As overdose deaths surge, top NYC mayoral candidates back supervised drug use sites
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An overdose prevention center in Toronto. Photo courtesy of Dr. Brett Wolfson-Stofko
By David Brand
As opioid overdose deaths surge in New York City, several top mayoral candidates say they will follow through on a stalled effort to create supervised use sites across the five boroughs.
Six Democrats running for mayor told the grassroots advocacy organization VOCAL-NY on Wednesday that they would establish overdose prevention centers, or OPCs, during their first year in office.
Eric Adams, Shaun Donovan, Kathryn Garcia, Dianne Morales, Scott Stringer, Maya Wiley and Andrew Yang each said they would create OPCs, though Garcia said she would defer to affected communities. Only one, finance executive Ray McGuire, said he did not yet support OPCs.
Supporters and health experts say OPCs, also known as safe consumption spaces, provide a secure environment for people to consume drugs under the supervision of healthcare workers and peers, while providing counseling, medical care and case management services. Opponents tend to take a hard-line abstinence approach and say governments that sanction the facilities condone substance use.
Various candidates at a forum Wednesday said they would establish OPCs as part of a holistic approach to assisting substance users. Roughly 120 such facilities exist worldwide, according to the Drug Policy Alliance.
“I think that overdose prevention centers are something that is proven to work around the world,” said Stringer, the city comptroller. “This is now no longer something that is not possible. This is the way we bring our people back.”
“No one wants their babies, who are 25 years old, dead because government could not see beyond our street corner,” he added.
Adams, the Brooklyn borough president, said he backs OPCs and would like to go “one step further” by incorporating wraparound services like supportive housing.
Morales, a social worker and nonprofit administrator, said the facilities are a foot in the door that can open opportunities for vulnerable New Yorkers to pursue additional services.
“We need to prioritize care that means moving away from the dehumanization of our people and providing them with the support they need to heal,” Morales said. “That includes overdose prevention centers that provide a safe space while building trust and relationships so people can get the care they need.”
Donovan, a former Housing and Urban Development secretary, described himself as the first candidate to support OPCs. “I would make sure we are directly connecting those who are struggling with the housing and services they need,” he added.
A 2017 New York City Health Department report called for the creation of OPCs, though Mayor de Blasio’s administration kept the plan under wraps for months. In response to activism from harm reduction advocates, like VOCAL-NY, de Blasio released the report in 2018 and said the city would implement OPCs at four locations in Brooklyn, Manhattan and the Bronx.
Later, however, he said the city could not proceed without permission from the state — a position he maintains. De Blasio and the Health Department renewed calls for the state to approve OPCs as part of a police reform plan released earlier this month.
New York State Health Department spokesperson Jonah Bruno said the state has hesitated to approve OPCs until the resolution of a legal fight in Philadelphia, where the Department of Justice has sought to block safe use spaces.
“While we fully support efforts to reduce the harms caused by the opioid epidemic, we are also reviewing the most recent ruling in Philadelphia over supervised injection facilities and considering the impact it could have on efforts to launch similar facilities here,” Bruno said.
VOCAL-NY’s Drug Policy Campaign Coordinator Jasmine Budnella said the city and state have both “punted” on the issue, at the expense of thousands of New Yorkers.
“For us, the next mayor should stand up and implement these sites with or without Cuomo and I think there is a growing coalition of people across the state who support that,” Budnella said.
New York City has not yet released overdose death data during the COVID-19 pandemic, but numbers from the first three months of 2020 show a disturbing rise in the number of people killed by opioids. At least 440 New Yorkers died from drug overdoses in January, February and March 2020, an all-time high, according to Health Department data.
There were 1,463 drug overdose deaths in 2019, with fentanyl identified in two-thirds of the people who died. Advocates say the crisis has only gotten worse during the pandemic, as people are forced into isolation and public attention focuses on a different public health crisis, the coronavirus.
“We see a historic, devastating rise,” said attorney Maya Wiley, the former counsel to de Blasio. “That is unacceptable.”
Wiley said she supports OPCs, but suggested that many New Yorkers would likely oppose the facilities at the community board level. Their recommendations would be non-binding, however. It is unclear whether they would have any formal say on the siting of the OPCs, which, under the city’s 2018 pilot plan, would be located inside existing needle exchange facilities.
She said she would seek to reform land use policies to curb “the kind of NIMBYism that prevents us from making progress in ensuring that we all have what we need for the city in dignity.”
Mayoral candidates Shaun Donovan, Maya Wiley and Kathryn Garcia told VOCAL-NY Co-Executive Director Alyssa Aguilera they support overdose prevention centers. Image via VOCAL-NY forum stream
Yang, an entrepreneur and former presidential candidate, touted his support for OPCs on the national level. He also described community resistance to the sites, but said he would override that as mayor.
“The purpose of everything we do should be to save lives,” he said. “To some extent this has been a political issue because people are not excited about having OPCs in their neighborhood, but people wouldn’t object to having a hospital in their neighborhood. And this to me has this same purpose — to keep people alive and ensure that mothers, fathers and brothers and sisters can see their families again.”
Garcia, the former Sanitation commissioner, said she too supports OPCs, but deferred to local communities and the land use process. She put the onus on local councilmembers by citing the legislative body’s tradition of member deference — the full body votes in line with the member representing the affected district on land use issues.
“This is one of those places where I definitely believe in overdose prevention centers, but it is not only the mayor’s decision on land use,” Garcia said. “I will advocate but it is the councilmembers in the affected area who has final say on land use.”
Only McGuire declined to support OPCs. He disputed the notion that OPCs had been proven effective elsewhere and cited “mixed responses” from the few locations around the world that sanction the facilities, such as cities in Canada, the Netherlands and Switzerland.
“We’ll have to look into it, but you don’t have a clear cut example … of where this works on a consistent basis,” McGuire said.
Various peer-reviewed studies, however, indicate that the facilities reduce public drug use, decrease HIV rates and lead to more connections to substance use treatment.
Budnella, VOCAL-NY’s drug policy coordinator, said she found McGuire’s response “disappointing,” especially in the midst of an historic overdose crisis. She also said she found Garcia’s response confusing because she has never heard land use introduced into the debate over safe consumption spaces before the forum.
She praised the candidates who supported OPCs and urged whoever wins the November election to move with speed to implement a proposal first introduced by de Blasio three years ago.
“In this current moment, what we know is that 2020 will be the worst year on record for overdoses nationally, city- and statewide and we need to be doing everything we can,” Budnella said. “There is no time to drag our feet on a lifesaving intervention that, frankly, we should have had done since 2018.”
