I resuscitated one of my sons after an overdose. Court, Biden must push prevention sites.

Like many criminal justice reform advocates, all three of us believe in providing a place where individuals struggling with addiction can use their drug, be rescued should they overdose and get recovery treatment. But only one of us, Dr. Bonnie Milas, has had firsthand experience in the nightmare of addiction that proves why overdose prevention sites – which have worked throughout Canada and Europe – are vital to saving lives.

In the space of only 14 months, I lost both of my adult sons, to drug overdoses. I had experiences no parent should have. I tore drugs from my sons’ hands so they wouldn’t inject them. I resuscitated one of my sons after multiple overdoses. I stopped a son from jumping through a second-story window after he was revived from an overdose with Narcan.

Yet drug overdoses took my children from me anyway.

My sons' lives, and the lives of thousands of other Americans like them, didn’t have to end. Overdose prevention sites are an effective tool to save those struggling with addiction, but we have resisted them, and refused to learn from other nations that have embraced a public health model that addresses substance use disorder as a disease, not a crime. 

More than 100 such sites successfully operate in 10 countries. They provide a safe space for people to use drugs under the supervision of trained harm reduction professionals who can intervene immediately when someone exhibits signs of overdose. These centers have prevented scores of overdoses with no reported fatalities, according to the Drug Policy Alliance, a group that pushes for more humane drug policy. 

Quite simply, these sites save lives. If they had been deemed lawful in the United States, they could have saved my sons' lives. 

Americans are struggling with drug addiction on an unimaginable scale. Far too many are dying unnecessarily. During a 12-month period that ended in February, nearly 100,000 Americans died of drug overdoses. Yet for some reason, federal leaders have yet to take strong action against an ongoing court battle filed by the prior administration that seeks to block these sites. While new public health approaches can’t bring back the many sons and daughters already lost, they can save other children and keep other parents from pain and loss.

The U.S. Supreme Court is being asked to review a case that addresses whether Safehouse, a nonprofit group seeking to open an overdose prevention site in Philadelphia – the very city where my children died – should be allowed to open, or whether this public health response is barred by federal laws designed to shut down crack houses. Police chiefs, prosecutors and sheriffs nationwide are supporting Safehouse in this legal fight.

It's obvious that the drug laws then-Sen. Joe Biden supported years ago should not be invoked to block these sites – they could not possibly have been intended to prosecute groups seeking to save lives. 

While this litigation has been pending, more than 2,300 lives have been lost in Philadelphia to drug overdoses. If the Supreme Court rules in favor of Safehouse, the nonprofit may be the first to open a sanctioned overdose prevention site in the country. 

That city isn’t alone in trying to move this reform forward. In July, Rhode Island established a pilot program for overdose prevention sites. New Mexico, Illinois, Massachusetts and California similarly have bills pending to advance these sites.

Ultimately, though, Biden must lead the way.

At least one member of his administration has endorsed public health approaches to drug use. Health and Human Services Secretary Xavier Becerra, while serving as attorney general of California, embraced overdose prevention sites as necessary to help communities devastated by the overdose crisis.

This new direction in federal leadership is sorely needed. Our traditional approaches to drug addiction – zero tolerance, abstinence-only rehabilitation and criminal consequences for those who fail to kick their habit – have failed. We have needlessly locked away millions of Americans, disproportionately people of color, and wasted billions of dollars, in a misguided attempt to address a public health problem with police and prisons.

Given these failures, it’s time for the president to step up and lead.

The White House must take concrete steps to help establish overdose prevention sites and distance itself from the prior administration’s decision to block Safehouse’s opening. Disappointingly, the administration’s lawyer chose to take no position regarding Safehouse’s request for review by the Supreme Court of the lower court decision applying federal drug laws to this public health response. The administration must reverse course.

The Biden administration must also make clear that overdose prevention sites should no longer fear criminal prosecution – whether through encouraging piloting of this strategy or legal guidance clarifying that federal drug laws will not be used to shut down these facilities.

If my children had had access to an overdose prevention site, they might be alive today.

Biden, all of us urge you to not wait one minute longer to make sure that more American families don’t have to go through tragic losses.

Dr. Bonnie Milas is a professor of clinical anesthesiology and critical care in the Perelman School of Medicine at the University of Pennsylvania. The opinions expressed in this article do not represent those of the University of Pennsylvania Health System or the Perelman School of Medicine at the University of Pennsylvania.

Larry Krasner is the district attorney in Philadelphia, where Safehouse seeks to operate, and Miriam Aroni Krinsky is a former federal narcotics prosecutor and currently serves as the executive director of Fair and Just Prosecution. Krinsky and Krasner have been involved in the legal fight supporting Safehouse dating back to 2019, and are among the prosecutors and law enforcement officials who petitioned the Supreme Court this year to take the case.