Safe consumption sites (SCS), also known as overdose prevention sites, are places where people can use drugs, safely and without threat of arrest or stigma, in the presence of folks trained to respond in case anyone accidentally overdoses. SCS supply sterile paraphernalia, reducing the risk of infection and disease, and guests can test their drugs for fentanyl before consuming.
As a harm reduction worker once reminded me, safe consumption sites have existed as long as humans have been doing drugs, with or without permission from the law. Whenever drug users come together to support each other–whether in a private home or public park, watching someone’s back when they nod out, making sure they’re on their side, administering the opioid-overdose reversing medication naloxone if someone needs it–that’s a safe consumption site. But being able to operate in the daylight, without fear of prosecution and with access to funding and social and medical services, would be safer.
In 2022, the number of Chicagoans who died from accidental overdose was higher than the number who died by guns. Also in 2022, Representative La Shawn Ford introduced the Overdose Prevention Pilot Act, calling for state support to open SCS sites in Chicago.
SCS are the opposite of the abstinence-only approach most of us are familiar (and therefore comfortable) with when it comes to reducing drug deaths, but evidence shows that in neighborhoods where they’re allowed to operate, overdose deaths are reduced, the number of ambulance calls for treating overdoses lowers dramatically, and HIV rates decrease. According to the Drug Policy Alliance, “more than 100 evidence-based, peer-reviewed studies” link SCS to outcomes like “increasing entry into substance use disorder treatment” along with other medical and social services, “reducing the amount and frequency that clients use drugs,” and “reducing public drug use and syringe and/or other drug paraphernalia litter.”
It’s not so much my answer has evolved as I have a personal lived experience where, in the neighborhoods in which Black people in particular live, drugs have been a very sore, hurtful, harmful, damaging experience to so many.
On January 30, 2023, WBEZ released their Chicago mayoral candidate questionnaire, which included the question, “Would you support setting up ‘safe consumption sites’ where people use pre-obtained illegal drugs under the supervision of trained health workers?”
Five of the nine candidates answered yes; Mayor Lori Lightfoot and Representative Chuy Garcia chose “other,” and Commissioner Brandon Johnson and former CPS CEO Paul Vallas replied “no.”
In his response, Johnson further elaborated: “Given Chicago’s history, these sites would most likely be on the South and West sides, further burdening already struggling neighborhoods. There are other ways to address the drug epidemic and aid those in need, while also protecting our communities.” However, later that morning, when a Twitter user asked Johnson if he does, in fact, support SCS, Johnson replied: “Yes, and it’s not either/or. It’s ‘we need more.’ I’ve lost family to mental illness, addiction, and homelessness. I want to go beyond safe consumption sites to address mental health care and [the] unhoused. I also believe sites should be accessible to those in need throughout our city.”
That afternoon, I asked campaign spokesman Ronnie Reese if Johnson would be up for an on-the-record conversation about where he’s at with SCS. Within 15 minutes, Johnson called my phone: we spoke for about half an hour. Below is our conversation, lightly edited and condensed.
Prout: I’ll start out just by asking you just straight up: Do you support safe consumption sites in Chicago?
Johnson: Yes, I do support safe consumption sites in Chicago, and I also want to make sure that there’s some real equity with these sites. I know I’ve mentioned this before, but my eldest brother died from untreated trauma, addicted and unhoused. I have another brother who is also struggling with addiction.
These individuals who are struggling like my brother—they’re parents. They’re attached to other lives. And so we have to treat the entire family, right? We know those who are struggling with addiction, they do have triggers. And in some cases, those triggers have a profound impact on the other people in their lives. Making sure that there’s childcare services, there’s counseling for families–they’re gonna need it.
With the WBEZ answer, just to be clear, is that an answer you don’t stand by? Did you say no, and then your view has evolved since answering that question?
It’s a combination, right? Like sometimes these spaces don’t allow for the context that I need to offer up a full answer. When you have multiple siblings who are struggling with addiction–I’m gonna date myself–you come home and your VCR or your class ring is stolen, or your coat is gone. Or you have children who have to figure out who to feed themselves, because, you know, their parents who are struggling with this addiction are not healthy enough to support their family.
Let’s talk about it this way. I have an older brother who died addicted and unhoused. How do I talk to my niece, nephew and his grandchildren about how their father or grandfather may have overdosed, and his brother, me, was trying to figure out a safe way for a drug to be administered? You know what I’m saying? These dynamics are complicated. Drugs have been used as a means to harm neighborhoods, and they’ve become the economic drivers for some individuals who believe that’s the only pathway to survive. So you have neighbors selling drugs to their neighbors in areas where schools are not funded, access to health care not available, transportation, jobs, accessibility–all of that is missing. It’s not so much my answer has evolved as I have a personal lived experience where, in the neighborhoods in which Black people in particular live, drugs have been a very sore, hurtful, harmful, damaging experience to so many.
And so, it’s not either yes or no. It’s like, well, I support these sites if it’s done in an equitable way, and we’re providing other services to communities that have had to live through the drug market. [Funding a safe use site] in the same community where a neighborhood school was not fully funded–you understand? The contradiction that exists in our society?
Once a week, I go to the Chicago Recovery Alliance in East Garfield Park to pack Narcan kits, sterile crack pipes, and sterile needles. It was counterintuitive at first: I thought, “But if you want to protect people, don’t you want to have them not using? Isn’t it just going to make their addiction worse? Isn’t this going to promote other people using more, or introduce people who haven’t used before?”
But conversations with Black people who live on the west side changed my mind. When one woman was talking about why she carries Narcan, she said, “People are overdosing in my front lawn. I might as well have the ability to bring them back.”
Now Narcan is becoming more socially acceptable, and is understood as a harm reduction tool. Safe consumption sites are still different. Right now there’s much more caution, more concern.
Yeah, you’ve laid it out well. The first thing I thought about when you were describing the evolution of this approach, is how we’re telling children, “Drugs are bad, say no to them. But we want you to come visit this site so that you can see how people use them safely.” I’m a parent and a teacher, I have family that’s struggled–it’s hard for me.
A nephew snuck into one of my house parties. I didn’t get a chance to see a lot of [as he grew up] because it was what his mother thought was better: to keep him away from everybody associated with his father, including his uncle and his aunts. Now his uncle is running for mayor. He’s gonna read that his uncle is trying to figure out how to have safe consumption sites for individuals who are struggling with an addiction, and it was that very addiction that kept him from being able to have a father growing up.
Can you talk a little bit more about what you mean by the “equitable distribution” of safe consumption sites?
We want to make sure that the sites are available in the neighborhoods that the individuals who are suffering from addiction live in. You want to eliminate as many barriers as possible.
Individuals who are struggling with an addiction, maybe they need a safe space where they can engage in that particular substance. But you know, these are individuals who are often already unhoused, right? Or they’re housing insecure, to say the least. So what are we doing to put people on a pathway where they’re not relying on this space? Where they can live, and work, and be part of their families?
My brother who’s still alive, he tells us he doesn’t want to continue to live with this addiction. That’s what he shared, and we always want to believe in that, believe him when he says that. So what type of support that we surround him with in order to secure the type of life that he desires, one without addiction?
I’m interested in what you said about how families need support. NA and AA groups talk about addiction being a family disease. Some folks I know on Lower Wacker and in the Loop have lost custody of a child as they’ve tried to deal with their own addictions. Can you talk specifically about what support for families that have a loved one who’s addicted might look like, especially when that person is a parent?
That’s powerful. It’s a really powerful question. My brother, he’s got a few children. But his youngest daughter is the person you can really see really struggling. I’m trying to condense this as much as I possibly can, but it’s pretty fresh.
The woman that my brother has this child with, she passed away. So the only parent she has is my brother now. Because of his addiction, there’s this question around suitability, right? But then there becomes this question, like, “Where? Where does this child go? Does she go with the brothers’ family? Her mother’s family?” How do you have a centered, focused support system for a child who will need adults to help her process losing a parent and having a parent who’s here, but who’s unavailable because of this addiction?
It’s not just having counseling, though I think that’s going to be important. But whatever place is best for a child to be who has a parent who is addicted, what are the arrangements that can be made that keep and maintain connection and support that is safe for everyone? Because the challenge with my brother is the addiction. He’s a great human being.
One of my own brothers struggles with addiction, so my heart goes out to you and yours.
Thank you for that. You know how hard it is as a family: I don’t know the extent to which you and your family deal with your brother, but with my brother who’s still living, he has children. It’s placed a great deal of stress on my niece. As a family, we bear the responsibility for being the support system for his children. I want to make sure as a city, we are committed to equity in how we deliver services to the communities hit hardest by disinvestment, which often leads to the type of addiction that we’re seeing explode in these neighborhoods.
I don’t know if I should go off the record for this, but you know, there are some people who, no matter what the situation is, they’re just a jerk. [Laughs] In this case, my brother is not a jerk! People probably will question my thinking on this, but outside of his addiction, he’s not a bad parent. I know that sounds like an oxymoron to some, but it’s not like he doesn’t have the ability to sit down with my youngest niece and work through with her with her homework when she’s getting frustrated or just being a typical little girl. And so, when we talk about support systems, I don’t know if it’s always best for parents to be completely removed and out of the picture entirely as they go through a restorative space, a healing space, even as they work through the addiction. [Groans] I’m sorry! There’s no simple way to put it.
I think that’s a rich answer for a complicated question.
It’s about equity, and it’s also about seeing it through the lived experience of poor people, of Black people, or brown people, or families that have been ripped apart as a result of addiction and drugs. Thank you for indulging me and giving me the opportunity to express this–the complication of all these decisions, provide context to the nuance, and why “yes or no” is not always the best way to be able to work through something that is dynamic as a safe site.
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