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Abstract

From medically assisted treatment to syringe exchange programs, the harm reduction movement has emerged as an evidence-based practice in response to the growing opioid epidemic. The supervised injection facility is a harm reduction measure that has proven effective in reducing overdose deaths and the spread of infectious diseases. Various countries around the world have initiated these programs and realized the benefits, and several states in the U.S. have proposed legislation to allow for such facilities as part of a broader approach to the opioid problem. Potential implementation of these facilities, however, is challenged on the basis that they would violate federal law, specifically 18 U.S.C. § 856—the “crack-house” statute. The threat of federal enforcement effectually prevents the passage of state legislation and stifles the positive impact supervised injection facilities have on preventing overdose deaths. However, an analysis of the legislative evidence combined with the concept that such an intervention is consistent with the Supreme Court’s commerce power jurisprudence, provides an alternate view of the federalism argument. Through appropriate state legislative action, it is possible to reconcile current criminal justice policies with the need for new and progressive harm reduction strategies in order to advance the fight against the opioid epidemic.

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