Editing Supervised injection site (section)

== Facilities ==
=== Australia ===
[[File:"You Talk, We Die" mural in North Richmond area of Melbourne, Australia.jpg|thumb|This "You Talk, We Die" mural was painted to advocate for a safe injecting facility in the [[North Richmond, Victoria|North Richmond]] area of [[Melbourne]], known for the heroin trade. The campaign was successful and a facility opened in 2018.]]
The legality of supervised injection is handled on a state-by state basis. [[New South Wales]] trialed a supervised injection site in [[Sydney]] in 2001, which was made permanent in 2010.<ref>{{cite web |last1=Thomas |first1=Matthew |title=Sydney's Medically Supervised Injecting Centre |url=https://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library/FlagPost/2010/September/Sydneys_Medically_Supervised_Injecting_Centre |website=Australian Parliamentary Library |access-date=28 October 2020}}</ref> After several years of community activism, [[Victoria (Australia)|Victoria]] agreed to open a supervised injection site in [[Melbourne]]'s [[North Richmond, Victoria|North Richmond]] neighbourhood in 2018 on a trial basis. In 2020 the trial was extended for a further three years, and the site remains open as of 2024. 

A second site for Melbourne's [[Central business district|CBD]] was approved<ref>{{cite web |title=Medically supervised injecting room |url=https://www2.health.vic.gov.au/alcohol-and-drugs/aod-treatment-services/injecting-room |website=Health.vic |access-date=28 October 2020}}</ref> and was to be placed in a building on [[Flinders Street, Melbourne|Flinders Street]] which had previously housed [[Yooralla]].<ref>{{cite web |last1=Eddie |first1=Rachel |last2=Waters |first2=Cara |title=Second Melbourne injecting room in limbo as Andrews walks back commitment |url=https://www.theage.com.au/politics/victoria/richmond-safe-injecting-room-to-remain-open-permanently-20230307-p5cpx7.html |website=The Age |date=7 March 2023 |access-date=7 March 2023}}</ref> However, as of 2024, the site has been rejected by Premier [[Jacinta Allan]] who cited disagreements over location, preferring to set up a new community health and [[pharmacotherapy]] centre instead. 

=== Europe ===
During the 1990s legal facilities emerged in cities in [[Switzerland]], [[Germany]] and the [[Netherlands]].<ref name="emcdda" /><ref name=dolan>{{cite journal |url= http://www.drugpolicy.org/docUploads/harm_reduction_digest_injecting_centres.pdf |archive-url= https://web.archive.org/web/20040924224813/http://www.drugpolicy.org/docUploads/harm_reduction_digest_injecting_centres.pdf |url-status= dead |archive-date= 2004-09-24 |last1= Dolan |first1= Kate |last2= Kimber |first2= Jo |last3= Fry |first3= Craig |last4= Fitzgerald |first4= John |last5= Mcdonald |first5= David |last6= Trautman |first6= Franz |year= 2000 |title= Drug consumption facilities in Europe and the establishment of supervised injection centres in Australia |journal= Drug and Alcohol Review |volume= 19 |issue= 3 |pages= 337–346 |doi= 10.1080/713659379 }}</ref> In the first decade of 2000, facilities opened in Spain, Luxembourg, and Norway.<ref name="emcdda" />
[[File:NaloxoneKit.jpg|thumb|Naloxone, a drug on hand at clinics used to administer in cases of [[opioid overdose]]]]

Whereas injection facilities in Europe often evolved from something else, such as different social and medical outreaches or perhaps a homeless shelter, the degree and quality of actual supervision varies. The history of the European centers also mean that there have been no or little systematic collection of data needed to do a proper evaluation of effectiveness of the scheme. At the beginning of 2009 there were 92 facilities operating in 61 cities, including 30 cities in the Netherlands, 16 cities in Germany and 8 cities in Switzerland. Denmark passed a law allowing municipalities to run "fix rooms" in 2012, and by the end of 2013 there were three open.

To date in July 2022, according to [[European Monitoring Centre for Drugs and Drug Addiction]] Belgium has one facility, Denmark five, France two, Germany 25, Greece one, Luxembourg two, Netherlands 25, Norway two, Portugal two, Spain 13, and Switzerland 14.<ref>{{cite web |last1=EMCDDA |title=Infographic. Location and number of drug consumption facilities throughout Europe {{!}} www.emcdda.europa.eu |url=https://www.emcdda.europa.eu/media-library/infographic-location-and-number-drug-consumption-room-facilities-throughout-europe_en |website=www.emcdda.europa.eu |access-date=July 26, 2022}}</ref>

====Ireland====
Ireland has legislation to permit the opening of a service (as of May 2017) in the Misuse of Drugs (Supervised Injecting Facilities) Bill 2017; however, it has been halted by planning concerns.<ref>{{cite news |last1=McCann |first1=Eugene |last2=Duffin |first2=Tony |title=Opinion: Supervised drug injecting in Ireland – 10 years of advocacy, legislation and delays |url=https://www.thejournal.ie/readme/drug-injecting-and-policy-5658873-Jan2022/ |access-date=July 26, 2022 |work=TheJournal.ie |date=January 20, 2022 |language=en}}</ref>

====Netherlands====
The first professionally staffed service where drug injection was accepted emerged in the Netherlands during the early 1970s as part of the "alternative youth service" provided by the St. Paul's church in Rotterdam. At its peak it had two centers that combined an informal meeting place with a drop-in center providing basic health care, food and a laundering service. One of the centers was also a pioneer in providing [[Needle-exchange programme|needle-exchange]]. Its purpose was to improve the psychosocial function and health of its clients. The centers received some support from law enforcement and local government officials, although they were not officially sanctioned until 1996.<ref name="dolan" />
====Switzerland====
The first modern supervised consumption site was opened in [[Bern]], [[Switzerland]] in June, 1986.<ref>{{Cite web|last=Hedrich|first=Dagmar|date=February 2004|title=European report on drug consumption rooms|url=http://www.emcdda.europa.eu/attachements.cfm/att_2944_EN_consumption_rooms_report.pdf|access-date=October 5, 2020|publisher=European Monitoring Centre for Drugs and Drug Addiction|archive-date=March 26, 2020|archive-url=https://web.archive.org/web/20200326022000/http://www.emcdda.europa.eu/attachements.cfm/att_2944_EN_consumption_rooms_report.pdf|url-status=dead}}</ref>  Part of a project combatting HIV, the general concept of the café was a place where simple meals and beverages would be served, and information on safe sex, safe drug use, condoms and clean needles provided. Social workers providing counselling and referrals were also present. An injection room was not originally conceived, however, drug users began to use the facility for this purpose, and this soon became the most attractive aspect of the café. After discussions with the police and legislature, the café was turned into the first legally sanctioned drug consumption facility provided that no one under the age of 18 was admitted.<ref>{{cite book|first=Robert |last=Haemmig|title=Injecting Illicit Drugs|author2=Ingrid van Beek|publisher=Blackwell Publishing|year=2005|isbn=978-1-4051-1360-1|editor1=Richard Pates|pages=160–169|chapter=13 Supervised Injecting Room|editor2=Andrew McBride|editor3=Karin Arnold}}</ref>

====United Kingdom====
The United Kingdom opened one (officially unsanctioned) facility in Glasgow in September 2020. It was opened by Peter Krykant, a local drugs worker;<ref>{{cite web |last1=Livingston |first1=Eve |title='It's a lifesaver': Glasgow drug users and MP hail safe-injecting space |url=https://www.theguardian.com/politics/2020/sep/19/glasgow-drug-users-and-mp-hail-lifesaving-van-that-defies-uk-law |website=the Guardian |access-date=July 26, 2022 |language=en |date=19 September 2020}}</ref> however, lack of funding and support led to its closure in May 2021.<ref>{{cite journal |last1=Shorter |first1=Gillian W |last2=Harris |first2=Magdalena |last3=McAuley |first3=Andrew |last4=Trayner |first4=Kirsten MA |last5=Stevens |first5=Alex |title=The United Kingdom's first unsanctioned overdose prevention site; A proof-of-concept evaluation |journal=International Journal of Drug Policy |date=June 2022 |volume=104 |pages=103670 |doi=10.1016/j.drugpo.2022.103670|pmid=35523063 |s2cid=248553098 |doi-access=free }}</ref><ref>{{cite web |last1=Davies |first1=Natalie |title=Inside the UK's first unsanctioned drug consumption room |url=https://www.addiction-ssa.org/inside-the-uks-first-unsanctioned-drug-consumption-room/ |website=SSA |access-date=July 26, 2022 |date=26 July 2022}}</ref> In nine months of operation, 894 injection events were recorded at the facility and volunteers reported attending to nine overdose events, seven opioid overdoses, and two involving powder cocaine; but there were no fatalities.<ref>{{Cite news |date=4 May 2022|title=The United Kingdom's first unsanctioned overdose prevention site; A proof-of-concept evaluation |url= https://www.emcdda.europa.eu/news/2023/new-report-presents-latest-overview-drug-consumption-rooms-europe_en |work= International Journal of Drug Policy, Volume 104.|access-date=23 December 2023}}</ref>

In 2023, the [[Lord Advocate]]—Scotland's chief legal officer—announced that the [[Crown Office and Procurator Fiscal Service]] would institute a policy of not criminally prosecuting those using approved supervised drug consumption sites. Police Scotland have also confirmed they will exercise discretion in not prosecuting those using such a facility.<ref>{{Cite news |date=2023-09-11 |title=No prosecution plan for drug consumption rooms |language=en-GB |work=BBC News |url=https://www.bbc.com/news/uk-scotland-66775122 |access-date=2023-10-13}}</ref> An official facility is planned to open in Glasgow in October, 2024. <ref>{{Cite news |date=2024-08-21 |title=UK's first drugs consumption room to open in October |language=en-GB |work=BBC News |url=https://www.bbc.co.uk/news/articles/cvg4n8g331do |access-date=2024-08-21}}</ref>

=== Latin America ===
The first site opened in Latin American was in Bogota, Colombia during October 2024.<ref>{{Cite news |title= La titánica labor de acompañar a usuarios de heroína: "Le hacemos la tarea a salud pública"|date=7 October 2024 |url=https://elpais.com/america-colombia/2024-10-07/la-titanica-labor-de-acompanar-a-usuarios-de-heroina-le-hacemos-la-tarea-a-salud-publica.html}}</ref><ref>{{Cite web |last=Espectador |first=El |title=ELESPECTADOR.COM |url=https://www.elespectador.com/investigacion/heroina-en-bogota-asi-es-la-primera-sala-de-consumo-supervisado-de-bogota/ |access-date=2024-12-02 |website=ELESPECTADOR.COM |language=spanish}}</ref>

===North America===
==== Canada ====
[[File:Controversial Safe Injection Site.jpg|thumb|right|[[Insite]] in 2008]]
There are 39 government authorized SCS in Canada as of July 2019: 7 in [[Alberta]], 9 in [[British Columbia]], 19 in [[Ontario]], and 4 in [[Quebec]].<ref name=":6">{{Cite web|title=Debate over supervised consumption sites ramps up across Alberta|url=https://globalnews.ca/news/5477236/supervised-consumption-sites-alberta-drugs-debate/|access-date=2020-10-07|website=Global News|language=en-US}}</ref> An exemption to controlled substances law under [[Criminal Code (Canada)|Canadian Criminal Code]] is granted inside the facilities, but drug possession remains illegal outside the facility and there is no buffer zone around the facility.<ref name=":6" /> Canada's first SCS, [[Insite]] in [[Downtown Eastside]] of [[Vancouver]], commenced operation in 2003.<ref name="vanbeek">{{cite book|last=Van Beek|first=Ingrid|title=In the eye of the needle: Diary of medically supervised injecting centre|publisher=Allen & Unwin|year=2004|isbn=978-1-74114-381-2|location=Crows Nest|oclc=57515258}}</ref>

===== Alberta =====
In August 2020, [[ARCHES Lethbridge]] in [[Lethbridge]], [[Alberta]], the largest SCS in North America, closed shortly after Alberta revoked their grant for misuse of grant funds.<ref>{{Cite web|last1=Roulston|first1=Tom|last2=Nixon|first2=Liam|date=July 23, 2020|title=ARCHES audit findings turned over to Lethbridge police for investigation|url=https://globalnews.ca/news/7211328/arches-supervised-consumption-site-audit-police-investigation/|access-date=2020-09-27|website=Global News|language=en-US}}</ref> Shortly after opening in February 2018,<ref name="Pijl_20200113" /> ARCHES Lethbridge found itself repetitively necessitating police intervention and/or [[emergency medical services]] for opioid-related issues;<ref name=":8">{{Cite web|last=Vogt|first=Terry|date=2020-03-05|title=Government review says Lethbridge SCS has 'most problems in the province'|url=https://calgary.ctvnews.ca/government-review-says-lethbridge-scs-has-most-problems-in-the-province-1.4841210|access-date=2020-10-07|website=Calgary|language=en}}</ref> indeed, three weeks after its closure, the city noted a 36% decline in opioid-related [[Emergency Medical Services|EMS]] requests.<ref>{{Cite news|last=Labby|first=Bryan|date=September 26, 2020|title=3 weeks after province ends funding for injection site, unsanctioned space opens in Lethbridge|work=CBC News|url=https://www.cbc.ca/news/canada/calgary/lethbridge-supervised-injection-site-unsanctioned-1.5737627}}</ref>
The average per-capita operating cost of government sanctioned sites are reported to be CAD$600 per unique-client, with the exception of the ARCHES Lethbridge which had a disproportionately high cost of CAD $3,200 per unique client.<ref name=":8" />

In September 2020, a group in [[Lethbridge]], [[Alberta]] led by an ARCHES employee started hosting an unauthorized SCS in public places in a tent.<ref>{{Cite web|last=Gunn|first=Connor|title=Galt Gardens pop-up injection site moves location on 2nd night|url=https://lethbridgenewsnow.com/2020/09/26/galt-gardens-pop-up-injection-site-moves-location-on-2nd-night/|access-date=2020-09-27|website=Lethbridge News Now|language=en}}</ref><ref name=":5">{{Cite web|date=2020-09-26|title=Unsanctioned injection site sets up in Galt Gardens|url=https://lethbridgeherald.com/news/lethbridge-news/2020/09/26/unsanctioned-injection-site-sets-up-in-galt-gardens/|access-date=2020-09-27|website=The Lethbridge Herald – News and Sports from around Lethbridge}}</ref> The group did not have authorizations to operate an SCS or a permit to pitch a tent in the park. The organizer was issued citations for the tent; and the [[Lethbridge Police Service]] advised that users utilizing the unauthorized SCS would be arrested for drug possession, because exemptions do not apply to unauthorized sites.<ref>{{Cite web|last=Ferris|first=Danica|date=September 29, 2020|title=Pop-up overdose prevention site operators fined $300 by City of Lethbridge|url=https://globalnews.ca/news/7367572/pop-up-overdose-prevention-site-fine-lethbridge/|access-date=2020-10-03|website=Global News|language=en-US}}</ref><ref>{{Cite web|title=Lethbridge group sets up unsanctioned overdose prevention site in Galt Gardens|url=https://globalnews.ca/news/7361329/lethbridge-overdose-prevention-unsanctioned-galt-gardens/|access-date=2020-09-27|website=Global News|language=en-US}}</ref><ref>{{Cite news|last=Korol|first=Todd|date=October 5, 2020|title=Lethbridge drug-consumption site seeks Health Canada's permission to operate|work=The Globe and Mail|url=https://www.theglobeandmail.com/canada/alberta/article-lethbridge-drug-consumption-site-seeks-health-canadas-permission-to/|access-date=2020-10-07}}</ref> This opening of this illegal drug consumption tent was controversial and became a subject of discussion at the City Council meeting.<ref>{{Cite web|last=Goulet|first=Justin|date=September 29, 2020|title=Organizer of pop-up injection site issued fine|url=https://lethbridgenewsnow.com/2020/09/29/organizer-of-pop-up-injection-site-issued-fine/|access-date=2020-10-01|website=Lethbridge News Now|language=en}}</ref><ref>{{Cite web|last=Barrow|first=Tyler|date=2020-09-28|title=Protestors gather outside Lethbridge city hall frustrated over pop-up overdose prevention site|url=https://calgary.ctvnews.ca/protestors-gather-outside-lethbridge-city-hall-frustrated-over-pop-up-overdose-prevention-site-1.5123920|access-date=2020-09-29|website=Calgary|language=en}}</ref>

===== Ontario =====
Ontario has scheduled to close ten drug SCS by end of March 2025 and further establishment of SCS is now banned.<ref>{{Cite web |last=Alhmidi |first=Maan |date=2025-02-25 |title='Havens of love and care': Ontarians protest closures of supervised consumption sites |url=https://www.thestar.com/news/ontario/havens-of-love-and-care-ontarians-protest-closures-of-supervised-consumption-sites/article_71c9414a-b839-5866-9e74-2f22498c905c.html |access-date=2025-02-26 |website=Toronto Star |publisher=[[The Canadian Press]] |language=en}}</ref>

==== United States ====

Clandestine injection sites have existed for years. A ''[[New England Journal of Medicine]]'' study from July 2020 reports that an illegal supervised consumption site has been operating at an "undisclosed" city in the U.S. since 2014 where over 10,000 doses of illegal drugs have been injected over a five-year period.<ref>{{Cite journal |last1=Kral |first1=Alex H. |last2=Lambdin |first2=Barrot H. |last3=Wenger |first3=Lynn D. |last4=Davidson |first4=Pete J. |date=2020-08-06 |title=Evaluation of an Unsanctioned Safe Consumption Site in the United States |journal=New England Journal of Medicine |language=en |volume=383 |issue=6 |pages=589–590 |doi=10.1056/NEJMc2015435 |issn=0028-4793 |pmid=32640126 |doi-access=free}}</ref> Supervised consumption sites with some degree of official sanction from a state or local government have been contemplated, but are rare due to the [[Controlled Substances Act|federal regulation of drugs]] and the explicit opposition of federal law enforcement to any form of [[decriminalization]].<ref>{{Cite web |date=2019-11-08 |title=Deputy Attorney General Jeffrey A. Rosen Delivers Remarks at Wake Forest School of Law |url=https://www.justice.gov/opa/speech/deputy-attorney-general-jeffrey-rosen-delivers-remarks-wake-forest-school-law |access-date=2022-07-25 |website=www.justice.gov |language=en}}</ref>

Local governments in [[Seattle]], [[Boston]], [[Vermont]], [[Delaware]], and [[Portland, Oregon]] have considered opening safe injection sites as well.<ref>{{cite web |title=Cities Planning Supervised Drug Injection Sites Fear Justice Department Reaction |website=[[NPR]] |archive-url=https://web.archive.org/web/20230513122625/https://www.npr.org/sections/health-shots/2018/07/12/628136694/harm-reduction-movement-hits-obstacles |archive-date=2023-05-13 |url-status=live |url=https://www.npr.org/sections/health-shots/2018/07/12/628136694/harm-reduction-movement-hits-obstacles}}</ref><ref>{{Cite news|url=https://www.bizjournals.com/portland/news/2018/03/15/a-legal-site-in-portland-to-inject-heroin-elected.html|title=A legal site in Portland to inject heroin? Elected officials, advocates explore the idea|last=Hayes|first=Elizabeth|date=March 15, 2018|work=Portland Business Journal|access-date=April 28, 2019}}</ref> Plans to open an injection site in [[Somerville, Massachusetts]] in 2020 were delayed by the [[COVID-19 pandemic]].<ref>[https://www.wbur.org/news/2020/09/11/somerville-delays-supervised-drug-use-clinic Somerville Delays Plan To Open First Supervised Drug Use Clinic In Massachusetts]</ref>

The governors of California and Vermont both vetoed supervised consumption site bills in 2022, and Pennsylvania's Senate voted for a ban on them in 2023.<ref>{{Cite web |date=2023-05-08 |title=Effectiveness of safe injection sites to be evaluated in government-backed study |url=https://www.pbs.org/newshour/health/effectiveness-of-safe-injection-sites-to-be-evaluated-in-government-backed-study |access-date=2023-09-05 |website=PBS NewsHour |language=en-us}}</ref>

===== Denver (2018) =====
In November, 2018, [[Denver]] city council approved a pilot program for a safe injection site with a 12-to-1 vote. The [[Drug Enforcement Administration]]'s Denver field office and the [[United States Attorney]]'s office for the [[United States District Court for the District of Colorado|District of Colorado]] issued a statement together on the proposed site stating that "the operation of such sites is illegal under federal law. 21 U.S.C. Sec. 856 prohibits the maintaining of any premises for the purpose of using any controlled substance."<ref>{{Cite web |last=KKTV |date=December 4, 2018 |title=DEA responds to proposed safe injection site in Colorado for illegal drugs |url=https://www.kktv.com/content/news/Colorado-is-one-step-closer-to-having-a-supervised-injection-site-for-drugs-501300142.html |access-date=2019-04-20 |website=KKTV |language=en}}</ref>
===== New York City (2021)  =====
The first government-authorized supervised injection sites in the US (operated by [[OnPoint NYC]]) began operating in New York City in November 2021.<ref name="nyn">{{Cite news |last=Kim|first=Phenix|date=2022-12-03 |title=New York City's first safe injection sites avert 633 drug overdoses on anniversary |url=https://www.nynmedia.com/news/2022/12/new-york-citys-first-safe-injection-sites-avert-633-drug-overdoses-anniversary/380438/ |access-date=2023-06-15 |work=NYN Media |language=en}}</ref>

A peer-reviewed study of the first two months of the OPC's operation has been published in [[JAMA]].<ref>{{Cite journal |last1=Harocopos |first1=Alex |last2=Gibson |first2=Brent E. |last3=Saha |first3=Nilova |last4=McRae |first4=Michael T. |last5=See |first5=Kailin |last6=Rivera |first6=Sam |last7=Chokshi |first7=Dave A. |date=2022-07-15 |title=First 2 Months of Operation at First Publicly Recognized Overdose Prevention Centers in US |url=https://doi.org/10.1001/jamanetworkopen.2022.22149 |journal=JAMA Network Open |volume=5 |issue=7 |pages=e2222149 |doi=10.1001/jamanetworkopen.2022.22149 |pmid=35838672 |pmc=9287749 |s2cid=250559693 |issn=2574-3805}}</ref> 

Public criticism of the New York City OPC's has so far been limited. One problem brought up by the leadership of the [[Metropolitan Transportation Authority]] is how use migrates from the centers to nearby [[New York City Subway]] stations when the OPC's are closed.<ref name="thecity.nyc">{{Cite web |date=2022-05-17 |title=When Safe Injection Sites Close, Subway Becomes Next Best Stop |url=https://www.thecity.nyc/2022/5/17/23076577/safe-injection-sites-subway-harm-reduction |access-date=2022-07-25 |website=The City |language=en}}</ref> In response [[Mayor Eric Adams]] called for the centers to be funded to operate continuously.<ref name="thecity.nyc"/>

Though sanctioned by the city, the sites arguably remain illegal under federal law, and rely on non-enforcement by federal officials to keep operating.<ref>{{Cite news |last1=Mann |first1=Brian |last2=Lewis |first2=Caroline |date=2021-11-30 |title=New York City allows the nation's 1st supervised consumption sites for illegal drugs |language=en |work=All Things Considered |url=https://www.npr.org/2021/11/30/1054921116/illegal-drug-injection-sites-nyc |access-date=2022-07-25 |via=NPR.org}}</ref> The [[United States Department of Justice]], during the [[Presidency of Joe Biden]], has signaled some openness and stated that 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."<ref>{{Cite web |title=Justice Department Signals it May Allow Safe Injection Sites |url=https://news.wttw.com/2022/02/07/justice-department-signals-it-may-allow-safe-injection-sites |access-date=2022-07-25 |website=WTTW News |language=en}}</ref>

===== Pennsylvania =====
An organization called Safehouse was hoping to open a safe consumption site in [[Philadelphia]] in February 2020 with the support of the city government. Immediate neighbors strongly objected to the site, and the owner of the first proposed location withdraw a lease offer under pressure.<ref>{{Cite web |title=Safehouse drops South Philly plans, looks to Kensington after judge suspends launch |url=https://billypenn.com/2020/06/26/safehouse-drops-south-philly-plans-looks-to-kensington-after-judge-suspends-launch/ |access-date=2020-10-07 |website=Billy Penn |date=26 June 2020 |language=en-US}}</ref><ref>{{Cite web |author=Lauren del Valle and Dakin Andone |title=Plans are on hold for a Philadelphia safe-injection site to combat overdoses |url=https://www.cnn.com/2020/02/28/us/philadelphia-safe-injection-site-on-hold/index.html |access-date=2020-10-07 |website=CNN|date=28 February 2020 }}</ref><ref>{{Cite web|last=Tanenbaum |first=Michael |date=February 26, 2020|title=Safehouse's plan to open overdose prevention site in South Philly sparks contentious reaction|url=https://www.phillyvoice.com/safehouse-south-philly-supervised-injection-site-heroin-overdose-prevention-community-protest/|access-date=2020-10-07|website=www.phillyvoice.com}}</ref> [[United States District Attorney]] William McSwain sued to stop the Safehouse project, losing in district court in October 2019, but winning an injunction in January 2021 from a 3-judge panel of the [[United States Court of Appeals for the Third Circuit]].<ref>[https://www.npr.org/sections/health-shots/2021/01/14/956428659/in-philadelphia-judges-rule-against-opening-a-medical-site-to-safely-inject-hero In Philadelphia, Judges Rule Against Opening 'Supervised' Site To Inject Opioids]</ref> Safehouse said its proposed operation was "a legitimate medical intervention, not illicit drug dens" and claimed protection under the [[Free Exercise Clause]] because "religious beliefs compel them to save lives at the heart of one of the most devastating overdose crises in the country".<ref>{{Cite web|url=https://www.philly.com/health/supervised-injection-site-religious-beliefs-safehouse-lawsuit-philadelphia-20190403.html|title=Supervised injection site supporters countersue feds, saying their Philly mission comes from religious and medical imperatives|last=Whelan|first=Aubrey|date=April 3, 2019|website=The Inquirer Daily News|language=en-US|access-date=2019-04-20}}</ref>

In May 2023, Pennsylvania senate passed a bill to ban supervised injection sites anywhere within the State of Pennsylvania with a 41-9 vote and it is pending house approval. The Pennsylvania governor [[Josh Shapiro]] expressed support for the bill.<ref>{{Cite web |last1=Whelan |first1=Aubrey |last2=McGoldrick |first2=Gillian |date=2023-05-01 |title=State Senate approves ban of supervised injection sites in Pa. |url=https://www.inquirer.com/politics/pennsylvania/safe-injection-sites-opioid-safehouse-20230501.html |access-date=2023-09-03 |website=Philadelphia Inquirer |language=en}}</ref>

===== San Francisco, California =====
For 11 months between January and December 2022, there had been drug addicts using within the center established by the health department.<ref>{{Cite web |date=2022-12-13 |title=Advocates, SF supervisors push back on Tenderloin safe injection site closure - CBS San Francisco |url=https://www.cbsnews.com/sanfrancisco/news/tenderloin-center-safe-injection-site-closure-advocates-sf-superviors-push-back-mayor-breed-sfdph/ |access-date=2023-08-13 |website=www.cbsnews.com |language=en-US |quote=He said the plan was for the Tenderloin Center to be a resource center while the Department of Public Health created a number of so-called "wellness hubs" around the city where addicts could consume their drugs, while being monitored to prevent overdoses. In its eleven months of operation as a consumption site, the Tenderloin Center reportedly prevented more than 300 deaths.  But now that the facility has closed, Seymour—and a lot of other people—feel betrayed.}}</ref> The center "morphed" from a social services linking service to a drug usage site.<ref>{{Cite news |last=Sjostedt |first=David |date=May 11, 2022 |title='Tenderloin Linkage Center' Morphs into Safe Consumption Site, Despite Legal Risks |url=https://sfstandard.com/2022/05/11/much-touted-tenderloin-linkage-center-morphs-into-a-safe-consumption-site-for-drug-use-despite-legal-risks/ |access-date=2023-08-13 |work=The San Francisco Standard |language=en}}</ref>

=== Virtual overdose monitoring services / non physical site ===
Virtual overdose monitoring services are similar to safe consumption rooms. These programs use phone lines or smartphone apps to monitor clients while they use drugs, contacting emergency services if the caller becomes unresponsive. These services include the National Overdose Response Service in Canada<ref>{{cite journal |last1=Matskiv |first1=G. |last2=Marshall |first2=T. |last3=Krieg |first3=O. |last4=Viste |first4=D. |last5=Ghosh |first5=S. M. |year=2022 |title=Virtual overdose monitoring services: A novel adjunctive harm reduction approach for addressing the overdose crisis |url=https://www.cmaj.ca/content/194/46/E1568 |journal=Canadian Medical Association Journal |volume=194 |issue=46 |pages=E1568–E1572 |doi=10.1503/cmaj.220579 |pmc=9828965 |pmid=36442886}}</ref> and Never Use Alone in the US, as well as the smartphone apps Canary and Brave.<ref>{{cite web |date=8 June 2023 |title=When naloxone isn't enough: How technology can save lives when people use drugs alone |url=https://www.brown.edu/news/2023-05-02/overdose-detection-technologies}}</ref>