Are Drug injection sites the answer?

Source CityandStateNY.Com:

Sam Rivera’s office at the Harlem OnPoint supervised injection and harm reduction center hangs a sign that holds significant historical value. The metal sign, titled “Clean Needles Save Lives: Drug Users Doing It For Ourselves, 1991,” showcases a photo and description of the response to the HIV/AIDS crisis. The sign is even more meaningful because Rivera was actively involved in the early days of harm reduction. At the time, he would clean syringes in a bucket to prevent the spread of HIV in communal drug use spaces.

However, times have changed. Today, Rivera leads OnPoint NYC, the largest provider of harm reduction services for drug users in New York City. They also operate the nation’s first two supervised injection sites. These sites offer a safe and sterile environment for drug users to inject pre-obtained drugs under the supervision of trained professionals who can intervene in case of an overdose. OnPoint’s locations in Manhattan, one in East Harlem and another in Washington Heights, opened in November 2021 with the approval of the city government garnering national attention. As a pilot program, the outcomes of these sites are monitored closely by supporters and detractors.

The road to establishing supervised injection sites has not been easy, as the United States and New York grapple with a severe opioid crisis and rising overdose deaths. Advocates like Rivera are working hard to change the narrative around drug use and garner more public support. Harm reduction services, such as supervised injection sites, aim to minimize the harm caused by drug use by acknowledging that strict prohibition only drives it underground without saving lives. Rivera emphasizes the importance of looking back at the history of HIV and syringe exchange programs to normalize supervised injection sites as part of the response to the opioid and overdose crisis. He believes treating this crisis as a public health emergency, rather than blaming and stigmatizing drug users, is crucial.

However, the legality of supervised injection sites remains a contentious issue. They are currently illegal at the federal and state levels, which limits their funding to grants and donations. Despite having the support of New York City Mayor Eric Adams, these sites face opposition from community leaders who are hesitant to have them in their neighborhoods. At the state level, Governor Kathy Hochul has not expressed her support or approved the use of settlement money specifically designated to combat the opioid crisis for funding these facilities. A bill that would legalize supervised injection sites statewide has not made progress in the Legislature, and neither legislative leader has publicly endorsed it. Additionally, there is limited research on the impact of OnPoint’s sites in New York, making it difficult to provide concrete data on their success or failure. The eyes of the entire country are on New York City to see if their approach will work.

Governor Hochul has acknowledged the severity of the opioid and overdose crisis in New York, where rates of use and death remain alarmingly high. The State Department of Health reported a nearly 300% increase in yearly opioid overdose deaths since 2010, reaching 4,233 in 2020. According to the Opioid Settlement Fund Advisory Board, that number rose even further to 4,762 in 2022. Opioid use has led to thousands of hospital discharges and emergency room visits each year. While opioid prescriptions have declined over the years, they still remain high, especially outside of New York City. Governor Hochul has launched a statewide media campaign and podcast to educate the public about the crisis and highlight available services for those struggling. The state Office of Addiction Services and Support has partnered with other organizations to increase access to naloxone, an overdose reversal drug, using funds from the Opioid Settlement Fund.

Despite these efforts, Governor Hochul has not shown support for supervised injection sites and has not allocated funds from the Opioid Settlement Fund for their operation. This lack of support has left many in the harm reduction community feeling that the governor’s response falls short of addressing the magnitude of the crisis. Rivera questions the effectiveness of buying fentanyl test strips as a response, emphasizing that they do not save lives. OnPoint utilizes a different form of testing in collaboration with the New York City Health Department to detect and measure the amount of fentanyl present in drugs.

The Office of Addiction Services and Supports, in a letter to the Opioid Settlement Fund Advisory Board, rejected the recommendation for supervised injection sites on legal grounds. They cited existing federal and state laws, regulations, and case law that prohibit the operation of Overdose Prevention Centers (OPCs) and the allocation of state funds for them. This legal argument has been the primary reason given by Governor Hochul, despite the state engaging in other federally illegal practices, such as the regulation and sale of cannabis.

As the debate over supervised injection sites continues, it is essential to prioritize evidence-based approaches and consider the experiences of other countries that have successfully implemented these facilities. The opioid crisis is a complex and multifaceted issue that requires a comprehensive response, including prevention, treatment, harm reduction, and support services. Supervised injection sites have proven to be an effective harm-reduction strategy in reducing overdose deaths and improving the health outcomes of drug users. By embracing these evidence-based interventions, New York can take a significant step forward in addressing the opioid crisis and saving lives.

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