PHILADELPHIA -- Loved ones propped photos of more than a dozen young people lost to the opioid crisis against the outside of the federal courthouse in Philadelphia on Monday as a judge inside heard arguments on whether the city could become the nation's first to open a supervised injection center.
U.S. Attorney William McSwain, an appointee of President Donald Trump, believes the plan normalizes the use of heroin and fentanyl and violates federal drug laws. He has sued to block the site, supported by several leading Democrats in the city, including the mayor and district attorney, and at least seven state attorneys general.
In court Monday, with McSwain in the unusual role of lead attorney, U.S. District Judge Gerald McHugh Jr. heard from an emergency room doctor and a nonprofit leader supporting the plan to open Safehouse, presumably in the city's drug-ravaged Kensington neighborhood.
"We believe that this public health approach is lifesaving," said Jose Benitez, who runs a nonprofit that runs a needle exchange program and other health services and is spearheading the Safehouse effort with former Gov. Ed Rendell, a Democrat, and others.
Benitez has worked in addiction services for nearly three decades, and said clients today are using heroin and fentanyl as much as eight to 10 times a day, up from once or twice a day just five years ago.
He directs an agency called Prevention Point, which reversed more than 500 overdoses in the Kensington area last year. Staff members have often had to run several blocks through the neighborhood with medical equipment to reach people in time, he said.
Still, Philadelphia endured 1,100 overdose deaths last year, more than 200 of them in the Kensington ZIP code, he said.
Benitez, in declaring opioids a public health emergency, noted the 1,100 overdose deaths is more than three times the city's homicide rate.
Benitez and other organizers have visited a supervised injection site in Vancouver, British Columbia, that is something of a model for their program. The site looks like an urgent care center, with a central desk and individual bays.
"Clearly, I thought we should organize and try to do overdose prevention since we were losing so many Philadelphians," Benitez testified.
Safehouse would provide drug users with clean needles and ties and let them use their own drugs in the presence of medical staff. Advocates believe it will also provide a trusted place for them to be offered treatment.
"There would be medical staff observing an overdose reaction if one was to occur . and then providing medical care," Benitez said.
McSwain, questioning the proposed name, asked whether people who use marijuana might move on to heroin or fentanyl after thinking "now there's a safe place, called Safehouse, to take these drugs."
"Anything's possible," Benitez said. "It's not likely."
McSwain also questioned whether the Vancouver program had reduced fatal overdoses, and Safehouse's mission to provide a place to use drugs, in his words, "without judgment or stigma."
And he questioned how staff would screen out minors since clients can remain anonymous. Benitez said that anyone who looked under 18 would be asked for proof of age or referred to other programs.
Rendell, who was in the courtroom, has said Safehouse founders would consider an appeal if McSwain prevails. McHugh did not indicate when he would rule.