Will NYC’s supervised injection sites enhance overdose prevention efforts in other cities?

key takeaways

  • The opioid overdose epidemic is a public health emergency that has worsened since the COVID-19 pandemic.
  • In November, New York City opened the first regulated injection site in the United States. These sites saved at least 59 people from overdose.
  • Harm reduction advocates hope the New York City site will allow more overdose prevention centers to operate in other cities.

Two months ago, New York City became the first city in the United States to officially open regulated injection sites in an attempt to curb overdose. The opening is a long-awaited victory for harm reduction advocates across the country, some of whom already plan to launch their own websites.

A supervised injection point or overdose prevention center (OPC) is a facility where people can use injectable drugs (such as heroin, cocaine, methamphetamine, and various opioids) in a clean environment and have access to safe resources. These sites do not offer medication, but allow people to bring their own.

According to the National Institutes of Health, the main goals of the sites are to “reduce the acute risk of disease transmission through needle sharing, prevent drug-related overdose deaths, and connect drug users with addiction treatment and other health and social services. “. Drug Abuse (NIDA).

According to harm reduction advocates and addiction researchers, OPC is designed to save lives.

“The idea is to reduce drug-related health hazards,” Dr. Emily Einstein, head of NIDA’s Science Policy Unit, told VigorTip. “So far, the evidence shows that no one has died from a drug overdose at one of these sites.”

Einstein said NIDA supports evidence-based harm reduction and that supervised injection sites in other countries are not harmful. Going forward, the institute will monitor the New York City site and other sites in the U.S. to better understand its effectiveness.

According to NIDA, the study found that OPC significantly reduced public injecting drug use, unsafe disposal of needles, and rates of syringe sharing among users.

“Overdose deaths have grown exponentially over the past few years at least, so this is a very deep-rooted problem that’s only getting worse,” Einstein said. “It’s especially important that we innovate and come up with improvements. evidence-based approach to addressing addiction overdose because it is a serious problem.”

The New York City sites are located in East Harlem and Washington Heights and are managed by trained staff from the injury reduction organization OnPoint NYC. They provide users with clean needles, referrals to addiction treatment centers, and Narcan (naloxone), an overdose reversal drug.

In the first three weeks of operation, workers at the sites avoided at least 59 overdoses, according to the city’s health department.

What is Nalkan?

Narcan is a drug that can help counteract the effects of an opioid overdose. It is available as an injection and as a nasal spray, and takes about two to five minutes to work after administration.

How did the Overdose Prevention Center come about?

OPC or supervised injection sites have been in operation since the 1980s. The first OPC opened in 1986 in Bern, Switzerland. There are currently more than 120 such sites in Europe, Canada and Australia. The New York site is the only OPC licensed and operated in the United States to date.

In fact, New York City’s victory came after Philadelphia’s injury-reduced losses. For years, harm reduction advocates in Philadelphia have tried to establish a safe injection site called Safehouse in the Kensington neighborhood, which has been hit hard by the overdose epidemic.

In 2019, a federal judge used the “crack home statute,” co-sponsored by then-Senator Joe Biden in 1986, to prevent regulated injection sites from opening in Philadelphia. The Biden administration has expressed support for harm reduction, but not specifically for supervised injection sites. They have yet to express concerns or objections to these sites in New York City.

Advocates for Safehouse expect the case to be reviewed in early March.

A legal victory in Rhode Island

Although the first two sites are up and running, New York City has not passed any laws legalizing supervised injection sites. Instead, the city has the consent and support of former Mayor de Blasio and the police force.

The focus on the law appears to have suppressed plans to create an injection site in Philadelphia, while some praised New York City for reaching a deal without legal intervention.

Legal routes seem to be more successful elsewhere. Rhode Island also plans to open supervised injection sites, and in July 2021 passed a law authorizing a two-year pilot harm reduction center program.

Officials still have to decide the location and logistics of the centers, but advocacy groups welcome the legislation.

Philadelphia community is promoting overdose prevention tools

“I’m very excited about Rhode Island and hopefully we can be next after New York,” Colleen Daley Ndoye, executive director of the Weber RENEW program, told VigorTip. .

“We’re really proud because we’re a small state, and I think we’re sometimes overlooked,” she said. “We really pushed this to happen, it didn’t just happen. It took years for this legislation to pass.”

Daley Ndoye added that establishing supervised injection sites in the area could help harm reduction organizations respond quickly to fentanyl overdose.

Over the past few years, Rhode Island has seen an increase in drug overdoses, with most of those drug overdose deaths being fentanyl-related. In 2020, more than 250 people died from fentanyl overdose in the state.

“About 25 percent of the Narcan we distribute goes to save lives,” Daley Ndoye said. “We’re really feeling the pressure that we have to be out every day, during COVID, whenever. Everyone has a sense of urgency and everyone is affected by overdose.”

Amy Nunn, PhD, MS, executive director of the Rhode Island Institute of Public Health, told VigorTip that she and her team are trying to figure out how to contribute to the cause in ways that demonstrate their strengths.

“In my dream world, we’d have all sorts of different harm reduction services,” Nunn said.

Despite the local support, Nunn said she worries about federal backlash.

“A lot of people think ‘Should we do this, is this ethical for me?’ I don’t have that conundrum,” Nunn said. “It’s more like, how do you handle legal matters? Our leadership changed when the FBI went after you, or they didn’t like what you were doing, and you didn’t have a legal place to go – I’m having a strong sense of it. Interest looking forward to New York.”

Fear of community backlash and stigma

Community support plays a role in facilitating the opening of supervised injection sites in Rhode Island. Even with state laws, harm reduction groups are prepared to deal with community backlash, Daley Ndoye said.

“We’re not going to be naive to think that everyone is going to jump in right away and say, ‘Yeah, I want one of these sites, I want it right next to me,'” Daly N’Doye said, adding that these The rules for the site will be finalized around March.

“It’s hard to wait,” Daley Ndoye said. “If we could wave a magic wand, we’d have a site or sites open today. I know it would save lives.”

In Philadelphia, residents of Kensington have mixed opinions about opening an injection site. The neighborhood is often described as neglected by the city in terms of maintenance and policing. Arguments against the site usually revolve around not wanting children to pass through the site and fears that the drug problem will get worse.

“We have to listen to each other and actually come to some agreement,” Sterling Johnson, a Philadelphia injury reduction worker and a member of the Philadelphia Overdose Prevention Network, told VigorTip.

“I would say that what we have is health care segregation, and a lot of white people seem to be very comfortable with that,” Johnson said. “That’s why we haven’t really made progress on issues like overdose prevention.”

Racial disparities in injury reduction and overdose care are widespread in Philadelphia, he added. According to a recent study, overdose deaths among Black Philadelphians have soared by more than 50 percent since the onset of COVID-19.

Johnson said he hoped people would start seeing the pilot injection sites in New York as a point of health care. “Overdose prevention centers are healthcare, syringe visits are healthcare, drug testing is healthcare,” he said.

what does this mean to you

The main purpose of an overdose prevention center is to save lives. Field staff can provide users with clean needles, refer them to an addiction treatment center, and administer overdose reversal medications if necessary.