New York opens nation’s first overdose prevention centers for street drug users

The nation's first overdose-prevention centers opened in New York City on Tuesday, a major step in the adoption of a harm-reduction approach to the drug epidemic as the number of U.S. overdose deaths continues to soar.

Trained staff at two locations operated by a nonprofit organization in northern Manhattan will monitor drug users as they consume street drugs, prepared to step in if anyone overdoses, according to New York City health officials.

They are equipped with the opioid antidote naloxone and oxygen, the two critical tools in reversing overdoses from narcotics such as fentanyl, by far the most common killer of drug users. The indoor centers accepted people Tuesday, according to Chinazo Cunningham, outgoing executive deputy commissioner of mental hygiene in the city's Department of Health and Mental Hygiene.

The opioid files

While the number of overdose deaths prevented may be small, the opening of the centers is a break with U.S. policy in the effort to save the lives of people who use drugs. Cities and states have been fighting for years to open the facilities but were stymied most recently by the Trump administration, which adamantly opposed them, and, in some cases, opposition from neighbors of the sites.

The Biden administration has adopted a slate of harm-reduction strategies — without specifically taking a position on the controversial overdose-prevention centers — as the number of overdose deaths reached a record of 100,000 in a single year. Local and state governments and nonprofit organizations that want to open similar safe consumption centers, including Rhode Island, Philadelphia and San Francisco, will undoubtedly be watching how the federal government responds to Tuesday's events.

When he was a U.S. senator, President Biden was author and co-sponsor of the law that makes such facilities illegal under federal law.

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Spokesmen for the Department of Justice — which under President Donald Trump vowed to shut down any safe-consumption site that opened — and the Department of Health and Human Services declined to comment.

Safehouse, a nonprofit that has fought a so-far losing battle with the federal government to open a safe-consumption center in Philadelphia, congratulated New York for becoming the first city to authorize a facility.

"In communities across the nation, people are prepared to offer overdose prevention services," the organization said in a news release. "These efforts will save lives and decrease the stigma that interferes with care for people who are using drugs."

Cunningham said the city has had "productive conversations" with federal authorities. "But our take is we don't have the time to wait and that people are dying. And so we have to act now."

Outgoing New York Mayor Bill de Blasio said the step will save lives.

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

De Blasio's successor, incoming mayor Eric Adams, has tweeted that he is "going to establish more overdose prevention centers that include wraparound services like counseling, healthcare, & supportive housing. Our neighbors’ lives depend on it."

Similar facilities are open in 12 countries, including Canada, and have never suffered an overdose death while overseeing the use of heroin, fentanyl, methamphetamine, cocaine and other street drugs by millions of users, according to Alex Kral, a researcher at the think tank RTI International who conducts studies on safe-consumption sites.

Kral said research shows that supervised sites save lives, reduce transmission of HIV and viral hepatitis, help people get into drug treatment, and reduce crime, public drug use and discards of used needles.

But they are only one piece of a comprehensive effort needed to stem the historic U.S. overdose epidemic, which has taken more than 800,000 lives in the past 20 years. That includes much wider access to treatment drugs such as buprenorphine and methadone that help wean people off opioids, Kral said.

"It's the first step," he said. "There are so many things that we need to improve the conditions for people using drugs in this country."

Regina LaBelle, former acting drug czar under Biden, said the new centers are "a big deal in that it's an option … that hadn't been done," except for a clandestine facility that has been described in academic journals by Kral and other researchers. But, she said, "no one policy, including this one is a panacea. Researchers, policy folks, recognize that there's a ton of work to do."

The New York centers are operated by the nonprofit organization OnPoint NYC in locations in East Harlem and Washington Heights that already offer drug users clean needles and other drug paraphernalia. Leaders of the organization did not return telephone calls and emails seeking comment Tuesday.

Eva Chan, a community board member in Harlem and member of the Greater Harlem Coalition, which opposes the sites, argued that her neighborhood already has become oversaturated with drug treatment clinics.

Chan and others in the coalition have questioned why the two new consumption centers are opening in areas with a predominantly Black population.

"With all the talk about systemic racism, this type of structural racism of putting undesirable social services in Black and Brown neighborhoods continues to this day," Chan said. She added that she does not dispute the help safe-injection sites can provide drug users, but she worries they will become magnets for drug dealers soliciting clients, as treatment clinics have in her neighborhood.

Shana Harmongoff, a recent New York State Senate candidate, also called for other neighborhoods to host safe-consumption sites, citing the number of treatment centers already open in Harlem.

"I’m all for drug addicts getting the treatments that they need because it's a disease and they definitely need the care," Harmongoff said. "However, why does Harlem have to keep being oversaturated with treatment clinics?"