New York opens the US’ first safe injection sites after fatal wave of overdoses

After record wave of overdose deaths, supervised facilities to offer clean needles and administer overdose-reversing medication if necessary

Following a surge in overdose deaths across the US, New York City will open two supervised injection sites in Manhattan, allowing people to use drugs such as heroin while under supervised medical care with access to social services and addiction treatment.

The city’s first two pilot overdose prevention centres in the East Harlem and Washington Heights neighbourhoods will provide clean needles and administer overdose-reversing medication if necessary.

A health department study determined that such facilities would save as many as 130 lives a year.

“After exhaustive study, we know the right path forward to protect the most vulnerable people in our city. And we will not hesitate to take it,” New York City Mayor Bill de Blasio said in a statement on 30 November.

Overdose prevention centres “are a safe and effective way to address the opioid crisis,” he said. “I’m proud to show cities in this country that after decades of failure, a smarter approach is possible.”

The sites, which are currently used for clean syringe exchange programmes, are the first of their kind in the US, following proposals for similar facilities in California as well as Boston, Philadelphia and Seattle.

Similar sites across Europe began launching more than 30 years ago. In North America, Toronto’s public health office opened the city’s first “permanent supervised consumption service” in 2017. There are at least 39 such government-supported sites across Canada.

More than 2,000 people in New York City died from drug overdoses last year, marking the highest death toll from drug-related incidents since such reporting was first collected more than 20 years ago.

Opioids were involved in 85 per cent of all overdose deaths in New York, according to the city. The synthetic opioid fentanyl – which was present in 77 per cent of overdose deaths in 2020 – is driving most overdose deaths.

The US Centers for Disease Control and Prevention recorded more than 90,000 drug overdose-related deaths in 2020, the deadliest year on record.

Within a 12-month period that ended in April, more than 100,000 Americans died of drug overdoses, a nearly 30 per cent spike from 78,000 deaths within the prior year, according to the National Center for Health Statistics.

At least 596 people in New York died from drug overdoses within the first few months of 2021, according to the city.

New York City health commissioner Dr Dave Chokshi said “the national overdose epidemic is a five-alarm fire in public health, and we have to tackle this crisis concurrently with our [Covid-19] fight.”

“Giving people a safe, supportive space will save lives and bring people in from the streets, improving life for everyone involved,” he said in a statement.

Mayor-elect Eric Adams, who is set to enter office in January, also supports safe injection sites.

The city will not operate the sites; nonprofit groups New York Harm Reduction Educators and the Washington Heights Corner Project, which have merged as OnPoint NYC, will staff the facilities.

“After a devastating year of record overdose deaths, our city’s life-saving action will reverberate across the nation,” said Jasmine Budnella, director of drug policy for harm reduction advocacy group Vocal-NY.

“For over a decade, drug users and harm reductionists have fought to bring Overdose Prevention Centers to the United States. Many of them are not here to see this day,” she said. “This is one step forward towards ending the drug war.”

The city-supported programmes do conflict with federal law, which prohibits designated locations for illegal drug use under the so-called “crack house statute”. In 2019, the US Department of Justice under then-president Donald Trump sued the city of Philadelphia to block the opening of a supervised injection site.

President Joe Biden’s administration has not explicitly endorsed such facilities as part of its harm reduction platform.

Dr Chokshi told The New York Times that the city has had “productive conversations” with federal and state health officials that he believes share the city’s “sense of urgency” to address the growing crisis.