Michael Rouwhorst, 28, prepares a dose of heroin and cocaine in Philadelphia in 2017. A city effort to open a facility that allows abusers to use illicit drugs while supervised — to help prevent fatal overdoses — has been challenged in court. (Salwan Georges/The Washington Post)

The federal government has filed a lawsuit to block the city of Philadelphia from opening a site where people can go to illegally use drugs while under supervision, an effort aimed at preventing overdoses amid the nationwide opioid epidemic. The lawsuit sets up a court battle over whether such facilities violate federal law or save lives.

The Justice Department sued Safehouse, a nonprofit organization that planned to open what is known as a supervised injection facility in Philadelphia. Such facilities allow illicit drug abuse but monitor users closely, getting them immediate help in the event of an overdose or adverse reaction. The idea has gained some traction elsewhere — including San Francisco, Seattle and New York — but has not yet resulted in official facilities for illicit drug use.

Philadelphia leaders have warmed to the idea, and the city is closest to opening one. The city’s district attorney has said he would not prosecute those who operate such a facility or those who use drugs there.

Advocates say that such drug sanctuaries could be an important tool in the fight to stem the opioid epidemic. Philadelphia, which has one of the nation’s most active heroin markets, has seen a high toll from opioid abuse. Supervised injection facilities exist in other countries, and advocates contend they save lives by allowing people to use drugs in sanitary conditions where they are monitored for signs of adverse reaction, rather than overdosing on the street, where help might not be available. Advocates also say safe injection sites curb the spread of HIV and hepatitis C by limiting needle-sharing.


A chair near train tracks in Philadelphia sees regular use as a place to inject drugs. (Salwan Georges/The Washington Post)

The Justice Department has vowed to aggressively crack down on cities that open the facilities, and it made good on that promise Wednesday. William M. McSwain, the U.S. attorney for the Eastern District of Pennsylvania, claims that Safehouse would violate federal law by allowing the supervised use of illegal drugs.

Opening the facility, McSwain argued in court documents, would violate the Controlled Substances Act. The facilities appear to violate a portion of the law aimed at crack houses that criminalized opening or running places where illegal drugs are knowingly used.

In a news conference, McSwain laid out the ways his office has fought the opioid epidemic, including dismantling “pill mills,” prosecuting rogue doctors and arresting drug traffickers, particularly those dealing fentanyl, a powerful synthetic opioid that is now driving an increase in overdose deaths in the United States.

McSwain said that research into safe injection facilities might not apply to the situation in Philadelphia and that “setting up a drug house is illegal.”

“For purposes of this action, it does not matter that Safehouse claims good intentions in fighting the opioid epidemic,” McSwain wrote in court documents.

Safehouse said it will continue to move forward to open the facility, which it says will be critical to saving lives in Philadelphia.

“We respectfully disagree with the Department of Justice’s view of the ‘crack house’ statute,” said Ilana Eisenstein, a lawyer for Safehouse. “We are committed to defending Safehouse’s effort to provide lifesaving care to those at risk of overdose through the creation of safe injection facilities.”

The lawsuit was met with dismay by many public health experts, who say the facilities are one more tool that could be useful in stemming the tide of overdose deaths.

“This isn’t black and white. There is an entire cannabis industry functioning in blatant violation of federal law. Bottom line is that the federal government is CHOOSING to enter into this battle, just as it’s paying lip service to public health,” Leo Beletsky, a professor of law and health sciences at Northeastern University, wrote on Twitter.

The facilities also appear to be moving forward elsewhere. In California, where then-Gov. Jerry Brown (D) last year vetoed a bill that would have allowed San Francisco to open a safe injection facility, two legislators reintroduced a bill to let the city’s site go forward. Gov. Gavin Newsom (D) has been receptive to the idea of a safe injection facility there.


A man walks through a Philadelphia neighborhood known for its drug market and illicit drug abuse, in 2017. (Salwan Georges/The Washington Post)