Overdose prevention centers, where people with substance use disorder consume illicit drugs under supervision, keep people alive and prevent them from using drugs in public, those involved in a New York City program say. Still, supervised drug use remains in a legal gray zone, holding back its widespread implementation, officials from the city’s Department of Health and Mental Hygiene and representatives of OnPoint NYC, which runs the sites, wrote in a study published in the NEJM Catalyst this week. Why it matters: The U.S. has reported record levels of fatal overdoses in recent years, driven by illicit fentanyl, a powerful synthetic opioid. New York City is no exception. More than 3,000 people died of an overdose in 2022, the highest number since the city started reporting such cases in 2000, according to the study authors. Older New Yorkers, Black and Latino residents, people experiencing homelessness and residents of high-poverty neighborhoods are the most affected. OnPoint NYC, a nonprofit, opened two overdose prevention sites in Washington Heights and East Harlem on Nov. 30, 2021. They are the first government-supported centers for supervised use of illicit substances in the U.S., the authors write. New York City finances some services like prevention, risk reduction and counseling. But it doesn’t finance direct supervised consumption since it’s illegal. Private donations fund that service. The results: In the year after the two sites opened, more than 2,800 people used their services some 48,500 times — a heavy usage rate, the authors write. The users — mostly middle-aged Latino men — are homeless or have unstable housing. That, together with their higher exposure to the criminal justice system and a lack of resources, puts them at higher risk of an overdose than users in less precarious situations, according to the New York City health department and OnPoint representatives. Staff had to intervene to reverse an overdose during about 1 percent of the visits — 636 — while emergency services were called just 23 times. That likely saved the city’s emergency health services money since the base cost per transport is estimated at around $900, according to the study authors. No overdose deaths occurred at the sites. Most participants reported during their visits that they would have otherwise used drugs in public, which can increase the risk of a fatal overdose or lead to arrests and pushback from people in the area. Visits to overdose prevention centers avoided nearly 40,000 instances of public drug use and potentially nearly 20,000 syringes being improperly discarded, wrote the city health department and OnPoint representatives. Most visitors also accessed meals, laundry and medical services through OnPoint. What’s next? Despite the benefits the proponents found for people at risk of a fatal overdose and communities, the sites typically can’t receive public funding. They’re also hampered by legal barriers and stigma from the community toward such sites and their users. The federal government is funding a study on the centers over the next three years.
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