Safe Injection Sites in New York

By: Laura Jaramillo

Over-prescription of opioids has incited heroin addiction in many people (NIH). While attempts at regulating opioid prescription have been implemented through guidelines (CDC), and reducing addiction has been encouraged through rehab, opioids continue to claim around 130 lives every day (CDC). Those inflicted by the addictive substance struggle to escape the crisis. But the crisis also has rippling effects, impacting not only the health of communities through the presence of, for example, infected needles, but also the economy (Bendix). In fact, almost 1 trillion dollars of the economy are spent on costs related to the opioid crisis (Wright).

An opioid is a substance whose chemical make-up allows it to attach to opioid receptors which helps block pain messages from the body (ASAHQ). While the body contains natural chemicals, such as endorphins, that contribute to the reduction of pain (Froehlich), constant use of opioids leads the body to stop creating its own endorphins, This causes the person to rely on prescribed opioids (Family Doctor). In 1991, deaths involving opioids in the United States began to increase rapidly following a spike in the prescriptions of opioids (Poison Control). Such a spike in prescription was influenced by pharmaceutical false advertising that marketed the drug as a nonaddictive painkiller for all types of pain (Wright). Eventually, in 2010, as addiction rates continued to soar, efforts to limit prescriptions were voiced. However, making the acquisition of prescribed opioids harder resulted in many who suffered from addiction to turn to heroin, a cheap and widely available illegal opioid (Poison Control). As doctors continue to overprescribe opioids and typical rehab methods seem to result in relapses or incomplete treatments (American Addiction Centers), addiction rates continue to increase and current policies and programs don’t appear to be slowing them down (CDC).

However, New York has recently taken a very controversial, and what some might call extreme, approach to handling the opioid crisis. On November 30, 2021, New York authorized two supervised injection sites, becoming the first city in the United States to authorize such sites (Mays et al., 2021). The basic idea behind it is that drug users can safely use drugs under supervision; clean needles are provided, trained providers are onsite to deliver naloxone if needed, and options for addiction treatment are available (Mays et al., 2021).

One big fear associated with this decision is the effect it will have on the surrounding community; more specifically, whether this will attract crime. However, a systematic review of similar sites found that while overdoses were reduced, there was no increase in crime or nuisance activities (Mays et al., 2021). Better yet, it was found that safe injection site areas were associated with reduced levels of public drug injections and dropped syringes (Potier et. al, 2014). Lastly, people were more likely to initiate detoxing due to feeling welcomed and safe rather than judged and forced into rehab (Gordon).

So far, a two-month study has already been conducted on the injection sites in New York. “Between November 30, 2021 and January 31, 2022, 613 individuals used OPC services 5975 times across 2 sites” and there were no fatal overdoses (Harocopos et. al, 2022). In a self-report, 75.9% reported that without the site, they would have used their drugs in a public/semi-public location (Harocopos et. al, 2022). And last, but not least, over 50% of users have received “additional support such as naloxone distribution, counseling, hepatitis C testing, medical care”, and other holistic services (Harocopos et. al, 2022). While much more time and data is needed to reach a strong conclusion, preliminary results indicate that these safe injection sites could benefit various stakeholders and address a big public health problem that only seems to be growing.

Reference List:

Bendix, Aria. “San Francisco's Dirtiest Street Has an Outdoor Drug Market,

Discarded Heroin Needles, and Piles of Poop on the Sidewalk.” Business Insider, Business Insider, 19 Sept. 2019, www.businessinsider.com/san-franciscos-dirtiest-street-has-a-drug-market-and-piles-of-poop-2018-10.

Harocopos, A., Gibson, B. E., Saha, N., McRae, M. T., See, K., Rivera, S., & Chokshi, D. A. (2022, July 1). First 2 months of operation at first publicly recognized overdose prevention centers in US. JAMA network open. Retrieved September 19, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9287749/

“How Naloxone Saves Lives in Opioid Overdose.” MedlinePlus, U.S. National Library of Medicine, 3 Apr. 2019, medlineplus.gov/medlineplus-videos/how-naloxone-saves-lives-in-opioid-overdose/.

Mays, J. C., & Newman, A. (2021, November 30). Nation's first supervised drug-injection sites open in New York. The New York Times. Retrieved September 19, 2022, from https://www.nytimes.com/2021/11/30/nyregion/supervised-injection-sites-nyc.html

Potier C, Laprévote V, Dubois-Arber F, Cottencin O, Rolland B. Supervised injection services: what has been demonstrated? A systematic literature review. Drug

Alcohol Depend. 2014 Dec 1;145:48-68. doi: 10.1016/j.drugalcdep.2014.10.012. Epub 2014 Oct 23. PMID: 25456324.

Staff, Familydoctor.org Editorial. “Opioid Addiction - Pain Relief - Signs ofAddiction.” Familydoctor.org, 26 Feb. 2019,familydoctor.org/condition/opioid-addiction/.

“What Are Opioids? – When Seconds Count.” When Seconds Count | Anesthesia, Pain Management & Surgery, https://www.asahq.org/whensecondscount/pain

management/opioid-treatment/what-are-opioids/