Queering the CUES: Doing More for LGBTQ+ Drug Users in Philadelphia

LGBTQ+ folks in Philadelphia need to feel safe and welcome at proposed Comprehensive User Engagement Sites (CUES). We need a voice in the plan moving forward.

On January 23, 2018, the City of Philadelphia announced its encouragement of a private sector push for Comprehensive User Engagement Sites (CUES). This announcement followed a longstanding call-to-action from many Philadelphia residents after witnessing over 2,100 people die from opioid overdose in the last two years alone (2016-17). Our city is losing ground on the opioid epidemic, and quickly.

Along with the City's recommendation was a thorough review of evidence in support of CUES and safe injection sites as public health interventions for a city and nationwide overdose epidemic. Through the 46-pages, however, you will find no no mention of the words, "gay", "lesbian", "transgender", "LGBTQ+", etc. Intervention tools like engagement and injection sites are relatively new concepts in the United States and Canada (where they have experienced earlier uptake and support), and their intersection with the LGBTQ+ community has rarely been explored. Conversely, grassroots harm reductionist organizations have been working with and in LGBTQ+ user communities in Philadelphia and across the country for years, but CUES mark a shift into broader public light and scrutiny that has little precedence. We must work with grassroots organizers and LGBTQ+ users to make sure their voice is heard at this critical inflection point in Philadelphia's opioid history.

In 2015, the Substance Abuse and Mental Health Services Administration (SAMHSA) published a nationwide survey, which showed that 2-3x as many people who identify as sexual minorities than those who do not reported using heroin or prescription pain relievers in the last year (2014). This was the first time questions about sexuality appeared in a national survey on substance use and mental health issues. (A discussion about their LGBTQ+ surveying methods is for another time!)

It's clear: across the country and here at home in Philadelphia, there is a great need for reaching out specifically to LGBTQ-identified individuals in building spaces and planning drug overdose prevention messaging and intervention services. Engagement and injection sites need to be safe and free from stigma, and they need to be inclusive of our LGBTQ+ users who seek their services. This means empowering present queer and harm reduction community leaders to work beyond a barrier that has for too long stood in the way.