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LAST WEEK, a federal judge in Philadelphia made a landmark ruling on a proposed safe injection site.

US District Judge Gerald McHugh found that a provision of the Controlled Substances Act meant to shutter crack houses could not be used to bar a program aimed at helping the city’s opioid addicts.

“No credible argument can be made that facilities such as safe injection sites were within the contemplation of Congress” when lawmakers adopted the legislation in 1986 or amended it in 2003, McHugh wrote.

The ruling does not apply to other parts of the country. But it was a considerable blow, nonetheless, to a Trump administration that’s vowed to block any and all facilities that allow drug users to shoot up under medical supervision.

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And it should embolden activists and elected officials weighing similar sites in Seattle, San Francisco, New York — and right here, in Boston.

The facilities, if controversial in the United States, are common in Canada, Australia, and Europe. And research shows they can prevent overdoses and save lives.

One study found that users of a Vancouver site were more likely to seek addiction treatment than other drug users — dispelling concerns that the facilities promote drug abuse rather than contain it.

Mayor Marty Walsh has undergone an admirable evolution on the idea. A recovering alcoholic, he started out as a self-described “hard no.” But he began to question his opposition, he told Globe columnist Nestor Ramos, when he heard someone at an Alcoholics Anonymous meeting say, “Whatever the pathway into recovery is, we should be accepting of it.”

The mayor asked his staff to gather up the literature on safe injection sites and, after visits to facilities in Montreal and Toronto, he sounded like a convert. “It’s time for the United States to have a real serious conversation about safe injection sites,” he told the Globe in April. “These sites save lives.”

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Walsh has made it clear, though, that the city won’t move forward as long as federal law stands in the way. And it doesn’t appear that the Philadelphia court ruling has shifted his view. Contacted by the Globe, the administration declined to go beyond the mayor’s previous statements about the legal obstacles to action.

But with the opioid epidemic claiming hundreds of lives per year in Massachusetts, it’s time for the mayor to get more aggressive. The city should plan a facility — and stand up for it in court when the time comes.

And state lawmakers, weighing legislation that would establish a pilot program for safe injection sites, need to accelerate their efforts, too. While safe injection sites alone won’t solve the crisis, they can be a powerful tool.

McHugh, the federal judge in Phladelphia, is right. These facilities are nothing like crack houses. They trade in life, not death.

But they can only soften the blow of the opioid epidemic — they can only begin to save lives — if local leaders recognize the opportunity to act, and seize it. To his credit, Walsh has already been moving in the right direction. Now he just needs to press another step forward.