Pubdate: Thu, 25 Jan 2018
Source: Philadelphia Daily News (PA)
Copyright: 2018 Philadelphia Newspapers Inc.
Author: Aubrey Whelan


It was an idea born in the middle of a devastating epidemic with an
ever-rising death rate. It drew the ire of state officials, threats to
arrest those who operated it, and fears that it would encourage drug
use and addiction.

No, Philly did not just approve of 'Hamsterdam'

It was a needle exchange to prevent reusing hypodermic needles, and
the year was 1991.

Twenty-seven years later, those involved in the struggle to open
Prevention Point - still Philadelphia's only needle exchange - say the
parallels are clear between that fight and the city's decision to
encourage the opening of safe injection sites, where people in
addiction can inject drugs under medical supervision and access treatment.

Back then, the epidemic was HIV/AIDS, frequently spread by drug users
sharing needles. Today, the city faces an overdose epidemic - mostly
opioids - that killed an estimated 1,200 people last year in
Philadelphia. City officials say a safe-injection site will save lives
and usher more into treatment.

"It's the same thing," said former Gov. Ed Rendell, who legalized what
had been an underground operation as one of his first acts as mayor in
1992. "We went through the exact same stuff that the Kenney
administration is about to go through. And I strongly support the
actions that Mayor Kenney has authorized. I think he deserves a lot of
credit for having the courage and foresight to do this."

He added that he thinks the city should consider funding a safe
injection site itself, though city officials stressed on Tuesday that
they would leave the funding to private entities.

Jose Benitez, Prevention Point's director for the last 11 years, said
he sees a clear line between the AIDS crisis and the opioid epidemic -
which has now outstripped the death rate during the worst years of the
AIDS epidemic.

"Then, you're talking about us having half of the new cases of HIV
emerging among people who were sharing syringes," he said. "And we're
now talking about an overdose death rate that's four times the
homicide rate."

In the face of the opioid crisis, staffers there have taught thousands
how to use the overdose-reversing spray Narcan - in a year, a single
outreach worker there saved about 40 people from fatally overdosing -
and, from their Kensington offices, offer outreach, medical care and
treatment programs.

AIDS activists opened the needle exchange, unofficially, with the
written support of Mayor W. Wilson Goode Sr. in 1991, when nearly half
of the city's new HIV infections were caused by intravenous drug use,
and obtaining syringes without a prescription was illegal. They
operated in secret in Kensington - now the epicenter of the opioid
epidemic - for months before Rendell officially authorized the program
in July 1992.

Rendell said the tenor of today's criticism over safe injection sites
reminds him of what he heard back then.

"There is no getting around the fact that distributing needles
facilitates drug use and undercuts the credibility of society's
message that using drugs is illegal and morally wrong," Bob Martinez,
then President George H.W. Bush's drug czar, wrote in a federal report
on needle exchanges in 1992.

Rendell had been wary of the concept before a meeting with his health
commissioner and police chief. "I was a former district attorney, and
the first time they brought me the idea of a needle exchange, I
instinctively reacted negatively."

He said he was convinced otherwise in less than an hour: People in
addiction "would shoot up whether we had Prevention Point or not - but
if not, they would use dirty needles and that would promote the spread
of AIDS," he said. "And people with doubts of the efficacy of this
program should look at what a success Prevention Point has been over
the last 25 years."

In 2011, a city report cited the needle exchange as a factor in a
consistent decline in the number of injection-related HIV cases in
Philadelphia, where the new infection rate among people who inject
drugs has been dropping for years.

But after Rendell authorized the needle exchange, the state health
commissioner threatened to arrest its operators, the former mayor
recalled. He responded that they should arrest him first. On the first
day Prevention Point officially opened in Kensington, no arrests were

"It's the same fight today," said the city's newly elected district
attorney, Larry Krasner, who was retained as Prevention Point's legal
counsel during its early days, when organizers feared arrest. "I see
them as very parallel. And it is wonderful that Philadelphia is on the
right side of this, and early."

Some early reactions to the safe injection site announcement have been
strong - House Speaker Mike Turzai called it a "stark violation of
federal law" and urged Gov. Wolf to send the city a cease-and-desist
order. Both then and now, these ideas remain controversial among many
in the neighborhood. But Benitez and Rendell said that the
conversation around harm-reduction measures like needle exchanges has
changed dramatically in the decades since Prevention Point fought to

Wolf declared an opioids emergency this month, Benitez noted, and,
while he has not expressed support for a safe injection site, he has
not signaled he would move to shut one down, either.

"The city's attitude, the public's attitude, wasn't anywhere near what
it is today about the use of narcotics," Rendell said. "I think the
opioid epidemic is so pervasive that I think the public will support
this. But whether they do or not, it's the right thing to do."

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Aubrey Whelan is a staff writer assigned to the enterprise team. Since
joining the Inquirer in 2012, she has covered crime in Philadelphia
and everything in Chester County.
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