A stalled pilot program to bring supervised injection facilities to New York City—endorsed last year by Mayor Bill de Blasio but still awaiting state approval—got a major boost this week from a federal judge in Philadelphia.

In a decision likely to have nationwide consequences, U.S. District Judge Gerald McHugh ruled on Wednesday that the attempt by Philadelphia nonprofit Safehouse to open the country's first injection site was not in violation of federal law.

The Department of Justice had sued to stop the facility under the so-called crackhouse statute, a three-decade-old law that makes it a felony to knowingly operate a space where controlled substances are used. Other cities planning to erect such facilities—including Denver, San Francisco, and New York—could expect "swift and aggressive action," according to former attorney general Rod Rosenstein.

That threat apparently spooked Governor Andrew Cuomo, who'd tentatively backed the harm reduction strategy during his re-election campaign, but has since declined to press the issue; a spokesperson for his office warned Gothamist earlier this year of a "demonstrably real threat of federal legal challenges," and said they'd be watching the Pennsylvania lawsuit closely.

While the Justice Department has vowed to appeal the decision, Ronda Goldfein, vice president of Safehouse, told Gothamist on Friday that the government's central argument had been effectively undermined. "I'm not sure how much they have left after this ruling," she noted. "The judge made it very clear: our purpose is not one of the prohibited purposes [under the federal law.]"

For harm reduction advocates here in New York, this week's ruling also nullifies the state's justification for delaying implementation of the city's pilot program. "He touts himself as a progressive, but Cuomo is now standing farther to the right on this issue than a federal judge," said Jasmine Budnella, a drug policy coordinator at VOCAL-NY.

The Governor's Office, meanwhile, has repeatedly brushed off criticism about the stalled rollout, claiming approval of the sites falls to the state Department of Health. Activists aren't buying it. "Cuomo had an emergency action to ban vapes, but has done nothing on the opioid crisis," said Budnella.

Asked on Friday whether the judge's decision would influence the state's urgency on the issue, Rich Azzopardi, a senior advisor to the governor, again deferred questions to the health department.

A spokesperson for the state health department, Jonah Bruno, provided Gothamist with a statement, but declined to answer questions about the implications of the ruling, or whether the department was in touch with the city about moving ahead with the pilot.

“We continue to explore all options to reduce opioid deaths, including dialogue with advocates and the City about harm reduction initiatives," Bruno said. "We are reviewing today’s decision in Philadelphia and will consider how it may affect efforts in New York State to operate safe injection facilities here.”

A spokesperson for Mayor Bill de Blasio pointed to "a moral obligation to save lives and connect people to treatment," adding that they were still awaiting authorization from the state.

After seven straight years of increases, overdose deaths in New York City ticked down slightly in 2018. But the first three months of this year saw 331 fatal overdose, the vast majority of which were opioid related. Advocates note that safe injection facilities have been shown to reduce overdose rates and disease transmission when implemented abroad.

Asked how a Philadelphia nonprofit had managed to take on the federal government, while ostensible progressives like Cuomo had balked, Goldfein, the Safehouse executive, cited a confluence of factors. Among them: a health commissioner and mayor willing to expend political capital on the issue, and a progressive-minded state attorney general.

"Your governor is afraid, understandably, of federal enforcement," Goldfein added. "But we know the evidence says this work, and we felt like we had to take this step."