New York City Is Funding America's First Official Safe Injection Site for Drug Users

As the U.S. reaches new terrible milestones in overdose deaths, a harm reduction system that has proven itself elsewhere finally launches where it’s needed most.

New York City is giving its blessing to safe consumption sites where intravenous drug users will be able to inject without fear of arrest and with the knowledge that medical professionals will respond in cases of overdose. These sites will be the first publicly funded facilities of their kind to operate in the United States. 

Outgoing Mayor Bill de Blasio and the city's Health Department announced the move this morning. The consumption sites will be found at locations where needle exchange services are already provided by nonprofit groups. Sites in East Harlem and Washington Heights are set to open their doors to users as early as today. They will provide clean needles to users while staff will be on hand to administer naloxone, a drug used to reverse opioid overdoses. Users will have to provide their own illegal drugs.

New York City will not be running the consumption centers. Instead, the two nonprofits who currently run the needle injection programs have joined up to form an organization named OnPoint NYC, which will also run the safe consumption sites. These nonprofits receive city funding.

Safe consumption sites (also called safe injection sites) have been operating in Canada and Australia for years. While New York City will be the first U.S. city to offer these services, San Francisco, Seattle, and Philadelphia also have plans in the works. All of these cities have seen increasing rates of public use of injected drugs such as heroin, as well as high rates of overdoses and overdose deaths. New York City reported more than 2,000 drug overdose deaths in 2020. The United States as a whole has also seen a record number of overdose deaths—more than 93,000 for 2020.

Given such numbers, safe consumption sites are a necessary and long-overdue harm reduction measure, properly focused on keeping drug users alive rather than on waging a punitive and failed drug war. The American Medical Association supports the use of safe consumption sites, noting earlier this year that not a single overdose death has been reported in the 120 safe consumption sites operating elsewhere in the world. That is precisely because health professionals at those sites are prepared to respond to emergencies.

Unfortunately, U.S. drug laws have made it difficult to open similar sites here. Section 856 of the federal Controlled Substances Act makes it a felony to knowingly allow a space to be used for the purpose of consuming drugs. This law was crafted in 1986 to shut down so-called "crack houses," but when Philadelphia allowed nonprofit Safehouse to open a safe consumption site in that city in 2019, U.S. Attorney William McSwain of the Eastern District of Philadelphia invoked federal law to stop the site from opening. Judge Gerald Austin McHugh of the U.S. District Court for the Eastern District of Pennsylvania initially took Safehouse's side and said the text of Section 856 did not forbid city-approved, medically monitored consumption sites. But that ruling was reversed by the U.S. Court of Appeals for the 3rd Circuit, which held that federal law did prohibit sites like the one operated by Safehouse. In October, the U.S. Supreme Court declined to take up the case. The Safehouse site has not opened.

So while New York City is now funding safe injection sites (incoming mayor Eric Adams is on the record supporting them) there's still the question of what the federal government might do in response. The New York Times reports that while the Biden administration has taken a position in support of harm reduction methods to prevent drug deaths, it has not endorsed safe injection sites. New York City Health Commissioner Dave Chokshi told the Times that the city has had "productive conversations" with the Biden administration and believes the federal government won't attempt to interfere.