Ninety percent of residents and 63 percent of business owners and staff surveyed in Philadelphia’s Kensington neighborhood support opening an overdose prevention site in their community, according to a study led by researchers at Drexel’s Dornsife School of Public Health published this week in the Journal of Urban Health. Overdose prevention sites – also known as supervised injection facilities or safe consumption sites – are places where individuals use previously obtained drugs under the supervision of a trained health professional who can intervene in case of overdoses and link visitors to additional health services.
They have been operating since the mid-1980s in Europe and currently exist in 11 countries, although no sanctioned sites exist in the United States. Studies have shown that overdose prevention sites save lives, reduce infectious diseases, and facilitate access to substance use treatment. They also help the communities where they are located by reducing public injections and publicly discarded syringes.
“Since Kensington has been a proposed site for an OPS, it is important to hear the opinions from residents and businesses about placing them in their neighborhoods as well as their exposure to drug related activity,” said lead author Alexis M. Roth, PhD, MPH, an assistant professor of Community Health and Prevention in Drexel University’s Dornsife School of Public Health. In the largest survey to date of a neighborhood’s attitudes toward an OPS, Drexel researchers conducted in-person surveys of 360 adult residents and 79 business owners and staff in Kensington.
Potential study participants were approached in the neighborhood or at their business establishment and asked how often they saw drug-related activity, such as public drug use, in their neighborhood during the past 30 days, and whether they support an overdose prevention site opening in Kensington. More than 90 percent had witnessed public injection or observed discarded syringes in their neighborhood in the past 30 days.
Support for the OPS in Kensington was high among all study participants. However, two statistically significant differences emerged among participating groups. Among residents, persons who currently use opioids were more likely to support opening an OPS, compared to persons not reporting opioid use (97 percent versus 85 percent). Among business owners and staff, Asian, African American, and Hispanic/Latinx respondents were more than twice as likely to favor the OPS opening in Kensington than their white counterparts (69 percent versus 27 percent).
The findings — the first to systematically gather public opinion of the surrounding community around a proposed overdose prevention site in Philadelphia— come as the overdose crisis devastates communities throughout the United States. Roth attributes the high acceptability found among Kensington residents and business owners/staff to their frequent encounters with drug-related social problems.
By solely surveying those residing or working in the ZIP code most affected by a proposed OPS in Philadelphia, the Drexel study helps lay the groundwork for other cities exploring whether to open an OPS. In addition to Philadelphia, San Francisco, New York City, Ithaca, Seattle and Denver, have proposed OPS to stem the number of overdose-related deaths, which totaled over 70,000 in 2017, according to the Centers for Disease Control and Prevention.
The need for relief is profound in Philadelphia, home to the highest overdose mortality rate among large U.S. cities, with 1,074 unintentional, fatal opioid-associated overdoses in 2017. The Kensington neighborhood is located in the ZIP code with the highest overdose rate in the city. Recent phone-based polling by The Pew Charitable Trusts and The Philadelphia Inquirer of Philadelphia residents suggest mixed views on opening an OPS.
“In this sample, nine out of 10 people report frequently seeing drug use, discarded paraphernalia, and overdose in their neighborhood,” said Roth. “Our findings suggest residents and businesses are open to an intervention that has been shown to improve these issues in the cities where they have been implemented.”
The study authors note that future studies should look into whether proximity to an OPS influences how likely someone is to support its opening and how support for an OPS changes after it opens.
Additional authors on this research include Alex H. Kral of RTI International, Peter Davidson of University of California San Diego, and Allison Mitchell, Rohit Mukherjee and Stephen E. Lankenau of Drexel.