The Legal Risks of Operating Safe Injection Facilities

Use these links to jump to different sections:

• Can Safe Injection Sites Fix the Problem?
• Safe Injection Facilities in Philadelphia: From Approval to Ban
• What Laws Control Supervised Injection Sites?
• Have Questions? Consult with an Experienced Attorney

According to data from the Centers for Disease Control and Prevention (CDC), more than 560,000 Americans died from an opioid-related drug overdose from 1999-2020. 75 percent of fatal drug overdoses involved an opioid in 2020. And in 2021 alone, 4,522 Pennsylvanians died of an opioid overdose. In short, the opioid epidemic is a dire public health situation.

“Clearly something needs to be done,” says NiaLena Caravasos, a criminal defense attorney in Philadelphia. “It’s myopic and naïve to do nothing but jail people for their addictions. We need to think outside of the box.”

Can Safe Injection Sites Fix the Problem?

In Europe and Canada there has been great success with the introduction of Safe Injection Facilities (SIFs). These facilities offer a safehouse for people who inject drugs (PWIDs) to inject. They offer clean needles and medical supervision from professionals who are trained to administer life-saving drugs (such as Naloxone) to prevent drug overdoses.

While it may seem counter-intuitive that such environments curb the problem, the spaces also provide access to counseling and resources to help drug users seek aid such as addiction treatment. “People’s visceral reaction of seeing these SIFs as condoning illegal drug use is short-sighted and false,” Caravasos says. “These facilities are a mechanism to have someone conquer their addictions instead of struggling alone on the streets.”

Statistics from the United States National Institute of Health show that these facilities lowered overdoses, brought down public drug use, increased access to proper health care, and reduced the transmission of blood-borne illnesses—all without “enhancing drug use or drug trafficking.”

Safe Injection Facilities in Philadelphia: From Approval to Ban

Philadelphia was the first U.S. city to approve the implementation of SIFs. The plan was to allow a nonprofit, Safehouse, to run and maintain the sites in order for the city to stay away from violating federal laws. The district attorney pledged not to prosecute those who operated SIFs. However, in September 2023, the Philadelphia City Council passed a near-total ban on future SIF development in most parts of the city. Meanwhile, New York City opened the first safe injection site in the U.S. in 2021.

Though consumption sites have seen success at overdose prevention and curbing substance use, medical professionals should be wary of being involved in these facilities so long as the U.S. Department of Justice’s drug policy regards opioids like Fentanyl as criminal on a federal level. “Just because the local prosecutor isn’t going to prosecute those who run these facilities will not prevent the federal authorities from going after the medical professionals only trying to help,” Caravasos adds.

What Laws Control Supervised Injection Sites?

The Controlled Substance Act governs the legality of controlled substances and opioids are illegal unless prescribed or administered by a medical professional.

“For these facilities to work, we will need to do more to decriminalize addiction,” Caravasos says. “In Portugal, the opioid crisis was beaten because of a shift in philosophy. They put it on another track. They viewed the problem differently. They saw it as more important to save people’s lives and work to get people healthy again rather than focusing on the importance of putting PWIDs in prison, as we do in this country.”

Medical professionals should be wary of being involved in these facilities so long as opioids remain criminal under federal drug laws, Caravasos says. “The premise behind these facilities is good and progressive, but a foundation must be laid in decriminalizing an addict’s behavior or an exclusion [made] for health professionals written into law should happen before anyone risks their professional license at an SIF.”

Have Questions? Consult with an Experienced Attorney

If you’re a medical professional and want to work at an SIF, it might be good to have an experienced Pennsylvania criminal defense attorney in case your facility faces legal challenges from law enforcement. PWIDs face the same risk of a potential raid or simply being picked up outside the facility, and may likewise need the advice of an attorney.

For more information on this area of law, see our overview of drug and alcohol violations.