De Blasio moves to bring safe injection sites to New York City

The endorsement of the strategy by New York, the largest city in the country, which last year saw 1,441 overdose deaths, may give the movement behind it impetus.

For the sites to open, New York City must still clear some significant hurdles. At a minimum, the plan calls for the support of several district attorneys, and, more critically, the state health department, which answers to Gov. Andrew M. Cuomo. The city sent a letter Thursday to the state, asserting its intention to open four injection centers.

Although Cuomo and de Blasio are Democrats, they have engaged in a yearslong feud that has seen few examples of cooperation. Cuomo, who is facing an energetic primary challenge from Cynthia Nixon, has not said whether he supports injection sites, a popular cause among more left-leaning Democrats.

The plan calls for four sites to open after a 6- to 12-month period of outreach to the communities where they will be located. They would operate as pilot programs for a year.

At the sites, which would be called Overdose Prevention Centers, trained staff would be available to administer medications, such as naloxone, to counteract drug overdoses. Social workers would also be on hand to possibly counsel drug users in the hope that they could be steered into programs intended to help them with their addiction.

The sites would be financed and run by nonprofit groups authorized by the city, and may be located within social service providers that already operate needle exchange sites.

The mayor’s office said that the centers would be located in Washington Heights and Midtown West in Manhattan; the Longwood section of the Bronx; and Gowanus, Brooklyn.

“After a rigorous review of similar efforts across the world, and after careful consideration of public health and safety expert views, we believe overdose prevention centers will save lives and get more New Yorkers into the treatment they need to beat this deadly addiction,” de Blasio said in a statement.

De Blasio has faced pressure from activist groups who support safe injection sites, and who have staged demonstrations at City Hall that have included civil disobedience, with numerous protesters, including City Council members, arrested.

But even as the mayor unveiled his plan, he seemed to be doing so at arm’s length. On Thursday morning, he held a news conference on the sunny Brooklyn waterfront to discuss ferry service, with no mention of the injection sites.

City Hall officials refused to make de Blasio available for an interview; the earliest he could answer questions about the plan would be Friday, in his weekly appearance on New York Public Radio.

The plan is based on a report commissioned in 2016 by the City Council and pushed by the Council speaker, Corey Johnson, when he was chairman of the health committee. The report was completed months ago but its release was delayed by City Hall as the mayor weighed his decision.

“This is ultimately about saving lives while we have a major opioid crisis in New York City and around the country,” Johnson said Thursday, after speaking with de Blasio about the proposal.

The letter sent on Thursday from Deputy Mayor Herminia Palacio to Howard A. Zucker, the state health commissioner, asked him to authorize or license four injection sites. The letter said that Zucker had the authority to permit such sites if they were part of a “research study.”

“You are authorized to license research studies that may include the possession of controlled substances,” the letter said. It cited as a precedent the authorization by the state health commissioner of needle exchanges in the early 1990s. Those exchanges began as an effort to halt the spread of HIV among drug users who shared needles.

The state health department said it would review the city’s request. “We of course support the mission of reducing opioid-related deaths and have been studying multiple options for combating the opioid epidemic,” Gary Holmes, a spokesman, said in an emailed statement.

The most serious obstacle to the safe injection sites may be the federal government. A section of federal law known as the crack house statute makes it illegal to own, rent or operate a location for the purpose of unlawfully using a controlled substance.

The enforcement of the statute in the case of safe injection sites, however, would be up to the discretion of federal authorities. While it is unclear how the Trump Justice Department will respond to the city’s proposal, Attorney General Jeff Sessions has taken a hard line on drug policy.

“We don’t believe a president who has routinely voiced concern about the national opioid epidemic will use finite federal law enforcement resources to prevent New York City from saving lives,” Eric F. Phillips, the mayor’s press secretary, said in a written statement.

Advocates for the sites point out that needle exchanges were considered illegal when they began, and they are now commonplace; in 2015, for example, when Mike Pence was governor of Indiana, he put aside his moral opposition to needle exchanges and allowed a program to stem the flood of HIV cases.

There were 1,441 drug overdose deaths in New York City last year, according to a study commissioned by the City Council, an increase from 1,374 deaths in 2016. Officials have said that more people die of overdoses in New York than the combined total of deaths by murder, suicide and vehicle crashes. In data for the first nine months of 2017, Brooklyn, the most populous borough, had the greatest number of overdose deaths with 260. The Bronx, with a smaller population, was second with 250.

The Bronx and Staten Island have the highest rate of overdose deaths. In 2016, the Bronx saw 32 overdose deaths per 100,000 residents, and Staten Island had 30 deaths per 100,000.

Eric Gonzalez and Cyrus R. Vance Jr., the district attorneys for Brooklyn and Manhattan, said they supported the mayor’s plan. Darcel D. Clark, the Bronx district attorney, said that she was “open-minded on the matter” and needed more information to draw a conclusion.

San Francisco may be on track to be the first U.S. city to open a safe injection site. Rachael Kagan, a spokeswoman for the San Francisco Department of Public Health, said that officials expected to open two centers in the late summer or the fall — although officials there had previously said they hoped to open them by July. She said officials were “addressing the legal and siting issues.”

Philadelphia announced in January it expected to open sites within 18 months.

This article originally appeared in The New York Times.

De Blasio moves to bring safe injection sites to New York City

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