The Grassroots Hospital: A Call for Overdose Prevention Sites

The Grassroots Hospital: 

A Call for Overdose Prevention Sites

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The Current Crisis

Until the time when we as a nation have evolved to accepting Substance Use Disorder patients as patients and not as outcasts, we must open Safe Injection Sites and Overdose Prevention Sites NOW.

As I sit here in my suburban apartment, I am acutely aware that many of my Philadelphia friends are gathering at the Federal Courthouse. They are making their voices heard on the issue of Overdose Prevention Sites. My work schedule today prevents me from being there in person, so I wanted to share these thoughts from home.

The Hidden History of Community Care

Grassroots versions of Safe Injection Sites have existed for years—and likely decades. One could argue they have existed throughout the two and a half centuries of our nation's history.

Years ago, our nation's sons and daughters gathered in "The Tracks" to inject their "medicine." It wasn't a perfect system, but it was a community. About three years ago, when the city of Philadelphia closed The Tracks, those residents were displaced. Many of these daughters and sons created new communities under four Conrail overpasses along Lehigh Avenue. The largest of these was known as "Emerald City."

The Miracle of Emerald City

Emerald City and the distribution of Narcan gained attention at roughly the same time. During its height, between 80 to 100 people lived under one of those four bridges. Narcan was distributed as widely as possible among the residents.

The result was an incredible lack of deaths by overdose.

This does not mean there weren't overdoses; it means that nearly every person on death’s door was witnessed by someone else. Narcan was administered by fellow residents, often accompanied by resuscitative efforts and CPR. I witnessed five such events during my visits to Emerald City. Of those five nearly dead people, ALL were saved by members of that community: homeless patients in the grip of full addiction.

Street Level Community: The Actual First Responders

How did these saves happen? The answer is simple and controversial: Street Level Community.

By allowing our nation’s homeless Substance Use Disorder patients to gather in community—under bridges or along sidewalks—lives are saved. They come to know each other. They look out for each other. They become each other’s actual first responders in a life-or-death crisis.

These communities give a human being the opportunity to eventually choose recovery. They prevent parents from the agony of burying a child. They reduce the number of orphans left behind and traumatized for life.

A Failure of Compassion

These are human beings. No one should be forced to live under a bridge or on a public sidewalk because they have an officially recognized disease that society refuses to understand.

While it would make far more sense to treat Substance Use Disorder as a medical condition rather than a societal disgrace, our culture isn't there yet. We aren't opening our hospital doors to these intelligent people—most of whom rely on Medicaid—to give them the treatment they deserve.

The Next Best Option

Public injection, the physical toll of the disease, and the loss of dignity on our streets are not pleasant for anyone to observe. Therefore, the next best option is to create officially sanctioned Overdose Prevention Sites. In these sites, residents can inject the "medicine" their bodies demand while being supervised by professionals who can keep them safe. These professionals can then guide patients into services that have the potential to reunite them with their families and lead them down a path of healing.

The Ultimate Answer

Are Overdose Prevention Sites the ultimate answer to this horrific issue?

No. The ultimate answer is to create a culture that plows down the barriers preventing patients from getting care in an environment that recognizes their humanity.

But until we reach that evolution, we must open these sites now. Until they are open, we must recognize that street communities are the actual reality of grassroots Safe Injection Sites. They are, in essence, hospital wards where the patients are also the medical overseers.

The Last Stop's Sidewalk as a Hospital Ward

The Intersection of Kensington and Somerset as a Hospital Ward

 

Streets Outside Prevention Point as a Hospital Ward

Street In Front of the Kensington StoreFront as a Hospital Ward

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[1] It was called this because it was at the corner of Lehigh Avenue and Emerald Street.

[2] The total number of people under all four bridges was thought to be in the range of 300.

[3] Three of those five were saved by the same woman whose latest save count is pushing one hundred and fifty as of last week.

[4] Neither of which provides bathroom facilities.