increased awareness of the burden on the poor and minorities brought the war to a halt. One of the unintended consequences of stopping the criminalization of drug use has been the emergence of urban drug encampments. Recently the use of hard drugs has been allowed to fester in abandon parts of town, under bridges and in vacant lots that become vast villages of addicts. Open sales and drug use dominate these tent cities.

The new debate over criminal justice reform also is very active in Philadelphia with the election of reform-minded former defense attorney Larry Krasner to the District Attorney’s office. Krasner has already changed the landscape of our criminal justice system; stopping marijuana arrests, reducing sentences, calling for an end to the death penalty, instituting bail reform and overturning wrongful convictions. More is on the way. The opioid crisis gives us a chance for a new approach to an old problem. Several other cities are also contemplating safe injection sites.

On a recent trip to Amsterdam funded by the Independence Foundation, I have found the possible solution to our problem. In the Netherlands, aka Holland, they take a two-tiered approach to the drug problem. It is called Gedogan. Soft drugs such as cannabis are legalized and readily available in coffee shops. The shops flourish providing recreational opportunities, new businesses, jobs and tax revenue. Amsterdam not only seems to have a coffee shop on every corner but also has stores that sells cannabis seeds, a Cannabis Museum and a Cannabis College. There are as many as 1,500 shops. At the counter, a wide variety of sativa and indicia cannabis brands are offered in small quantities. Pre-rolled spliffs/joints, hashish, cannabis mixed with tobacco and edibles are also available. A smoking area has juices and coffee for sale as well as house bongs. Hard drugs are classified as a medical problem. Addicts are encouraged to register with the government and are given daily doses of pure pharmaceutical grade heroin at government-run health clinics. While treatment options are available at the clinics, the main purpose is to control crime and provide a safe setting for drug users. Public health experts in the Netherlands say that free distribution is one reason that drug-related deaths are far less common than in the United States. The program also reduces crime and improves the quality of the life of many users, according to Eric van den Hoogen who runs a clinic. I spoke with a patient outside the clinic who was drinking a beer and smoking a cigarette at 11 one morning. He indicated that he had just smoked heroin and would be back for another round in the afternoon. He then got on his bicycle and rode off seemingly unimpaired. Results are astonishing. Last year there were only 252 opioid-related deaths in the country which is 20 times smaller than the United States. Crime is virtually nonexistent, as is homelessness and panhandling. The program started in 1998, modeled after a similar successful effort in Switzerland, and several other European countries. Peter Blanken, a senior researcher with the Parnasia Addiction Research Centre in Rotterdam, says that the number of users has been reduced from 29,000 in the late 1990s to as few as 14,000 today.

Medical legalization is well underway in the United States. 33 states have some form of marijuana legalization including 10 states and the District of Columbia that have complete legalization of recreational pot. Studies have shown that availability of pot reduced opioid use. Pennsylvania has medical marijuana and has two bills SB 350 and HB 1600 would allow for recreational use.

In these times of crisis, there are opportunities to correct the wrongs of the past and move toward real solutions. The drug war was a disaster. The poor and people of color paid a steep price. The resulting mass incarceration was also a disaster. Again impacting the poor and minority population. Let’s take morality out of the equation and return to the days when drug use, like alcohol use was considered a medical problem. We can then follow the lead of the Netherlands and other European countries. Safe injections sites are a necessary step toward a real solution. Treating  addiction like the disease that it is. Let’s find a medical solution based on treatment, not criminality.

Angus Love is the executive director of the Pennsylvania Institutional Law Project (PILP). PILP’s mission is to ensure equal access to justice for indigent incarcerated and institutionalized people within the state whose constitutional and other rights are being violated.