The First US Safe Injection Sites Did Not Increase Crime: Study

The first government-sanctioned overdose prevention centers in the U.S. did not cause an increase in crime, according to a new study. 

In November 2021, two overdose prevention centers (OPCs)—spaces where people can use drugs without being arrested and be revived if they overdose—opened in Manhattan with the blessing of the city government. Since then, OnPoint NYC, the non-profit organization running both spaces, which are also called safe drug consumption sites, said it has reversed over 1,000 overdoses. But New York Governor Kathy Hochul has refused to use money from opioid settlements to fund the sites, and more recently, has questioned their efficacy. One of the main criticisms of overdose prevention centers is that they encourage drug use and criminal activity in their surrounding neighborhoods—an idea that’s been previously debunked in places like British Columbia, Canada, where they are legal. 

The study about New York’s sites, published in JAMA Network Open, tracked reported crime and disorder complaints, and 911 and 311 calls in the areas surrounding the two overdose prevention centers from January 1, 2019 to December 31, 2022. It compared that data to calls around 17 syringe exchange programs around the city and found that “no significant changes were detected in violent crimes or property crimes recorded by police, 911 calls for crime or medical incidents, or 311 calls regarding drug use or unsanitary conditions observed in the vicinity of the OPCs.” 

“To those who worry that opening overdose prevention centers will increase crime in neighborhoods that need these types of programs, I would say that our analysis does not bear that out,” said lead study author Brandon del Pozo, assistant professor of medicine and of health services, policy and practice at Brown University, in a news release. 

There was also an 82 percent reduction in low-level drug possession arrests around the sites and a 56 percent reduction in weapons possession arrests in the immediate vicinities of the two sites. 

The study said that may “reflect the municipality’s desire to not deter clients from visiting OPCs if they fear arrests for narcotics possession.” 

It also said the OPCs may be absorbing “behaviors that would have generated 911 calls, 311 calls, and resulting police activity” since about a third of users reported being homeless and 76 percent said they would use drugs in public if they didn’t have access to the sites. 

Sam Rivera, executive director of OnPoint, said the results are “exciting” though not surprising considering the OPCs have been used nearly 100,000 times. 

“Of course public use has come down because 100,000 times people use with us indoors and not in the community,” he said, adding the OPCs have also collected 2 million units of hazardous waste material, some of which may have ended up in the neighborhoods instead. 

He said working with New York police and seeing officers direct drug users to the OPCs instead of arresting them has been “mind blowing.” 

The study comes after U.S. Attorney for New York, Damian Williams, said his office is willing to prosecute OPCs, which remain federally illegal, unless New York policymakers take action. 

"My office is prepared to exercise all options, including enforcement, if this situation does not change in short order,” he told the New York Times in August. 

Rivera said he interpreted that as a challenge for Hochul to protect OPCs under state law. 

It’s been “painful” to watch the governor refuse to use opioid settlement funds on the sites, despite having champions of the sites like Dr. Chinazo Cunningham on her team, he added. 

“(Hochul) is making a decision to use dollars earmarked specifically on the lost lives of beautiful people in the state of New York and throughout the country who use opioids—she's deciding not to use those dollars to keep those people alive.”  

New York’s sites have been the exception across the U.S., as many state and city governments have struck down safe-injection site proposals.  

Philadelphia, which is grappling with an overdose epidemic being fueled by tranq dope, was once set to open the first OPC in the country but city council recently voted to pre-emptively ban the sites almost everywhere. Last year, California Governor Gavin Newsom vetoed a bill that would have allowed some to open in the state, citing concerns about “a world of unintended consequences.” 

Rhode Island was the first state to legally sanction overdose prevention centers; at least one site is slated to open in early 2024.

In addition to reversing overdoses, the sites also connect people with detox and treatment services and wound care, and show them how to safely shoot up drugs. 

The study on New York’s OPCs is in line with similar recently published papers showing that decriminalizing drugs does not lead to an increase in fatal overdoses or violent crime. 

Rivera said he expects more overdose prevention centers to open soon in New York and around the country, despite the opposition. 

“People are managing their pain of watching loved ones die by taking action.”