With another year comes another opportunity for New York State to formally sanction and fund overdose prevention centers (OPCs), proven facilities that specialize in providing a place for people with substance abuse issues to test and use opioids and other drugs while being directed to services that can help them ultimately kick the habit.
For the past few years, two such centers have been run by the nonprofit OnPoint in Upper Manhattan with the blessing of NYC but not Albany, despite plenty of proof that the model works. With the state’s Opioid Settlement Advisory Board meeting last week to hash out recommendations for allocating tens of millions of dollars in settlement funds for opioid relief, the state’s recalcitrance keeps the option of funding OPCs off the table.
Officials point to the federal so-called “crack house” statute, which prohibits providing space for the use of illicit drugs. Yet the state’s ability to stretch the limits of the law with creative interpretations or pure bluster is well-established. Absolutely no lay person would imagine that laws permitting gambling on the premises of a few upstate casinos would authorize statewide mobile sports gambling just because the servers technically executing the transactions are located at the physical casinos themselves.
Marijuana, while now in the process of reclassification, remains a federally illegal drug, yet the state managed, like many others, to not only decriminalize the drug but create a regulated recreational market (which it’s done poorly, but that’s beyond the point). The state routinely blows legally-mandated deadlines and otherwise skirts around requirements when it is convenient for lawmakers and officials, yet in this case it’s an insurmountable obstacle, apparently.
In the meantime, opioid deaths in the state remain high, spiking again in the last year, with more than 3,400 reported overdoses across New York between May 2022 and 2023. The deadliness of the drugs obscures the extent to which overdoses are survivable; in fact, pretty much anyone overdose in progress can be reversed if opioid antagonists are administered immediately. That fact is driven home by the fact that, to date, not a single person has ever died after overdosing in an OPC, not here in our two centers in NYC, not in the pioneering Insite center in Canada, not at the longtime ones in Europe, not anywhere.
It comes down to timing. The second an overdose begins, a clock is ticking down to the user’s likely death. If a user is alone, that person probably is out of luck. Even if someone else is there, there needs to be an antagonist like naloxone at hand or immediately call 911, which must arrive quickly. An OPC, meanwhile, is structured such that it is almost impossible for much time to elapse between an overdose and the application of an antagonist.
Both some of the public perception and the federal law that ostracizes these centers are practically envisioning dirty, dangerous drug dens that will emanate crime and disorder. In reality, the OnPoint facilities are somewhere between halfway houses and clinics, with staff trained in medical practices and wraparound services offered to often grateful drug abusers. These are only one plank in the broader harm reduction and prevention strategy, but a crucial one. You cannot provide treatment or assistance to the dead.
