The majority of residents and business owners in Kensington support opening an overdose prevention site in their neighborhood, according to a Drexel University study published today in the Journal of Urban Health.
This could be a boon to Safehouse, the Philadelphia-based nonprofit dedicated to harm reduction and saving lives by providing a range of overdose prevention services, namely opening an overdose prevention site, originally planned for Hilton Street in Kensington.
“We’re vindicated that the people who are most affected believe that it’s needed,” Ronda Goldfein, Safehouse vice president and secretary and executive director of the AIDS Law Project of Pennsylvania, told PW. “We recognize that we need multiple sites, but let’s be realistic that we need to put our first site where the need is greatest.”
News of a possible Hilton Street location sparked outrage among area residents and culminated in a petition that has garnered 573 signatures opposing overdose prevention sites in the city and on Hilton Street specifically, led by the Harrowgate Civic Association neighboring Kensington. The Drexel study included Harrowgate in its definition of Kensington.
Opponents say that they are worried about drug sales and concentrating drug use in an area already walloped by the epidemic and that the city has not offered a safety plan for such sites, also known as supervised injection facilities.
In addition, U.S. Attorney William McSwain filed a civil lawsuit in February asking a federal court to declare supervised injection facilities illegal. Safehouse filed a response in April arguing, in part, that it believes supervised consumption sites (another name for overdose prevention sites) are legal and save lives.
This new study, headed by Alexis Roth, an assistant professor of Community Health and Prevention at Drexel University’s Dornsife School of Public Health, could indirectly boost Safehouse’s stance by showing that most people in Kensington not only support the opening of an overdose prevention site in their neighborhood but also of multiple sites across the city.
“We wanted to do a large and systematic assessment of residents and business owners and staff to better understand their opinions towards an overdose prevention site in the Kensington neighborhood because they are the ones who are most likely to be impacted by it,” Roth told PW. “We know that public opinion is important to enacting drug policy… Knowing how residents and business representatives in the neighborhood feel is critical to those conversations.”
The Drexel study confirms what Safehouse leaders and board members thought – “that the people who are most affected in that area need to have a change,” Goldfein said. “It’s not that people are rushing to have safe injection sites, but they know that things cannot continue the way they have been going.”
Goldfein added that she and Safehouse Executive Director Jose Benitez, also executive director of Prevention Point Philadelphia, one of the largest syringe exchanges in the country that provides a range of other medical and social services, “want to hear from the neighbors. We want to find the best locations, and we’re optimistic that a court will agree that saving lives is not illegal.”
The Drexel study is the largest survey ever conducted of a neighborhood’s attitudes toward an overdose prevention site. Of the 360 adult residents and 79 business owners and staff interviewed, the majority came out in favor of a supervised injection facility. Ninety percent of residents and 63 percent of business owners and staff surveyed said they were in favor of opening an overdose prevention site in Kensington.
“It is encouraging to us that an overwhelming majority of Kensington residents understand that overdose prevention sites not only save lives, they also help drug users get into treatment and reduce the number of people injecting drugs on the street,” Philadelphia Health Commissioner Dr. Thomas Farley told PW in a statement Tuesday. “When over a thousand people are dying of drug overdoses in Philadelphia each year, we need to provide these services as soon as possible. Just as syringe exchange was once controversial but is now a widely-accepted and proven way to prevent HIV/AIDS, overdose prevention sites will likewise be shown to save lives and help affected neighborhoods.”
Philadelphia has been particularly hard hit by the opioid epidemic. It has the highest mortality rate from unintentional drug overdoses of any major city in the country, with 1,116 people dying of drug overdose deaths in 2018 and more than 1,200 drug overdose deaths the year before – with Kensington at its epicenter.
Mayor Jim Kenney formed The Mayor’s Task Force to Combat the Opioid Epidemic in Philadelphia in 2017 to explore, among other responses to the crisis, the possibility of opening a supervised injection facility in the city. Such sites have been operating in Europe since the mid-1980s and exist in 11 different countries. One has yet to open legally in the United States, though an unsanctioned site has been operating in the country since 2014. In addition to Philadelphia, other cities are also debating opening overdose prevention sites, including Seattle, San Francisco, New York and Denver.
For the Drexel study, surveyors approached residents and business owners along a 1.5-mile stretch of Kensington Avenue and at major intersections. “A strength of this study is that we talked to nearly 450 men and women on the street who are very diverse,” Roth said. “It’s a large and diverse sample from a very large swath of Kensington Avenue.”
Roth attributes the high degree of support for opening a supervised injection facility in Kensington, where drug users could receive overdose prevention and links to other services, to peoples’ exposure to seeing public injection and finding syringes and other drug paraphernalia in their neighborhood.
“Residents and business owners and staff are very aware of what’s happening in their neighborhood,” Roth said. “They frequently experience quite a bit of drug-related social problems, and they’re ready for that to change. I think this is supported by the low proportion of respondents indicating the city response to the overdose-related opioid crisis is sufficient.” (28 percent)
Of those surveyed, more than 90 percent had witnessed public injection or seen discarded syringes in the neighborhood over the last 30 days.
Support for a site was significantly higher among adults who were unstably housed or currently using drugs as opposed to their counterparts, according to the study (97 percent versus 85 percent). In the business sample of the Drexel study, it was people of color who were more supportive compared to their white counterparts (69 percent versus 27 percent).
The Drexel study is useful because “it gives us this baseline temperature of Kensington resident and business owner and staff opinion on the acceptability of an overdose prevention site in their neighborhood,” Roth said. “Should a site open, it will be important to track how opinion changes over time post-implementation.”
“I think that Philadelphians need to look at what this really means,” Goldfein said. “All along, we’ve insisted that this is Philadelphians helping Philadelphians. Now we have Philadelphians asking for help.”
This Drexel study is being published the same day Philadelphia Fire Commissioner Adam Thiel and Mayor Jim Kenney announced a new EMS alternative response unit to focus on overdoses. The unit will bring paramedics and social services case managers to travel together to provide care and support to overdose survivors with the aim of getting them into treatment. This is a collaboration between the Philadelphia Fire Department, the Philadelphia Health Department and the city’s Department of Behavioral Health and Intellectual disAbility Services.
This effort stems from Kenney’s 2018 executive order to combat the opioid crisis and the resulting Philadelphia Resilience Project to clear drug encampments, reduce the number of unsheltered individuals, clean up trash, increase treatment options and reduce the spread of infectious diseases.