The New York Times reports that New York Mayor Bill de Blasio has released a plan calling for four supervised injection facilities (SIFs) throughout the city as a harm reduction strategy for intravenous drug users. The Times also notes that the study on the feasibility of SIFs was completed months ago and the mayor delayed its release as he decided whether or not to support the plan.
The delay had frustrated activists. For months, groups including Housing Works, which fights for lifesaving services for people living with HIV/AIDS, and the Drug Policy Alliance, which advocates for more lenient drug laws, have staged rallies at City Hall, including one in April where protesters chanted, “Release the report!” At a rally Wednesday morning, protesters appeared with a large banner reading, “Mr. Mayor: While you wait, we die.” After blocking traffic outside of City Hall, about ten protesters including City Councilman Steve Levin were taken into custody.
In 2016, the New York City Council allocated $100,000 for a report on how SIFs worked in other municipalities, including in Canada and Europe, and whether they’d be feasible in the Big Apple. City Health Commissioner Mary Bassett has already said she supports the sites, telling a council committee in March: "I think that the public health literature is clear."
De Blasio hinted in late January that the report would be released “soon.” Then it was supposed to be released in April. On Friday and again on Monday, the mayor insisted it was coming soon. April 30th came and went without the report.
The Times reports that the four sites, which would be known as Overdose Prevention Centers, would open after six to 12 months of outreach in the communities they'd be located in: Washington Heights and Midtown West in Manhattan; the Longwood section of the Bronx; and Gowanus, Brooklyn. Each location would be staffed with people trained to administer the overdose drug naloxone as well as social workers available to offer counseling to people who want it. The facilities would be financed and run by nonprofit groups approved by the city and would operate as pilot programs for a year.
De Blasio said in a statement to the Times: "After a rigorous review of similar efforts across the world, and after careful consideration of public health and safety expert views, we believe overdose prevention centers will save lives and get more New Yorkers into the treatment they need to beat this deadly addiction." The Times said City Hall officials refused to make the mayor available for an interview.
Safe injection sites save lives. Medical supervision for people who take illegal intravenous drugs prevents overdoses and, surprisingly, cuts down on drug use. Reducing the risks faced by people who use drugs shouldn’t be a radical notion, and more than 60 cities around the world have SIFs. (They’re also called safer consumption spaces, or SCSs.)
In the United States, progress has been slower, though cities such as Philadelphia, Seattle, Denver, San Francisco, and Ithaca, New York, have considered them. In 2016, New York City saw 1,374 overdose deaths—one death every seven hours—and more than 80 percent of them involved opioids.
Kassandra Frederique, New York State director of the Drug Policy Alliance, underscored the urgency of the situation, saying that overdoses kill more New Yorkers than than traffic accidents, homicides, and suicide combined. “If we want to save lives, reduce criminalization, and end racial disparities, we need comprehensive, innovative, and forward-thinking approaches like safer consumption spaces,” she said in a statement Wednesday. “New York is in a unique position to step up and implement innovative drug policies rooted in science, compassion, and public health as we did with syringe exchanges before. It is time for Mayor de Blasio to take action to save lives immediately."
In a statement to Politico on Wednesday, City Council Speaker Corey Johnson said: "I don’t know what the hold up is. Other cities are moving forward and we’re stuck in limbo. Meanwhile, the number of people overdosing continues to skyrocket. This is not a time for inaction. The mayor knows how strongly I feel about this and we will continue to push for the study’s release.”
De Blasio’s hemming and hawing over the report was especially frustrating to activists given the amount of research that already demonstrates the effectiveness of SIFs. When officials in Philadelphia wanted to defend their decision to consider SIFs, they pointed to Toronto’s facility, which saved 139 lives in six months last year. A similar site in Philly, their report concluded, could save between 25 and 75 lives per year—people who’d otherwise be lost to overdoses. And it would save millions in hospital costs and public funds.
Of course, there are powerful authorities who don’t support SIFs because they say they violate federal law, including the Drug Enforcement Administration and the Department of Justice. Last December, the US Attorney’s Office delivered a stern rebuke to Vermont, one of the states hardest hit by opioid misuse, which was considering a SIF. “It is a crime, not only to use illicit narcotics, but to manage and maintain sites on which such drugs are used and distributed,” the office said in a statement. “Rather than encourage and normalize heroin injection by affording a purportedly legal setting for use, the government must help addicts stop using.” Discussion then stalled in the state legislature. (The only SIF in the US is a facility operated in secrecy, because it may be illegal.)
New York City's plan calls for the support of several district attorneys and the State Health Department. The mayor's office has asked the state health commissioner to authorize the four sites, noting that the commissioner has the authority to do so if they're part of a research study.
Some law enforcement officials have shown ambivalence about the sites, which go against the prevailing view of drug misuse as a criminal problem, rather than a public health issue. Philadelphia’s police commissioner shifted his position after visiting a SIF in Vancouver, going from “being adamantly against [the sites], to having an open mind.” NYC’s police commissioner, James O’Neill, said in February that he similarly has an open mind about the sites, but "also ha[s] real concerns about quality of life and crime issues around that site.”
No one would deny the issue is complex—a point de Blasio reiterated repeatedly on Friday. “We’re going to come out with a vision of how to handle this very complex matter,” he said. “However we handle this, it is a very complex matter legally and in terms of law enforcement.”
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