New York City Mayor Bill de Blasio has approved four supervised injection sites for intravenous drug users, joining cities like Seattle, Philadelphia, and San Francisco enacting a harm-reduction strategy aimed at curbing fatal overdoses and providing linkage to care for those with substance use disorders. The city’s Health Department reports that in 2017, there were 1,441 drug overdose deaths, 67 more than the previous year. This marked the sixth consecutive year that overdose deaths have increased and the final figure for 2017 is expected to be even higher, mirroring national trends showing year-over-year increases in opioid overdose fatalities.
Supervised injections sites, also known as supervised injection facilities or SIFs, provide a safe, sterile, and medically supervised environment for intravenous drug use while also offering linkage to care, whether for abstinence-based treatment or transition to opioid substitution therapies like buprenorphine or methadone. The object is to prevent fatal overdose and to incrementally guide users toward treatment. The de Blasio administration says the measure aims to reduce the public health implications of opioid use disorder and provide users with health care, psychosocial support, and recovery resources. The sites still need to be approved by the state Health Department and district attorneys, as well as local representatives of the four districts in which the sites are slated to be located. This year-long pilot program will be the first of its kind New York City.
Those in support of the safe injection sites, which is still subject to several levels of review, believe that experienced and qualified healthcare professionals supervising intravenous drug use can help mitigate fatal overdose and shepherd patients toward treatment. Opponents fear the facilities may pose a serious public health threat to the communities in which they will be established: Brooklyn, Midtown West, Washington Heights, and The Bronx. Similar programs have been implemented in Canada and Europe and have been demonstrably effective. The proposal for the NYC injection sites says the program can save as many as 130 lives and up to $7 million in related costs during its implementation.