On January 23rd, 2018, Mayor Kenney of Philadelphia was delivered a report from DBHIDS (Department of Behavioral Health and Intellectual Disability Services). After studying examples in Seattle, Canada, and with expert opinion, Kenney’s Office has decided to establish Comprehensive User Engagement Sites (CUES), in Canada known as Supervised Injection Facilities.
CUES are modeled after the Seattle proposition and Canadian implementation of government-sponsored sites where drug users may receive service on a walk-in basis and be given a legal pass to use injectable drugs, the equipment necessary to do so, and treatment if they overdose—all without the deterrence of punishment or repercussion.
It’s important to note the precedent established by Seattle and Canada in order to examine the possible effects of such sites. Seattle has been trying to create similar facilities due to the large proportion of heroin use within the city. However, justifying the $2 million needed from taxpayer money has proven to be a challenge for years.
In British Columbia, Canada, there is a better estimate of effects on drug users. The first Canadian Supervised Injection Facility (SIF) was approved in 2003, and the number has increased every year, culminating in 2016: the province of British Columbia experienced 922 illicit drug overdose deaths in 2016, a 78% increase over 2015. The same report shows that illicit needle-drug use, specifically fentanyl, increased in the same span that the number of injection facilities increased.
What does this spell out for the future of Philadelphia’s proposed CUES? Mayor Kenney’s office justified the effort by stating that there was an expected 24 to 76 opioid overdose deaths to be avoided each year with the support of these sites. However, this estimate neglects the problem that Canadian facilities had – the use of illicit drugs increases, so the city may reduce the deaths out of 1000, but because there are more users overall, the numbers of opioid overdose deaths increases.
At the end of the day, who is financing the drug abuse of hundreds more Philadelphians? In Seattle, the taxpayers will take the brunt of the expenditure (assuming the site is implemented like it was supposed to have been years ago); in The City of Brotherly Love, however, the government will encourage “community nonprofits or medical organizations to operate and fund one or more CUES.” The City, to do its part, “will not operate a CUES” and instead “will bring together key stakeholders and identify organizations that are interested in operating, funding, or offering a location for such a facility.”
A City that has been governed by the Democratic party for over 60 years and has traditionally expressed skepticism over the benevolence of corporations and advocates that governmental solutions are superior to market solutions is now going to turn to corporations with a change of heart?
The atmosphere of Philadelphia must also be examined. If Mayor Kenney’s Office is expecting nonprofits and medical communities to provide this service, the nonprofit distribution should also be observed. The largest problem plaguing Philadelphia’s low-income community is shelter volatility. As a result, the focus of nonprofit and charitable organizations is providing housing services to those in need—not enabling heroin addicts.
Another central question is the legality of such a measure. The 14th Amendment of the United States Constitution declares that States cannot “deny to any person within its jurisdiction the equal protection of the laws.” This means that within the realm of a State, all laws must be applied to each person equally – meaning no free passes for some, while others would suffer punishment for the same actions.
If the CUES became a part of Philadelphian life, those closer to the sites (which would be closer to the inner-city communities) would be able to feasibly enjoy a luxury of a service to their drug abuse as well as an “above-the-law” privilege while those suffering from the same problems across the rest of the state would be tried felons for opioid abuse.
This is a similar phenomenon that many Democrats argued in regard to abortion clinics. The argument from pro-abortion advocates was that if a state is forced by the federal government to allow abortion clinics to surface, that zoning them only in out-of-the-way locations where they couldn’t be used would be illegal because it would create inherent inequality.
Opioid abuse is a growing epidemic plaguing Philadelphia—there’s no question of that. However, the focus should be on reducing usage and creating conditions for Philadelphians where heroin and other substances are not appealing. To simply allow addicts a space to get high without repercussion is like putting a Band-Aid on a severed artery.
The fundamental issue of disproportionately high drug use in Philadelphia is a harder problem to solve. However, it’s the only focus that will achieve results without creating an externality that’s exponentially worse than the conditions the City started with. Imagine trying to solve Philadelphia’s opioid problem with ten-times more addicts that grow to expect that they won’t be punished and that there aren’t consequences for drug use. The City argues it wants to educate the community on why drug use is bad, but this system teaches Philadelphians by example that there are no harms because the Government will bail drug users out at the cost of the community around them.
(Photo from Laurent Vu/The Lancet/AFP/Getty Images)