President Trump’s plan to curb “urban disorder” could spell the end of “safe injection sites” that flout federal drug laws.

The idea that local governments have to comply with federal law has, improbably, become contentious — thanks to “sanctuary city” laws barring local police from cooperating with American immigration authorities. 

Yet even as the Trump administration challenged New York and Chicago’s sanctuary laws, a new White House executive order aimed at reducing “urban disorder” could open the door for an analogous case: a federal challenge to the okay given by New York City government for two “safe injection sites” where addicts use drugs, illegal under federal law, under medical supervision.

There’s reason to think the White House may not turn a blind eye — as did the Biden Administration — to a practice of unproven long-term benefit that has sparked neighborhood opposition, and violates federal law. 

The nonprofit OnPoint NYC has, since 2021, operated two such “harm reduction” centers at Washington Heights and East Harlem neighborhoods — justifying supervised use of illegal and illegally obtained drugs to reduce overdose deaths.  

The city’s health commissioner has endorsed the idea of opening five more such sites. OnPoint claims to have reversed 1,825 overdoses, as part of its broader mission to help “people who use drugs or engage in sex work” to “enhance the quality of their lives and live with dignity.”

The White House sees these illegal operations differently. Mr. Trump, in his  executive order last week, “Ending Crime and Disorder on America’s Streets” — chiefly focused on ending street homelessness and its “disorderly behavior, sudden confrontations, and violent attacks (that) have made our cities unsafe” — characterized safe injection sites as “efforts that only facilitate illegal drug use and its attendant harm.”  

The order calls for the Substance Abuse and Mental Health Services Administration to make sure that none of its “discretionary grants” are indirectly funding such sites. 

OnPoint NYC lists the Substance Abuse and Mental Health Services Administration as a funder — in addition to a host of corporate (Deutsche Bank) and foundation (Open Society) donors.

The executive order explicitly opens the door for that funding to be withdrawn — perhaps with an attention-getting announcement.

But “safe injection” could also face legal challenge — if the United States attorney’s office for Manhattan were to follow the precedent set at Philadelphia. There, the organization Safehouse has sought to open its own safe injection site.  

In 2019, during the first Trump administration, the United States attorney for the Eastern District of Pennsylvania filed a civil action to block it, asserting that the site would violate the federal Controlled Substance Act. 

The Third Circuit Court of Appeals agreed, writing, “Safehouse’s benevolent motive makes no difference; its safe-injection site falls within Congress’s power to ban interstate commerce in drugs. Courts are not arbiters of policy but must apply the laws as written.”  

The Supreme Court declined to review that decision. Yet appeals have continued — notwithstanding that the Philadelphia city council has voted to preemptively prohibit such sites in all but one council district.  

Safehouse has gone back to court, arguing that its goals should be considered to be religiously inspired — and protected by the First Amendment. It cites the Supreme Court Hobby Lobby decision, in which a private company, citing Christian principles, was permitted to exclude abortion from its health insurance policies.

It’s a clever argument — which the Third Circuit ruled last week Safehouse has legal standing to make.  

Those concerned about drug overdoses and safe cities, however, should want to know more about the fate of those whose overdoses have been reversed. Do they continue to use harmful drugs? Do they seek treatment? Are they alive a year after?  If OnPoint NYC is allowed to stay open, it should track such statistics. 

Notably, at Vancouver, the problems associated with a legal safe injection site there led to a law mandating treatment for substance abusers.  

For now, in America, the legal table is set. The Trump Department of Justice will have to decide whether it will continue to be involved in the Philadelphia case — and, crucially, whether it will use the existing precedent to take on New York’s OnPoint — as it has sanctuary city laws.