Rhode Island made history yesterday, as it became the first state to legalize safe consumption sites. Governor Daniel McKee signed a bill that will set up two pilot programs within the state dubbed “harm reduction centers,” both of which will receive no taxpayer funding but will be financed by private donations and foundations.

In 2019 and 2020 I testified before the Maryland legislature which was considering legalizing safe consumption sites. Alas, that didn’t happen.

Safe consumption sites, also called safe injection sites, have been in existence since the mid-1980s, and now operate in more than 120 locations in 66 major cities throughout Europe, Canada, and Australia. Unfortunately, federal law, specifically the “Crack House Statute,” makes them illegal in the U.S.

As I explain here, safe consumption sites are an effective means of reducing overdose deaths, the spread of infectious diseases, and of bringing into rehab people with substance use disorder. They offer an advantage over syringe services programs (“needle exchange”), which are federally legal. This is because safe consumption sites bring people inside, safe from the elements and from physical assault (and out of view of children and other members of the community), where they are given clean needles and syringes to inject their drugs under the watchful eye of nearby staff, ready with the overdose antidote naloxone. Unlike in needle exchange programs, the used needles and syringes are then safely discarded by the staff. Clients can return as often as they wish to safely consume their drugs. They are also provided with a place to shower and clean up, as well as to stay inside to “chill” after injecting. Tests are offered to screen for HIV and hepatitis, and fentanyl test strips and naloxone are often given to clients upon departure. As trust builds from this non-judgmental relationship, many clients “open up” to staff and are brought into rehab.

Vancouver, BC in 2003 became the first city in North America to have a safe consumption site, called Insite. Safe consumption sites exist in multiple locations in Canada today.

Passersby in cities coast-to-coast recoil at the sight of people on the street—many of them homeless—injecting drugs in plain sight of families with children. Harm reduction advocates should emphasize to them that safe consumption sites are one means of addressing this problem.

In 2019 a group of private individuals, including former Pennsylvania Governor Ed Rendell, were given permission by the Philadelphia city council to create “Safehouse,” with completely private funding. While this would have been the first safe consumption site to legally operate in the U.S., one has been operating clandestinely for several years. Its results have been reported in the peer-reviewed medical literature.

Unfortunately, the U.S. Department of Justice intervened in the effort, claiming the Philadelphians were violating the federal “Crack House Statute.” Sadly, Safehouse’s future is still in legal limbo.

At a March 2019 harm reduction conference held in the Cato Institute’s Hayek Auditorium, Darwin Fisher, the Program Manager of Vancouver’s Insite, Cato Senior Vice President Clark Neily, and former Pennsylvania Governor Ed Rendell discussed safe consumption sites and their prospects for overcoming federal obstacles in the U.S. You can view the lively discussion here.

Philadelphia’s Safehouse is still fighting for its life. Hopefully, Rhode Island won’t run into the same federal buzzsaw. In any event, the Ocean State’s new law should add momentum to efforts across the nation to break the federal government’s blockade of this proven harm reduction strategy.