With about a month left in office, Mayor Bill de Blasio of New York announced the opening of the first two sanctioned safe consumption facilities in the country, designated places where people who are addicted to opioids can inject illegal drugs like heroin and fentanyl under medical supervision. For such a controversial move, it was done quietly. But make no mistake: De Blasio’s step is a major milestone in the fight against the opioid epidemic, which has continued to rage in the shadows of the COVID-19 pandemic.
Authorizing the sites took some political courage, because they are of uncertain legality, and there are many moral arguments against them; critics often argue that safe consumption sites only encourage individuals to use drugs. The federal government blocked an earlier effort to open a safe injection site in Philadelphia. By reviving the idea, de Blasio is leading the way for other mayors to follow, and Boston Mayor Michelle Wu should be next.
More than 100,000 Americans died of drug overdoses in the first year of COVID-19, from April of 2020 to April 2021. That’s a record high: about 273 fatalities a day. Similarly, 2020 was the deadliest year on record for drug overdoses in New York; over 2,000 individuals died there last year. According to New York officials, that is a toll larger than deaths due to homicides, suicides, and motor vehicle crashes combined.
Locally, the picture is just as grim: Opioid-related overdose deaths increased by 5 percent statewide last year. And Boston recorded a notable increase from 2019 to 2020 as well: The number of overdose deaths that occurred in the city jumped 20 percent, per the latest state report.
Clearly, we’re losing ground in the fight against opioid deaths. To save lives, harm reduction strategies like needle exchanges and supervised injection sites must be part of the solution. At supervised sites, personnel can respond quickly to overdoses. Consider the limited but compelling data we have from the New York centers. During the first two weeks of operation, staff at the two facilities, in East Harlem and Washington Heights, have reversed 36 overdoses, according to media reports.
The New York facilities previously operated as needle exchanges before becoming medical-consumption sites. The evidence from harm reduction approaches is overwhelmingly positive. “Nearly 30 years of research has shown that comprehensive [syringe services programs] are safe, effective, and cost-saving, do not increase illegal drug use or crime, and play an important role in reducing the transmission of viral hepatitis, HIV, and other infections,” according to the Centers for Disease Control and Prevention. There are more than 120 supervised consumption sites operating in Canada, Australia, and Europe. A new review of these sites, published last month, found that “for people who inject drugs, supervised injection facilities may reduce the risk of overdose morbidity and mortality and improve access to care while not increasing crime or public nuisance to the surrounding community.”
In the United States, as of today, only New Yorkers have access to such facilities. “These centers in New York City . . . are the same places that do needle exchange,” said de Blasio during an appearance on MSNBC’s “Morning Joe.” “We had the same debate decades ago about needle exchange. . . . Folks said, how on earth are we going to give someone a needle? Because it saved lives on a huge level.”
De Blasio is right. It’s time to follow the science and move past the stigma that safe injection sites carry. During the mayoral campaign, Wu said she supports taking every step to save lives in the opioid crisis and establishing such a site. She should make Boston the next American city to open a safe injection center. It will unquestionably save lives. What are we waiting for?
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