New York, NY: In response to New York State's overdose epidemic, Assemblymember Linda B. Rosenthal (D/WF-Manhattan) introduced legislation authorizing safer consumption spaces as an emergency public health tool to combat overdose deaths. Safer consumption spaces (SCS), also called supervised injection facilities (SIF), are facilities where people can legally consume previously purchased illicit drugs with supervision from trained staff who help make their use safer, respond immediately to overdoses, and connect them with medical care, drug treatment, and social services.
The bill creates a framework for supervised consumption spaces to operate, which would likely be sited within existing syringe exchange programs, which would integrate supervised consumption services into their operations. It also requires an evaluation of the efficacy of the services, and would provide legal protections for the programs and participants and allow local jurisdictions to choose to permit a safer consumption space.
The legislation is supported by a broad coalition of healthcare professionals, public health experts, advocates, elected officials and people with a history of drug use who want to ensure that New York is using every approach possible to save lives amid the overdose crisis that is on track to surpass all previous records for overdose deaths this year.
Supervised consumption spaces are designed to reduce the health and societal problems associated with drug use. Such facilities provide sterile injection equipment, information about reducing the harms of drugs, health care, treatment referrals, and access to medical staff. Some offer counseling, drug treatment, and other services. Extensive research on these facilities consistently demonstrates a variety of cost-saving public health benefits including reducing public nuisance associated with illicit drug use, such as public drug use and improper syringe disposal; reducing overdose deaths; increasing access to drug treatment; and reducing risk behaviors for Hepatitis C and HIV.
“Overdose deaths as a result of opioid use continue to increase despite our best efforts. When our success is measured in lives lost, it’s vital that we use every harm reduction tool at our disposal to prevent overdoses and help save lives. Safer consumption sites work in hundreds of other cities across the world, and if we are serious about reducing overdoses and helping people into recovery, then we have a responsibility to explore SIFs here in New York,” said Assemblymember Linda B. Rosenthal (D/WF-Manhattan), Chair of the Assembly Committee on Alcoholism and Drug Abuse.
Nearly 100 safer consumption spaces exist around the world, with millions of injections having taken place at some of them. Yet, not one overdose death has been documented in these facilities.
"Our health care system has struggled to reach people who use drugs; we often see people only after they've contracted HIV or Hepatitis C, or nearly died from an overdose. We cannot continue to promote a health care model that neglects people until they hit rock-bottom, which too often means an overdose death in a public restroom or abandoned building," said Dr. Jonathan Giftos, a Clinical Instructor of Medicine at Albert Einstein College of Medicine, where he provides clinical care for justice-involved patients with opioid use disorders. "Instead, we must invest in a continuum of harm reduction services that help people out of the shadows.Safer consumption spacesmeet people where they are at in their drug use with the goal of keeping them safe. They represent a compassionate, evidence-based approach to reduce the harms of drug use that helps people to feel safe, supported and cared for in order to engage in the challenging road to drug treatment and recovery."
“The New York Academy of Medicine sees SIFs as a promising strategy moving forward to reduce overdose deaths and to engage injection drug users in health care and drug treatment services,” said Peter Schafer, Acting Director, Center for Health Policy and Programs, The New York Academy of Medicine.
“Safer Consumption Spaces are a vital Harm Reduction tool we are missing in our work in NY. If we truly want to reduce overdose deaths and create more empowered, healthy communities, we can no longer ignore the success SIF/SCS have had across the globe and include them in our efforts to make our most vulnerable communities safer,” said Jose M. Davila, President and CEO, BOOM!Health.
"If we genuinely care about the lives of people who use drugs, our children, our friends, we will provide safe consumption spaces where overdose deaths can be prevented throughout upstate New York. It really is just that simple. The research and data is in, these sites improve the public health and prevent needless deaths throughout the world and have for decades. We must stop punishing people, it accomplishes nothing. We must get our hands dirty and join them on their journey to wellness. We know how to help, we need only develop the political will to do what is necessary. Our common humanity demands it," said John Barry, Executive Director of the Southern Tier AIDS Program.
"I want to thank Assemblymember Rosenthal for introducing this legislation. I urge all elected officials to realize this is a moral issue, not a political one. People are dying. Safer consumption spaces have proven to work around the world. The only reason a politician would not support their creation would be for political reasons or a lack of understanding. To those who have questions, we are happy to answer them. To those who will oppose, know that more will die due to your inaction," said Shantae Owens, a leader of VOCAL-NY, who spent most of the 1990s homeless and injecting in public spaces.
“We should explore all types of services and programs for people who use substances in our community,” said Emma Fabian, Director of Substance User Health Policy “Treating people with dignity and respect should lead our conversations as we explore alternative approaches that maybe beneficial for the communities we serve.”
“If an opportunity arises for ACR Health to expand our vital, life-saving services, we will seriously consider the needs of the community and our capacity to respond. Opening a Supervised Injection Facility would be in line with our public health approach, said Julia LaVere, Director of Syringe Exchange Programs at ACR Health.
“A wave of overdose deaths has hit New York and in the last year alone the lives affected has increased by 50%. Supervised consumption sites can begin to address this epidemic immediately. We have seen the evidence that sites like this work and in places like Switzerland, Germany, Australia and Canada evidence shows they save health care systems money,” said Liz Evans, former Founding Director of Vancouver’s Insite and current Executive Director of New York Harm Reduction Educators. “Millions of injections have taken place in these sites and no one has ever died. Instead people have found access to health care, support and hope. Supervised consumption sites save lives.”
“New York is in a unique position to step up and implement comprehensive, innovative, and forward-thinking approaches like safer consumption spaces, an evidence-based solution that can help dramatically in saving lives, reducing criminalization, and improving public health,” said Kassandra Frederique, New York state director at the Drug Policy Alliance. “New York previously led the nation in implementing groundbreaking drug policies rooted in science, compassion, and public health as we did with syringe exchanges. We can no longer afford to let fear and stigma stand in the way of saving lives.”
This week the American Medical Association (AMA) voted to support the development of pilot safer consumption spaces. The New York Academy of Medicine and Massachusetts Medical Society also both publicly support safer consumption spaces, and the Journal of the American Medical Association recently published a review of research supporting safer consumption spaces. In April, more than 100 New York City healthcare professionals signed an open letter in support of safer consumption spaces, urging elected representatives to adopt them as a public health intervention to prevent overdose deaths.
Nationally, there were 500,000 opioid-related deaths between 2000 and 2015. In 2015, opioid and heroin overdoses killed 52,404 people across the country–more people than traffic accidents and homicides combined. Despite increased spending on treatment, in New York State deaths from drug overdoses increased 71 percent between 2010 and 2015. New York City saw more than 1,300 overdose deaths in 2016 alone–a 46 percent increase from 2015. The overdose rate among Black New Yorkers increased by 80 percent.
While safer consumption spaces do not yet exist in the United States, there is tremendous interest in opening safer spaces across the nation. California legislators passed a Supervised Consumption Services Bill in the state Assembly earlier this month and similar legislation has been introduced in Maryland, Vermont, and Massachusetts. Kings County in Washington State has approved opening the nation’s first SCS and is in the process of opening sites, and both Ithaca, NY and New York City are studying potential implementation.
As stakeholders around the state are demanding that we prioritize saving lives and recognize that “we can’t arrest our way out of this problem,” New York State must continue to shift its approach away from the failed policies of the war on drugs to evidence-based drug policies, such as safer consumption spaces, that prioritize public health over costly criminal justice strategies that produce disastrous health outcomes and major racial disparities in law enforcement. Supervised consumption spaces are an essential component of a continuum of care for people who use drugs and must be considered alongside other harm reduction tools and resources.