NOEL KING, HOST:
Here at home, lawmakers in more than a dozen cities are talking about creating spaces where people can use heroin and other illegal drugs under medical supervision. There are about a hundred of these so-called safe injection sites around the world, but no U.S. city has officially opened one. Advocates say these spaces can save lives in the middle of a deadly overdose crisis, but fears over a clampdown from the federal government are keeping many local leaders on the fence. Bobby Allyn has the story.
BOBBY ALLYN, BYLINE: Outside of a needle exchange in Manhattan, we found Jeff. We agreed to use just his first name since he uses illegal opioids. He's been battling addiction for a long time.
JEFF: Over 25 years - this thing is not a joke. It really isn't.
ALLYN: Jeff says using on the streets is risky, which is why he's welcoming New York City's proposal to open four supervised injection spaces. People would bring their own drugs and use under the watch of workers armed with an overdose antidote.
JEFF: It's not good to have a person strung out on this stuff. But you definitely don't want them doing this alone. And you definitely don't want to find out they died alone.
ALLYN: Just as needle exchanges helped contain the spread of the AIDS epidemic decades ago, harm reduction advocates today say allowing people to use drugs in a medical setting can curb fatal overdoses and provide a bridge to treatment. NPR found that there are at least 13 efforts underway to open the country's first official supervised injection facility. And the forms vary. Seattle is planning a safe injection van. Philadelphia is considering pop-up tents. And some elected officials in places like Denver and Vermont are trying to gather support for proposals.
SCOTT BURRIS: You can talk about cities racing to be first. But my guess is that you have a lot of cities who are actually racing to be second.
ALLYN: That's Scott Burris. He leads Temple University's Center for Public Health Law Research. He says municipalities are worried about a showdown with Jeff Sessions' Department of Justice. And what insurance company would cover the site? In Philadelphia, where overdoses kill four times as many people as murder, Eva Gladstein says it's time to act. She's a top official with the city's Health and Human Services department.
EVA GLADSTEIN: We estimate that we would save up to 75 lives in one year. And if any of those 75 people are a member of your family, you would, I think, agree that that is something that's desirable.
LOU LAPPEN: You're talking about an extremely dangerous situation with people injecting these drugs into their veins...
ALLYN: Philadelphia-based federal prosecutor Lou Lappen.
LAPPEN: ...That is killing them at rates we have never seen before in the history of the world. So it's not something that we can just say - wow, that's a really great idea.
ALLYN: It's not just prosecutors who are unsettled by the concept. Massachusetts State Senator Will Brownsberger sponsored a bill to jumpstart a safe injection site movement. But many in the Boston area said, not in my backyard.
WILL BROWNSBERGER: If we had a place where people were ready for it, then we could probably get it done. But we don't have that right now.
ALLYN: To help grapple with some of these issues, city and state leaders have been taking trips to Vancouver, Canada. A safe injection site called Insite has operated there since 2003. There's a table in the waiting room with syringes and bandages. Above it, there's a message on a dry-erase board - drink water. Darwin Fisher works here.
DARWIN FISHER: So now we're heading out of the injection room. We're passing the treatment room, which is where a lot of...
ALLYN: Since the opioid epidemic started to worsen, he says being a tour guide has become a big part of his job. Dozens of city leaders have rolled through.
FISHER: They want the site demystified.
ALLYN: Back in New York, Governor Andrew Cuomo is still puzzling through the issue. Asked about his position on supervised injection facilities, he replied it's complicated.
Bobby Allyn, NPR News.
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