Last week, Philly gave the green light to a new method for combating opioid overdoses. City officials announced they would “actively encourage” a comprehensive user engagement site (CUES) — i.e. a facility that would allow people to use drugs and facilitate access to medical care and drug treatment.
You probably heard it referred to as safe-injection site — potentially the nation’s first.
But a safe-injection site and a CUES are not the same thing, said Philadelphia Health Commissioner Thomas Farley. Conflation of the two is one of several misconceptions that’ve been repeated in local and national coverage about Philly’s big move.
We sat down with Farley to separate the facts from the rumors. Here are the five biggest ways Philly’s backing of a potential CUES has been misinterpreted.
Misconception 1: It’s a safe-injection site
Even if you’ve been paying close attention, you probably haven’t heard the term “comprehensive user engagement site” more than a few times. Most have been referring to the potential facility as a safe-injection site. The two names aren’t synonymous, and Farley stressed that the distinction is important.
A safe-injection site is a facility where people can inject drugs with supervision so they don’t suffer from a fatal overdose. But CUES, in the city’s vision of them, have broader goals.
“We are envisioning something that is going to be much more than that,” Farley said. “A site where we’re really engaging people on a constant basis, trying to encourage them to go to treatment and then facilitating that transition.” The mission of the CUES, he said, is broader than just telling people, “You can inject here.”
The “safe-injection” title also implies people can only use intravenous drugs on site, Farley said, but people would be able to use any form of opioids while being supervised inside the CUES.
Misconception 2: It’s ‘government-sanctioned heroin use’
Yes, people can use heroin on site. But no, Farley said, the CUES is not sanctioning its use. And the facility would definitely not provide any drugs to users.
“We’re not giving people heroin,” Farley said. “It is not a heroin delivery site.”
In fact, the CUES isn’t exclusively meant for heroin use. Farley said the city is open to people using other forms of opioids there, and is determining whether intake of other types of drugs will also be allowed.
Misconception 3: It will diminish other publicly funded medical services
Last week, a guest column in the Inquirer implied the city would redirect funding from other medical services to fund the CUES. Many Philly residents appear to have made the same assumption.
Yes, in Vancouver — a model Philly officials looked at for inspiration — the safe-injection site uses public funding. But Philadelphia has not suggested or promised that any of its own money will fund the CUES. Instead, the city will do what it can to encourage interested private funders to build and maintain the facility.
“Taxpayers’ dollars will not be going to operate the site itself,” Farley said. Some public funding will go toward drug treatment programs in the city — which might see an influx of participants once the CUES opens — but that’s nothing new. Taxpayer dollars already help fund public detoxes and medication-assisted treatment beds in the city, among other related services.
Misconception 4: It will hurt Philly neighborhoods
Some residents have expressed their concerns about having the facility in their neighborhoods. Several in the Kensington community told PMN they fear a CUES will bring more opioid users to the area, and thereby increase public drug use.
However, Farley said, evidence from Vancouver shows these sites tend to relieve neighborhood problems associated with drug use, not the opposite.
“It reduces the amount of needles on the ground, [and] it reduces the amount of people who are seen injecting in public,” Farley said. “Both of those make perfect sense, because that behavior is now happening indoors.”
When Farley visited Vancouver a few months ago to tour the city’s safe-injection site, he said he stumbled upon the facility by accident. He didn’t even realize what it was.
“People may have a view that this is somehow going to be a big draw in the neighborhood, that it’s going to be a big change,” Farley said. “Once it’s there…it’s just another storefront.”
Misconception 5: It will be Philly’s main anti-overdose tactic
James Garrow, a spokesperson for the city’s public health department, said he’s heard one misinformed idea over and over again: that the CUES will become the primary — or even the only — method Philly uses to combat addiction.
Farley noted there are several other components to the city’s most recent plan, including:
- Preventing people from becoming addicted in the first place
- Implementing more evidence-based treatment
- Expanding access to medication-assisted treatment
- Distributing “tens of thousands” of doses of naloxone
“This is really to help one narrow piece of the problem,” Farley said. “Having people understand that this is part of this broader strategy is important. This is definitely not stand-alone.”