The Associated Press reports the U.S. Department of Justice announced it is “evaluating supervised consumption sites, including discussions with state and local regulators about appropriate guardrails for such sites, as part of an overall approach to harm reduction and public safety.” This is welcome news.

As I explained in a 2019 Cato Policy Analysis, safe consumption sites (also called “safe injection sites” and “overdose prevention sites”) have established a track record of saving lives and preventing the spread of HIV, hepatitis, and other infectious diseases since the late 1980s. This harm reduction strategy is used throughout Europe, Canada (which now has 38 sites), and Australia. In fact, the U.S. is an outlier among developed countries—federal law, 21 U.S.C. Section 856, dubbed the “Crack House Statute,” outlaws knowingly maintaining premises where controlled substances are used or stored.

When a private, self‐​funded organization in Philadelphia sought, with the City Council’s endorsement, to open Safehouse in the city’s Kensington District, it was thwarted by the Trump administration’s Justice Department. After losing in the Court of Appeals, the U.S. Supreme Court refused to hear the case. The harm reduction project is now in legal limbo.

Defying federal law, last summer the Governor of Rhode Island signed a bill permitting privately‐​funded safe consumption sites beginning this spring. New York City opened two safe consumption sites last November and plans to open two more in coming weeks. San Francisco plans to officially open a site in the coming weeks. In the meantime, a de facto site is working under the radar in a Tenderloin District Linkage Center. The state legislature is entertaining a bill to legalize safe consumption sites statewide starting in 2023.

Since 2014 a safe consumption site has been secretly saving lives in the U.S. while being monitored by researchers at an independent non‐​profit research institute based in North Carolina. The researchers provide data in the peer‐​reviewed medical literature which they update regularly, while keeping the name and location of the site confidential. To avoid interdiction, the site is only able to operate part‐​time.

In July 2020 the researchers provided five years (2014–2019) of data in the New England Journal of Medicine. There were 10,514 injections through 2019, with 33 overdoses over the 5‑year period—all of which were reversed. They reported that the types of drugs changed over that period, with combinations of opioids and stimulants comprising 5 percent of injections in 2014 and 60 percent of injections in 2019.

Last month these researchers reported in the Journal of General Internal Medicine that facility users were 27 percent less likely to visit emergency departments, had 54 percent fewer emergency department visits, and were 32 percent less likely to be hospitalized. Those who were hospitalized spent 50 percent fewer nights in the hospital. Therefore, in addition to saving the lives of people who inject drugs, safe consumption sites can reduce stress on the health care system.

Unfortunately, there will always be critics who claim safe consumption sites enable drug use. Like those who cling unrealistically to a “zero‐​COVID” policy, harm reduction critics seem to think we can achieve a drug‐​free society. Harm reduction advocates are realistic and non‐​judgmental. Their goal is to reduce the harms that attend the use of drugs obtained in the dangerous black market.

And harm reduction comes naturally to us doctors. When we prescribe blood pressure, diabetes, or cholesterol‐​lowering drugs to patients who are unwilling or unable to give up unhealthy lifestyle choices, we practice harm reduction.

Congress should repeal the Crack House Statute and get the federal government out of the way of state and local organizations who, unconditionally, want to save their neighbors’ lives. Until Congress makes that definitive move, it is encouraging to learn that the Biden Justice Department seems open to accommodating them.

If you want to view a powerful and illuminating panel discussion on safe consumption sites held at the Cato Institute in 2019, this is the video.