Providing a place for drug users to take illegal substances in relative safety may have seemed too risky for many grant makers. The idea has sparked opposition from residents of neighborhoods where the supervised injection sites are planned and from some in law enforcement. But a pending Department of Justice decision may clear the way for additional foundation grants.

Historically, philanthropy has mainly supported other approaches such as educating people about the dangers of drug use, financing rehabilitation centers, and advocating for tougher penalties to punish people who use or sell drugs.

To win people over, Philanthropy.com believes public-health leaders will have to provide hard evidence that the safe sites don’t lower the quality of life in the neighborhoods where they are set up but that they lower hospital and ambulance costs, reduce transmission of hepatitis and HIV, and, most important, are leading to a drop in fatal overdoses.