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Dissertation
Attempt to place a safe injection facility in Philadelphia, PA: a case study January 2018 to August 2023
Doctor of Health Science (D.H.Sc.), Drexel University
08 Sep 2025
DOI:
https://doi.org/10.17918/00011172
Abstract
Background: Philadelphia has one of the highest opioid overdose rates in the United States, prompting consideration of harm reduction strategies, such as safe injection facilities (SIFs). This case study examines Safehouse, a nonprofit organization that sought to establish the nation's first sanctioned SIF. Methods: Guided by Kingdon's Multiple Streams Framework, a qualitative content analysis was conducted of 35 articles, editorials, and opinion pieces published in The Philadelphia Inquirer between 2018 and 2023. Media coverage was coded across three streams, problem definition, policy alternatives, and political circumstances, and categorized as positive, neutral, or negative. Results: Coverage reflected divided political and public sentiment. Problem definition and policy alternatives were more often framed positively, emphasizing harm reduction, overdose prevention, and treatment linkage. Political circumstances, however, skewed negative, with opposition citing legal barriers, moral concerns, and neighborhood safety. Despite evidence and public health support, strong resistance from elected officials, federal authorities, and residents closed the policy window for implementation. Conclusions: Philadelphia's experience highlights both the challenges and promise of advancing SIFs in the U.S. While media narratives reframed opioid use as a public health crisis, not in my backyard (NIMBY) and political resistance dynamics limited policy progress. Insights from this case can inform advocates, policymakers, and public health leaders navigating the ethical, legal, and sociopolitical complexities of implementing harm reduction interventions.
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Details
- Title
- Attempt to place a safe injection facility in Philadelphia, PA
- Creators
- Christopher Tobias
- Contributors
- Stephen F. Gambescia (Advisor) - Drexel University, Health Administration
- Awarding Institution
- Drexel University
- Degree Awarded
- Doctor of Health Science (D.H.Sc.)
- Publisher
- Drexel University; Philadelphia, Pennsylvania
- Number of pages
- 104 pages
- Resource Type
- Dissertation
- Language
- English
- Academic Unit
- College of Nursing and Health Professions; Drexel University; Health Sciences
- Other Identifier
- 991022092952404721