As this unremittingly grim, even dark year, draws to a close, I offer one ray of light in the area of drug policy. For the first time, the United States now has overdose prevention sites up and running. 59 opioid overdoses, most potentially fatal, have been reversed in the first month of operation.
This major breakthrough took place in New York City on November 30. In two locations—Washington Heights and East Harlem–individuals struggling with substance use now can inject drugs under medical supervision, rather than doing so alone, often in dirty alleyways and public bathrooms.
These sites, soon to be linked in a new organization called OnPoint NYC, offer a variety of other medical services. Drug treatment is available but not required. Individuals can also test their drugs for the highly lethal drug fentanyl and other contaminants, thus protecting themselves from a major cause of overdose deaths.
Our nation experienced over 100,000 overdose deaths in 2020, with over 2,000 in New York City alone.
The United States has been waiting for too long – far too long – for overdose prevention sites. Over 120 in exist in 10 countries including France, Germany, Norway, Spain, Canada, and Australia. They save lives, result in safer communities, and enjoy the support of law enforcement.
Two years ago, it appeared that such a site would open in Philadelphia. The mayor, city council, and law enforcement officials were supportive. But the Trump administration’s regional U.S. District Attorney blocked the opening under the so-called crack house law, which bans operating, owning, or renting a location to facilitate the use of illegal drugs. The Supreme Court has declined to hear an appeal.
In New York City, Mayor Bill De Blasio began supporting overdose prevention sites in 2018 and has been joined by the district attorneys for Manhattan, the Bronx, Queens, and Harlem. Mayor-elect Eric Adams has also expressed support.
President Biden recently became the first U.S. president to endorse harm reduction and has proposed over $30 million in federal funding. The U.S. Justice Department has not yet commented on whether it will intervene. City officials have urged Attorney General Merrick Garland not to prosecute operators of sites where local officials have approved them.
These sites are not a new issue for Clergy for New Drug Policy. In 2016, we organized a clergy visit to Insite in Vancouver, at that time only such site in North America.
We have supported efforts to open sites in other locations. While New York City’s is the first, we were delighted to hear that the Rhode Island state legislature has authorized two pilot programs. The concept also is being intensely debated in cities across the country, including San Francisco, Denver, and Boston.
Why is this step in the United States such a significant breakthrough? The saved lives are surely important. 600 New Yorkers died of opioid overdose in the first three months of 2021. This number might have been cut by at least 30% had the two new sites been operating.
More fundamentally, the sites are important because they are the purest expression of harm reduction, in which the focus is on reducing harm to those struggling with substance use rather than insisting on abstinence as the only moral approach.
Measures such as: testing for contaminants such as fentanyl; sterile syringes; the availability of Naloxone, a drug that almost instantly can reverse the effects of an opioid overdose; and medication for opioid use disorder such as methadone, buprenorphine and other drugs. These measures are increasingly accepted, but they will not help individuals who are dead.
In their first month, the New York City sites have received strong community support. Their director, Sam Rivera, notes, “We are partnering with the NY Police Department,” as he told a New York City radio audience recently. “They are here at our sites to support us and make sure there are no disruptions to what we are offering. They ask us for paperwork so they can refer people to us who they see are using drugs.”
“The sites really speak for themselves,” commented staff member Kailin See. “They’re not just for people who use drugs, they are also for the communities where they’re located. The community asked for less public injection, fewer improperly discarded syringes on streets and playgrounds, less overdose death, less crime in their neighborhoods.”
The sites received high praise from an emergency department nurse: “In many cases, departments are overrun and the staff is exhausted. I’ve personally tried to resuscitate patients who — even though emergency services got to them and gave them Narcan – died because it was too late, and we’ve lost those patients. Anything we can do to decrease the burden on emergency services is really important.”
One New Yorker recalled, “I was a resident of Washington Heights [and] used some of the safe needle exchange services probably 10 years ago. Only because of programs you’re talking about was I able to get clean, stay clean, reintegrate into society, hold a solid job. I hear people saying things like ‘Not in my backyard.’ But you’re right, you are where there is the most need.”
As we close the door on a most difficult and troubling year, may I extend my best wishes for a healthier and happier New Year in 2022.
Rev. Alexander E. Sharp,
Executive Director, Clergy for a New Drug Policy