When President Donald Trump returned to office in 2025, one of the earliest signals on drug policy echoed a familiar stance from his first term: strong skepticism toward harm-reduction strategies, including harm reduction centers. During his previous administration, the Department of Justice fought Philadelphia’s attempt to open the Safehouse overdose prevention center, arguing that such facilities violated federal “crack house” statutes. That legal position remains unsettled in 2025: some states are piloting supervised injection sites while others wait for clearer federal guidance, leaving a patchwork of policies nationwide.
Federal decisions will likely determine whether cities can adopt one of the few interventions proven to prevent deaths, but the debate is shifting quickly. Clear, evidence-based reporting is important to counter myths, explain legal uncertainty and show what these centers actually do.
Opponents of harm reduction sites argue that they normalize and enable drug use, despite many public-health experts pointing to research showing they work extremely well for the people who use them. Many bases for debates involving this mode of intervention often reflect values rather than data. It’s crucial for journalists to distinguish between political rhetoric and evidence-based outcomes.
Here are answers to the most pressing questions about harm reduction centers to help inform your coverage.
Do harm reduction centers prevent overdose deaths?
Supervised injection sites are designed to prevent fatal overdoses by allowing people to use pre-obtained drugs under medical supervision, and the evidence supporting this point is remarkably consistent.
These outcomes matter because most fatal overdoses occur when people use alone. When overdoses happen inside supervised facilities, staff intervene within seconds, preventing respiratory failure and long-term injury.
Supervised injection sites prevent deaths, even if those lives saved don’t immediately show up in citywide mortality statistics.
While some earlier studies found declines in fatal overdoses near facilities, broader ecological studies — especially regarding fentanyl overdoses — show mixed results. That does not mean the sites are ineffective. In some cases, not everyone in the vicinity of a harm reduction center accesses it. It also reflects the overwhelming impact of an increasingly toxic and unpredictable drug supply, combined with structural factors like homelessness, lack of treatment access and inconsistent policy environments.
A single site cannot counteract shifts in fentanyl potency, the emergence of xylazine, or gaps in medication-assisted treatment availability. Population-level overdose deaths are shaped by many forces; supervised injection sites are one life-saving intervention among several.
Are centers a gateway to treatment and essential care?
Safe injection sites are not the end point of a public-health approach — they are often the entry point. Opponents sometimes argue that supervised injection sites “enable” drug use, but scientific research paints a very different picture.
Research repeatedly shows that people who use these sites are more likely to receive wound care, infectious-disease testing, primary care and referrals to addiction treatment.
Rather than trapping people in addiction, the evidence suggests these sites lower the threshold for seeking treatment by offering nonjudgmental, low-barrier contact.
Do centers bring more crime?
A persistent talking point is that supervised injection sites increase crime rates; however, research consistently finds no such effect.
Another recent evaluation of New York City’s overdose-prevention centers also reported no uptick in disorder or criminal activity, and no significant increase in 911 or 311 calls. However, there isn’t sufficient evidence to show that harm reduction centers reduce crime.
Studies also show reductions in public injecting and syringe litter after sites open. Neighborhoods surrounding the facilities generally see improved public order when sites are well implemented and paired with outreach because people no longer need to inject in parks, alleys, or business bathrooms when they have a safer, supervised, indoor option. For example, residents in Toronto, Canada, reported seeing more public drug use after a safe injection site in the city closed.
This matters both for public health — reducing infectious disease risks — and for perceptions of safety among residents and business owners. When journalists cover this issue locally, this is often the area where community impact is most directly felt.
Bottom line: Supervised injection sites are not a magic fix for a poisoned drug market, but they remain one of the few interventions with demonstrated life-saving benefits for the people who walk through their doors. Responsible coverage of this topic includes highlighting proven individual-level benefits of these sites and the broader structural factors driving overdose trends. This reporting strategy will help the audience understand what these centers can (and cannot) realistically solve.
