Sens. Bernie Sanders (I-Vt.) and Elizabeth Warren (D-Mass.) are vowing to put in place a controversial approach to stopping drug overdoses if elected.
Both Democratic presidential candidates endorsed supervised injection sites this week, a stance that conflicts with the federal government’s objection to allowing so-called “safe” locations that let drug users inject heroin and other drugs.
The Trump administration is currently suing to block what would be the first supervised injection site in the U.S. in Philadelphia, and threatening to block similar efforts in other major cities like Seattle and New York.
But advocates say these sites, which are staffed with medical personnel and have been successful in other countries, would curb overdose deaths in the U.S.
“For a presidential candidate to come out and publicly support it, particularly when the administration has a very public stance against it is significant,” said Lindsay LaSelle, director of public health law and policy with the Drug Policy Alliance.
“It shows that there are candidates who, in the context of the opioid crisis — which is still going strong — that they’re willing to think outside of the box and look at interventions that have proven successful in other countries.”
At supervised injection sites, medical professionals monitor for overdoses and provide clean injection supplies to discourage users from sharing needles and potentially spreading diseases.
Staff also refer users for drug and medical treatment and other services to help them quit. The sites do not provide drugs.
Twelve countries operate supervised injection sites, with studies showing Canada’s facilities have resulted in fewer overdoses deaths and less HIV infections.
But efforts to open similar facilities in the U.S. hit roadblocks under threats from the Trump administration, which argues supervised injection sites normalize drug use and are illegal under federal law.
The Department of Justice sued Philadelphia’s injection site, called Safehouse, before it opened in February, and U.S. Attorney William McSwain, a Trump appointee, argued this week for a judge to block it in court.
The case is in its early stages, but its outcome could have an impact on efforts to open supervised injection sites in cities like Seattle and San Francisco. If successful, Safehouse would be the first site in the country.
“Either way it’s decided, it will set the first legal precedent in the country,” LaSelle said.
Former Deputy Attorney General Rod Rosenstein said last August the DOJ would meet the opening of any injection site with “swift and aggressive” action.
But Sanders and Warren embraced the sites this week in their criminal justice reform plans.
Sanders’ plan says he would “legalize safe injection sites and needle exchanges around the country, and support pilot programs for supervised injection sites, which have been shown to substantially reduce drug overdose deaths.”
In her plan, Warren says she will “support evidence-based safe injection sites and needle exchanges and expand the availability” of drugs that prevent opioid overdoses.
As the opioid epidemic rages on, several states are considering opening supervised injection sites, but Trump’s opposition is creating obstacles.
Former California Gov. Jerry Brown (D) vetoed a bill that would have allowed supervised injection sites, noting that the administration threatened states with federal prosecution.
But current California Gov. Gavin Newsom (D) has said he is open to the idea. A bill that passed the state Assembly in May would create a limited pilot program in select cities, including San Francisco.
In New York, health officials have indicated they are waiting to see the outcome of the Philadelphia case before deciding on whether to approve a one-year pilot program proposed by Mayor Bill de Blasio (D), who is also running for president.
Meanwhile in Seattle, a $1.5 million pilot program stalled out after U.S. Attorney Brian Moran warned the city “not to go there.”
But after 2020, a new Democratic administration that supports supervised injection sites would be unlikely to threaten legal action against states that want to open one, LaSelle said.
In addition to Warren, Sanders and de Blasio, presidential candidate Andrew Yang has also said he supports the sites.
“Overdose prevention sites would save lives — they are already helping people struggling with substance abuse in other countries,” he tweeted earlier this month.
Health advocates and experts say the issue is one that must be urgently addressed.
While preliminary data from the Centers for Disease Control and Prevention shows drug overdose deaths fell in 2018, more than 68,000 people still died.
“Unfortunately, it takes crisis to move the trajectory,” said Carrie Wade, the director of harm reduction policy at R Street, a free-market think tank in DC.
“But I see it as a good thing that people are willing to consider different approaches other than abstinence in dealing with this. And to have such prominent people openly endorsing it is a great thing.”
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