We rate this statement as Mostly False.

There is not "clear evidence" that safe-injection sites offer "some benefit to those facing addiction."

Josh Shapiro
Said on Praise 107.9 radio
Jan. 30, 2018

Philly’s opioid crisis

Do safe-injection sites offer proven benefits to those facing addiction?

Pennsylvania’s attorney general is not a fan of Phily’s proposed CUES.

Pa. Attorney General Josh Shapiro

Pa. Attorney General Josh Shapiro

YouTube screenshot

Full Statement

“I guess while some studies may offer some benefit to those facing addiction, I don’t think there is clear evidence, and I am focused less on creating pathways to safe-injection sites and more on creating pathways to effective treatment to those who are in need.”

Our Analysis

On Jan. 23, Philadelphia officially announced it would “actively encourage” the creation of a a comprehensive user engagement site (also known as a safe-injection site). Safe-injection sites, which are medically supervised spaces where people can use drugs, currently exist in Canada and at least nine other countries around the world.

Like many other Pennsylvania politicians, Pa. Attorney General Josh Shapiro chimed in about a week after the announcement, voicing his opinion on the subject on the air to Praise 107.9 radio show host Solomon Jones.

Shapiro delivered criticism of the proposed site. He told Jones, “I guess while some studies may offer some benefit to those facing addiction, I don’t think there is clear evidence, and I am focused less on creating pathways to safe-injection sites and more on creating pathways to effective treatment to those who are in need.”

Philly’s proposal for a comprehensive user engagement site comes amid a nationwide and citywide opioid crisis. In 2017, an estimated 1,250 people died from opioid overdoses in Philadelphia — that’s up 30 percent from 2016.

Since the idea was announced, it has generated controversy in the city. Addiction recovery advocates and Philly’s public health officials have consistently cited data they claim points to the effectiveness of safe-injection sites. City councilmembers and religious figures have dragged their feet in considering the idea.

Meanwhile, the two groups fought so much over the idea that Philly instituted a series of community forums to explain comprehensive user engagement sites and dispel the rumors.

So is it true that there isn’t “clear evidence” behind safe-injection sites?

What is the data?

Dr. Thomas Kerr, the associate director of the British Columbia Centre on Substance Use, has personally conducted data on Vancouver’s safe-injection site. He believes there are about 40 peer-reviewed studies of similar sites around the world, all of which state their effectiveness.

“Not only is the evidence there,” Kerr told PolitiFact PA, “but it’s of a remarkably high quality.”

According to a study published by the American Journal of Preventive Medicine, data show safe-injection sites offer various benefits to communities dealing with addiction. A major one is a reduction in fatal overdoses. A separate study conducted at Vancouver’s safe-injection site estimated that out of 453 potentially fatal overdoses there between March 2004 and July 2008, between eight and 51 people could have died if the ODs had occurred outside the facility.

Another reported benefit is increased enrollment in detox. A report from the Society for the Study of Addiction found that among 1,031 injection drug users surveyed, there was a “statistically significant increase in the uptake of detoxification services” the year after Vancouver’s safe-injection site opened.

Lowering infection rates is a tertiary potential effect. At a safe-injection site in Sydney, Australia, 96 percent of people who visited were tested for HIV in 2009, and only 2 percent of that population was found to be positive. This showed, according to the Australian and New Zealand Journal of Public Health, that people who used the site had low rates of contracting infections due to their substance use.

Is the data applicable to Pennsylvania?

In a statement emailed to PolitiFact PA, Shapiro’s Communications Director Joe Grace cited a Dec. 2017 study by Main Line Health System and Thomas Jefferson University (Supervised Consumption Facilities – Review of the Evidence) and said, “The vast majority of academic studies on SIFs are based on one location in Vancouver. It isn’t certain how applicable the assumptions from that one location are to communities in other geographic areas.”

Though some of the research on effectiveness does come from Canada, the American Journal of Preventive Medicine reports that functional safe-injection sites operate in at least 10 different countries, with approximately 98 operating in 66 cities worldwide.

And before the City of Philadelphia announced its proposal, it commissioned a custom research study on the feasibility of a safe-injection site there.

Dr. Sharon Larson, the executive director of the Main Line Health Center for Population Health Research at the Lankenau Institute for Medical Research, led that study. Her team reviewed worldwide research on safe-injection sites, then tried to imagine replicating that in Philly, taking into account differences among the various communities.

A potential safe-injection site would likely have similar effects in Philadelphia as it did in Vancouver, Larson said. Her research leads her to expect it would cause a reduction in HIV and hepatitis C infections and avert overdose deaths.

Larson also estimates a safe-injection site would save Philly about $124,000 in ambulance calls and hospital costs associated with treating infections.

“We’re making an estimate about these kinds of things,” Larson said. “This is all contingent on the model.”

So it’s possible there isn’t enough data to confirm that a site in Philly would be as effective as it is in Vancouver. However, the worldwide data is substantial, and almost entirely supports the effectiveness of safe-injection sites.

Our Ruling

Attorney General Josh Shapiro said on Praise 107.9, “I guess while some studies may offer some benefit to those facing addiction, I don’t think there is clear evidence…”

At least 40 peer-reviewed studies of safe-injection sites around the world show clear evidence of benefit. These studies show reduced rates of drug overdose, increased rates of entry into detoxification treatment and fewer infections related to intravenous drug use.

We rule this claim Mostly False.

Want some more? Explore other Philly’s opioid crisis stories.

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