NYC gets it right: Safe injection sites save lives | Editorial

Published: Dec. 06, 2021

Overdose deaths blew past the 100,000 mark last year, a record-high in America, which leaves us with binary options: Either we surrender to the overwhelming tide of drug-related carnage, or we expand every evidence-based intervention that works to keep people alive.

New York City isn’t hesitating, and our state should follow the bold example the city set last week by opening overdose prevention centers (or “safe injection sites”) in Harlem and Washington Heights, where IV users bring their drugs, have them tested, and consume them with a well-trained staff member hovering nearby – one armed with Naloxone, a dose of compassion, and the kind of engagement skill that starts them on a path to treatment.

The opening of New York’s two overdose centers is a first for the US, but it won’t be the last. Rhode Island is developing guidelines for a summer launch. Pennsylvania generated political momentum for such facilities, before it met legal barriers from the Trump Administration. California’s legislature passed a measure permitting OPCs in three cities before it was vetoed by Jerry Brown, and is trying again.

In New Jersey, Senate Health Committee chairman Joe Vitale said he will soon re-introduce a bill to establish a pilot program, with four overdose prevention sites spread throughout the state. It is controversial, even radical, and perhaps counterintuitive to those unfamiliar with addiction and harm reduction.

“The evidence is clear that this is effective public health policy,” Vitale said, “and my colleagues need to hear it again, no matter how much it needs to be said.”

So it’s time to peel back the skepticism and fear.

Start by admitting there is a crisis: New Jersey’s 3,000 annual drug-related deaths are unacceptable, and when you only have 7 syringe access programs in the entire state, your harm reduction strategy is dismally deficient.

Then it’s time to ask a question: Should we continue along this same dark path, where addicts shoot up in empty buildings, under a bridge, or in an alley, where the only thing keeping them alive is a lucky phone call that brings an EMT or a cop or firefighter with a dose of Narcan?

Or should they be welcomed to a supervised and hygienic space, which drastically decreases the rates of overdose and HIV infection, reduces the level of public consumption and the health dangers of discarded needles, and increases the chance of getting addicts into treatment.

The first overdose prevention center in North America was Insite in Vancouver, which opened its doors in 2003 and remains the gold standard for harm reduction today. Insite receives about 400 visitors a day, and makes about 1,500 overdose interventions a year.

The number of deaths under its roof over Insite’s 18 years of operation: Zero.

That is not a fluke or an anomaly. Similar numbers are reported in OPCs throughout Europe and Australia.

“For so long, you relied on outreach teams to look for people and offer some basic nursing services,” said Insite founder Russell Maynard. “But an overdose prevention site changes that: Those 100 or 200 people come to your door, and once there, you can offer them services – from a cup of coffee to STD testing to supervised injection – and then you can connect them to a path to treatment.

“We have a treatment program upstairs, and they have about 400 intakes a year. I know of no other project in the world that connects 400-plus people to treatment a year.”

Following the spectacular success of Insite, Canada scaled up injection sites in 2016: There are now 40 such OPCs throughout the provinces.

Opening these programs require political courage. In New York, they have it in abundance: Both mayors – Bill de Blasio and the incoming Eric Adams – are vocal supporters of OPCs. The NYPD and city district attorneys have agreed not to prosecute anyone at these facilities, even though they technically run afoul of the federal “crack-house statute,” which bars anyone from operating a facility “for the purpose of unlawfully. . . .using controlled substances.” They are betting that they will avoid legal scrutiny from the Biden Administration.

Other cities will try their own innovations, such as Paterson, where Mayor Andre Sayegh is trying to land a $1 million grant from Bloomberg Philanthropies to expand a pilot which creates a hotline to a physician that can prescribe medically assisted treatment within 90 minutes. Maynard is dubious (“An outreach model is expensive and slow,” he says, “but set up a supervised site and they’ll come to you”), but we will keep hopeful eye on Paterson.

Until then, we can agree that success can be measured in lives saved and treatments entered. No one has ever died at a safe consumption site, and despite concerns that it encourages drug use, research has proved the opposite to be the case.

Now overdoses are surging, and we have lost far too many lives to this bonfire. New York is showing that it is fed up, and now it’s our turn.

Do you like this post?

Showing 1 reaction

published this page in News and Politics 2021-12-08 03:09:34 -0800