Since he was just 15 years old, the Puerto Rican “Fidel” started injecting heroin. Since then she has survived several overdoses. From go so far as to spend the night in the sewers of 126th street in Harlemexchanging syringes and using ‘crack’, now at 45, has one foot on a path which as he defines, could be different.
“Fidel” is one of the hundreds of New Yorkers who almost daily attend one of the two Big Apple Overdose Prevention Centers (OPC), where they not only provide you with syringes for your addictive “routine”, but also specialized personnel closely monitor that no reaction or excess of the narcotic interrupts your breathing forever. A fatality that is part of a crisis, particularly in some upper Manhattan neighborhoods, is very difficult to hide.
These controversial centers, one located in Washington Heights and the other in Harlem, received the support of the New York City Department of Health (DOHMH) since last November. And since then they have been the target of great praise, but also of strong repudiation.
In these new spaces, also known as injection sites or supervised consumption, hygienic cubicles were installed so that people who consume various types of drugs do so safely. In addition, connection is provided with health promotion services, such as harm reduction, mental health therapy, drug treatment, and social support.
People in addiction, carry their own heroin, crack, cocaine, amphetamines, opioids and other combined narcotics, and in these centers they are guaranteed syringes, alcohol pads and inhalation systems. And more importantly, oxygen and the opioid overdose-reversing drug naloxone.
“I used to do this in the streets”
“Here they are saving lives. I have seen the gray cloud of death several times. They are guardian angels. I used to do this on the street”comments “Fidel” while finishing a “lunch” after administering his dose.
The islander says that in this office, he connected with the necessary help to take a step towards a process of detoxification and rehabilitation.
“I’m going to treat it. It’s hard. But I am going to treat it”, she shares after being almost all of his life in the “tunnel” of heroinone of the most complicated addictions to overcome, which also constitutes one of the most bitter sides of the public health crisis in New York City.
A crisis that is addressed in the Big Apple, in an innovative way, but also very controversial, which has led some elected leaders to promote the expansion of this model to the five boroughs. And others they want to stop it “in its tracks” on several fronts.
“We are saving lives”
The two New York City Overdose Prevention Centers (OPCs) located in Upper Manhattan, are the first sites of their kind to be publicly recognized by a municipal authority.
OPCs are operated by OnPoint NYC in Washington Heights and East Harlem and are located within the Syringe Service Programswhich already existed in the city for several years.
For proponents of this program, it is a new “realistic care” spectrum for people who use drugs, which also avoids the dangerous exchange of syringes. It also means a way to stop the spread of infections like HIV and hepatitis C.
“We are saving lives. Since November we have prevented 226 overdoses in this program. Here in Washington Heights alone we have stopped 155. This plan keeps communities safer. These people are not using the trains or the parks to inject themselves. Nor are they throwing out the injectors on the streets,” he said. Jason Beltrecommunity director for OnPoint NYC.
The City initially estimated that the two OPCs would save between 100 and 130 lives each year. In just the first few months, the centers have already surpassed those numbers.
Indeed, according to data derived from the Sanitation Departmento In neighborhoods in Harlem and Washington Heights, the Department of Sanitation is collecting far fewer discarded syringes on the streets. From 13,000 per month to approximately 1,000.
The first centers in the whole country
In December, the Big Apple became the first city in the entire country, and one of the first in the world, to establish these centers that receive people with substance use disorders, so that they use drugs safely, under medical supervisionwhile they have the option of browsing other types of services.
After years of discussions, with other levels of government, former Mayor Bill de Blasio gave the go-ahead to this approach, which It could be expanded to other parts of the city.
In the first three months, the two sites in East Harlem and Washington Heights they received more than 13,181 visits and reversed 226 overdoses, according to data provided by OnPoint NYC, the nonprofit organization that manages these spaces.
“This is not a cave where drug use is encouraged. It is a shelter for hundreds of people, the vast majority of whom are homeless, to have a safe space that opens the door to options to save their lives. And that happens through the option that they know plans that the City offers to overcome their addictions. It is an effective health intervention”, explained Beltré.
To date, no one has died at any of the centers.
This first supervised consumption program in New York arises when the drug consumption crisis is registered deadliest in US history. Many moderate Republicans and Democrats argue that they encourage higher rates of drug use or simply provide social approval of the use of illegal substances.
One of the main and most powerful factors against these centers is that they are illegal according to the Federal Drug Abuse Act of 1986. Specifically, one statute makes it a felony to “knowingly open, lease, rent, use, or maintain any premises, whether permanently or temporarily, for the purpose of manufacturing, distributing, or using any controlled substance.”
Critics see them as “illegal responses” to the fight against addictions, but New York City in particular seems to have the clearest path with renewed support from the City and some Assemblymembers promoting legislation to expand them statewide.
“I proudly carry the bill to authorize Overdose Prevention Centers in the New York State Senate,” announced Senator Gustavo Rivera, who represents The Bronx.
The legislator argues that these are safe places, where people who use drugs can receive medical care. It also helps address the concerns that certain New Yorkers have regarding “the substance use on our streets and its impact on our communities”, argues the senator.
But on the sidewalk in front of this debate, the congresswoman Nicole Malliotakisa Republican representing Staten Island and parts of South Brooklyn, who even introduced a bill to “defund” OPCs by withholding federal funds from any city, state, tribe, or private entity where they operate.
“I have introduced legislation to ensure that federal funds do not fund these heroin Shooting Galleries, that only encourage drug use and deteriorate our quality of life. It is an egregious abuse that taxpayer dollars are used in this, ”he said in a statement shared by local media.
A deadly crisis in NYC
Overdose deaths in New York City have risen steadily over the past 15 years. In 2017, the data confirms 1,441 deaths from this causeconsidered the deadliest year on record.
According to some trends shared by DOHMH, someone is likely to die from a drug overdose every seven hours.
In fateful 2017, more people died from overdoses in the Big Apple than from suicide, homicide, and car accidents combined.
But precisely in the midst of the fight for the pandemic in 2020 and 2021, the alarms went off again: only in the first quarter of 2021, almost 600 people lost their lives due to excessive drug use, which means the highest concentrated fatality in three months since these statistics are tracked.
fentanyl that kills
All the investigations and statistical crosses crossed by DOHMH coincide that since 2014, fentanyl, an opioid 50 to 100 times more potent than morphine, has fueled the dramatic increase in overdose deaths.
The opioid overdose epidemic in New York City persists despite ongoing efforts, including the availability of treatment services, interventions, and increased access to rescue emergency overdose with the drug naloxone.
In Numbers: Dying from an Overdose in NYC
- 596 deaths in New York City in the first quarter of 2021, this represents the highest number of overdose deaths in a single quarter since reporting began in 2000.
- 30.5% increased the overdose death rate per 100,000 New York City residents in 2020, compared to 21.9 in 2019.
- 85% of overdose deaths in 2020 were linked to opioid use.
- 77% of overdose deaths in 2020 for four years in a row, fentanyl has been the most common substance.
- 93% of overdoses were associated with heroin, 81% with cocaine, 80% with alcohol overdoses.
- 77% of overdoses caused by opioid analgesics and 66% of amphetamine overdoses.
- 38.2 per 100,000 residents of the Big Apple affected by overdose deaths were African American.
- 2019 to 2020 This was the period when overdose death rates increased among white New Yorkers (24.3 to 32.7 per 100,000 residents) and Latino New Yorkers (27.1 to 33.6 per 100,000 residents).
- 68.7 per 100,000 South Bronx residents the highest rate of death from drug use was concentrated in the city.