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How the 2018 Mid-Terms Could Shape States' Approaches to Supervised Injection Sites

Gubernatorial races in states across the country could determine whether supervised injection sites—controversial clinics where people can safely inject drugs—will open in several U.S. cities and states where they're under consideration.
Used syringes at a supervised injection site.

Many states considering opening supervised injection sites are also host to gubernatorial races this year.

Coming into the mid-term elections, several cities and states across America were considering opening supervised injection sites—controversial clinics where people can inject drugs, knowing that there is staff on hand to administer aid if they overdose. Proponents claim the facilities are an important tool for preventing overdose deaths and encouraging drug users to get help, while opponents say governments shouldn't enable drug use in this way.

Many states considering opening supervised injection sites are also host to gubernatorial races this year. So what do those contests mean for supervised injection plans across the country? Below, highlights from a few states where safer drug consumption and harm reduction are major issues:


In August, the Mercury News of San Jose reported Democratic gubernatorial candidate—and onetime mayor of San Francisco—Gavin Newsom as being open to supervised injection. His Republican opponent, John Cox, called the idea a "disaster."

Then, in September, Governor Jerry Brown vetoed a bill that would have allowed San Francisco to open a facility. In response, San Francisco's current mayor, London Breed, released a statement saying, "we will still continue to work with our community partners on trying to come up with a solution to move this effort forward."


State House and Senate bills in Maryland, authorizing supervised injection, have failed, BuzzFeed reported in September. The Republican incumbent, Larry Hogan, has previously called the bills "absolutely insane." In his proposed opioid plan, Hogan's Democratic opponent, Ben Jealous, doesn't mention supervised injection at all.


After more than a year of intense debate in the public sphere, the Massachusetts Senate finally killed a proposed pilot supervised injection site this summer. Soon after, the state attorney general told WBUR his office "would seriously consider prosecuting the people involved" in opening such a facility. Still, the Democratic nominee for governor, Jay Gonzalez, told WGBH that Maryland should try supervised injection. "We've got to try new and bold things," he said. "We're not being aggressive enough." Incumbent Charlie Baker, a Republican, is more skeptical of the facilities.

New York

This spring, the mayors of New York City and Ithaca both said they want to open supervised injection sites. But they need authorization at the state level. In a recent debate, Democratic incumbent Andrew Cuomo said he's open to the idea and that the state is already studying it. Republican candidate Marc Molinaro is against supervised injection.


Early this year, Philadelphia officials announced theirs would be the first city in the United States to host an openly operating supervised injection site. (There is at least one underground operation, somewhere in the country, that has been reported in the scientific literature.) After the Department of Justice announced that it would crack down on cities that allowed supervised injection, "Philadelphia officials basically offered a collective, 'meh,'" as Philadelphia magazine put it.

Will the City of Brotherly Love also face opposition from its governor? Incumbent Tom Wolf, a Democrat, told WHYY that supervised injection sites are "not a workable solution." Republican candidate Scott Wagner's opioid plan, available on his website, doesn't mention the idea.


In July, the city council in Burlington moved forward with a measure supporting supervised injection, but it also included an amendment "noting that the measure wouldn't actually mean the city was moving forward with a safe injection site," Seven Days reports. Then, this month, Governor Phil Scott's Opioid Coordination Council concluded that it would be "virtually impossible" to open an injection site legally. His Democratic challenger for his seat, Christine Hallquist, seems a little more amenable to the idea: She said during the primary campaign that she wants to investigate whether the state should open injection facilities.