The most visible of these are supervised consumption sites. Also known as harm reduction centers, these facilities provide people with a place to use their drug of choice in the presence of staff armed with overdose-reversing naloxone. New York City and Rhode Island have allowed SCSs to be established, and Minnesota is expected to do the same. Cities around the world have also embraced them, and unapproved sites operate in other American cities.

Supporters of SCSs say that amid an unprecedented increase in overdose deaths, communities should do whatever they can to save lives. They’re not wrong. If SCSs measurably reduced deaths, they might be worth any problems they cause. One of us even argued as much in 2019.

The problem is these facilities don’t work, disrupt communities and are clearly illegal under federal law.

In a new report for the Foundation for Drug Policy Solutions, we reviewed the growing body of evidence that shows SCSs have no effect whatsoever on overdose deaths.

Defenders of the facilities generally point to the number of overdoses reversed at the centers as evidence that they save lives. The nonprofit that operates New York’s two sites, for example, says it has provided more than 2,000 “overdose interventions” — implying that every intervention had prevented an overdose death.

A death delayed is not a death prevented. If someone overdoses at a site and is revived, but then overdoses elsewhere later in the day, the site did not have a protective effect. Moreover, people who use the sites may differ behaviorally from those who don’t. Visiting a “safe” drug-use site probably means you seek to avoid overdose in other ways, too.

This reality helps explain why a large body of research has found that the sites have no effect on the rates of nonfatal overdoses or overdose deaths.

One survey of 730 drug users found that greater use of Barcelona’s SCS did not reduce rates of nonfatal overdose. Another study of 1,090 people in Vancouver, British Columbia, had a similar result, as did a third study that looked at 494 users who visited an unsanctioned SCS in an unnamed American city.

Other studies that compared parts of Canada before and after SCSs opened to areas without sites yielded the same results. The design of these studies allowed researchers to precisely match “treatment” areas to “controls,” and differentiate the actual effects of SCSs from mere correlation.

One such study compared areas in British Columbia and found that opening a site had no effect on hospitalization or overdose death rates. Another study conducted the same review in Ontario and concluded that SCSs had zero effect on emergency room visits, hospitalizations or deaths. A third study in Alberta reached the same conclusion.

Proponents of SCSs have their own studies to point to. One commonly cited paper reported a barely statistically significant result, using an improper control group that compared its results to the rest of the city, rather than a comparable area. It’s the kind of result that should always raise questions. Another had a similarly poor control group and also selected a very short period of observation, again raising questions about generalizability.

But effectiveness is not the only issue with SCSs.

A provision of the Anti-Drug Abuse Act known as the “crack house statute” makes it illegal to “knowingly open, lease, rent, use, or maintain any place” for the purpose of “using any controlled substance.” That may as well have been written to apply to SCSs. In 2021, the U.S. Court of Appeals for the 3rd Circuit ruled against an SCS in Philadelphia, determining that its activities were illegal under federal law. Last year, the Trump administration ordered a review of federal funding recipients to ensure they don’t violate the law.

Residents of neighborhoods with SCSs have raised concerns too. One of New York City’s injection sites, for example, sits across the street from a day care in East Harlem. Residents have begged the federal government to intervene and shut it down due to increased public drug use and other issues near the site.

However laudable the goals of SCS supporters may be, the best evidence available says policymakers should find better ways to spend taxpayer money and prevent overdose deaths.