Pubdate: Mon, 16 Nov 2020
Source: San Francisco Chronicle (CA)
Copyright: 2020 Hearst Communications Inc.
Source: San Francisco Chronicle (CA)
Authors: Chesa Boudin, Sarah George and Miriam Aroni Krinsky


All eyes were on Philadelphia this month, as the outcome of the
election rested in poll workers' hands. It's not surprising that the
citizens of Philly were ready for change - they've faced a
disproportionately heavy toll as a result of the current
administration's ineffective coronavirus policies. And that toll has
tragically included an increased rate of deadly opioid overdoses.

But Philly isn't alone - overdoses tragically have increased in
communities across the nation, from San Francisco to Burlington, Vt.

On Monday, a federal court is hearing arguments in the case to allow
Safehouse, a Philadelphia nonprofit organization, to open our nation's
first overdose prevention site. Others will be watching closely, as
fear of federal prosecution has previously derailed efforts by states
- - including a bill in California in 2018 vetoed by then-Gov. Jerry
Brown - to embrace this proven mechanism for saving lives. But the
escalating overdose crisis, and the Safehouse case, have given new
urgency and hope to advocates. California state Sen. Scott Wiener,
D-San Francisco, recently announced plans to reintroduce legislation
to legalize safe injection sites when the Legislature reconvenes in
December. A positive ruling in the Safehouse case would help clear the
way for California and cities like Burlington to open these lifesaving

Overdose prevention sites (OPSs), also called "supervised consumption"
or "safe injection" sites, provide a location to use drugs under the
supervision of people trained to immediately reverse overdoses.
They're also harm reduction outreach centers where people can receive
medical care, access social services, and explore treatment. As
leaders in prosecution, we know that OPSs provide lifesaving care that
countless communities desperately need - and in the wake of the surge
in overdoses, we need them more than ever. With a new administration
on the way to the White House, Philadelphia has the chance to model a
new approach to the overdose crisis that could inspire change across
the nation.

OPSs have found staunch allies in the reform prosecutor movement and
with a growing generation of law enforcement leaders. Earlier this
year, 85 criminal justice leaders joined in an amicus brief supporting
the legality of the planned OPS in Philadelphia, arguing that it
doesn't violate the Controlled Substance Act, and provides a
lifesaving service critical to public safety. As they noted, the need
for OPSs is especially important in the context of COVID-19 because
medical experts cautioned that these epidemics are "intersecting in
ways that are additively deadly" and predict "an overdose surge will
compound the COVID-19 pandemic if urgent action is not taken."
Tragically, they were right: 40 states have reported increased
overdose deaths since the start of the pandemic and nationally,
overdose deaths are on track to reach an all-time high. In San
Francisco, 441 people died of an overdose in 2019, and the number of
overdoses this year through August alone already exceeded that number.

Now, as coronavirus cases reach record numbers across the United
States, harm reduction strategies are even more critical. Overdose
prevention sites are a well-established means of preventing fatal
overdoses and they have other beneficial outcomes. Research shows that
they prevent overdose deaths; reduce the transmission of infectious
diseases, public injections, and discarded syringes; and increase the
number of people entering treatment programs. More than 120 such sites
exist worldwide, including many in Canada. Overdose prevention sites
should be part of a comprehensive COVID-19 strategy: They can provide
access to COVID-19 testing for the most marginalized people who
otherwise have little interaction with the health care system and
access to opioid substitution therapies like buprenorphine and
methadone, which are essential for ensuring those who use drugs can
successfully quarantine. But most importantly, they save lives.

The legal battle over Safehouse resulted from the misguided decision
by the current Department of Justice to fight a lifesaving strategy -
used successfully by other nations for years - based on a questionable
interpretation of the Controlled Substances Act. Despite the clear
intent of the so-called "crack house statute" to reduce illicit drug
use, not limit public health approaches, the DOJ has argued that these
laws bar OPSs. The Biden-Harris administration could open the door to
OPSs across the nation by embracing the thoughtful decision by United
States District Court Judge Gerald Austin McHugh and ending this
fight. While President-elect Biden's criminal justice platform does
not reference harm reduction or overdose prevention sites, now is the
time to promote interventions proven to saving lives: overdose
prevention sites.

A comprehensive overdose prevention strategy that includes overdose
prevention sites should be a given for anyone who says they believe
Black lives matter. Despite the perception of the overdose epidemic as
a crisis primarily in white rural areas, overdose rates have
skyrocketed in Black communities. From 2016 to 2017, the mortality
rate among Black people rose by 25%, compared with the 11% increase
among white individuals. In San Francisco, the overdose rate was four
times higher for Black people than white, and Black men in their 50s
suffer the highest mortality rates. In Philadelphia, in the first
three months of the pandemic, drug overdoses killed more Black
individuals than white for the first time, echoing the health
disparities made visible during the pandemic.

Philadelphia deserves better - and so does the rest of America. It's
time for the Department of Justice to stop standing in the way of
saving lives, and we hope the Third Circuit and the incoming
administration agree. Far too many lives have already been lost.
Philadelphia needs Safehouse today, just as San Francisco and other
cities around the nation - and our entire country - need a new path
forward toward ending the overdose epidemic.

Chesa Boudin is the district attorney of San Francisco. Sarah George
is the state's attorney of Chittenden County (Burlington), Vt. Miriam
Aroni Krinsky is the executive director of Fair and Just Prosecution,
a nonprofit that works with elected prosecutors around the nation
committed to reform.
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MAP posted-by: Matt