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POLITICO: Council, de Blasio administration to study supervised injection facilities

September 28, 2016

By DAN GOLDBERG and GLORIA PAZMINO
September 28, 2016

The New York City Council on Wednesday is expected to allocate $100,000 to the city’s health department to study supervised injection facilities, a controversial program that provides intravenous drug users a place to get high while under medical supervision.

“The Council’s new supervised injection impact study will assess the feasibility and impact of New York City having a program that provides a safe, clean haven to high-risk, vulnerable New Yorkers and will help prevent drug overdoses and disease transmissions,” Speaker Melissa Mark-Viverito said Tuesday.

The money comes from a $5.6 million pot of funding in the city’s most recent budget that was targeted toward ending the AIDS epidemic, which is also a top priority for Gov. Andrew Cuomo. The governor has promised to reduce the number of new HIV infections to below 750 by the end of the decade.

“Harm reduction is a critical tenet in the New York State plan to end AIDS,” Councilman Corey Johnson, chair of the health committee, said in a statement. “Supervised injection facilities around the world have been shown to reduce healthcare costs, decrease HIV and hepatitis B and C infection rates and prevent fatal overdoses. With the creation of this study, the Council is continuing our history of leading on innovative strategies to end the epidemic and address drug abuse.”

Health department officials have been meeting with various interest groups for the past few months to discuss the feasibility of an idea certain to encourage strong reactions from both supporters and detractors.

Hillary Kunins, an assistant commissioner in charge of the health department’s Bureau of Alcohol and Drug Use Prevention, Care and Treatment, has been involved in the discussions and is expected to lead the study.

There are currently no supervised injection facilities in the United States, though the model is common in Europe and Canada. A 2011 study in The Lancet found that the overdose rate in the immediate vicinity of Vancouver decreased by 35 percent.

Among American cities, only Seattle has taken steps to implement the idea.

But the discussion is not foreign to New York. It was one year ago this week that drug policy and homeless advocates gathered outside Manhattan’s Unitarian Church of All Souls to call for supervised injection sites.

In February, Ithaca Mayor Svante Myrick unveiled a plan for a supervised injection facility, drawing immediate condemnation from state legislators and academics who warned the idea would be akin to a government blessing for injection drug users.

Cuomo has never offered a public opinion on supervised injection facilities but a taskforce he commissioned recommended the idea as one that would help end the AIDS epidemic, and Cuomo has enthusiastically supported those blueprint recommendations.

The news comes the same day as advocates from across the country meet in Baltimore to discuss ways to push supervised injection facilities on to the public agenda, and as a growing number of cities, in an effort to deal with the nation’s opioid crisis, are experimenting with safe spaces for drug users.

Boston has Supportive Place for Observation and Treatment, or SPOT. And in New Hampshire, Manchester Mayor Ted Gatsas, a Republican running for governor, has turned firehouses into recovery rooms.

What New York City is exploring would go a step further, allowing drug users to possess a certain amount of heroin, or other drugs, and inject on premise. The idea being that addicts are less likely to overdose when supervised and more receptive to treatment options.

Advocates also point out that these facilities reduce the odds of needles being shared among intravenous drug users, limit the interaction between addicts and the criminal justice system and connect people to mental health services.

“The step that the City Council is taking is incredibly important,” said Matt Curtis, policy director for VOCAL-NY. “As much as this action is timely and important, we just can’t wait. People are dying every day.”

Heroin and fentanyl related deaths increased 17 percent in New York City in 2015, the fifth consecutive yearly increase, according to the latest statistics from the city’s health department.

Studying the possibility is a long way from implementing a program and there are some obvious hurdles public health officials would need to overcome.

Drug possession is a state and federal crime, and while the U.S. Justice Department has been amenable to overlooking states implementing medical marijuana programs, heroin, which has no medical purpose, might give the federal government more pause. Further, an Obama Justice Department might have a different take than a Hillary Clinton Justice Department and would almost certainly have a different take than a Donald Trump Justice Department.

Presumably, the NYPD would have to give at least tacit approval. A spokesman for the department did not respond to a request for comment.

Physicians would almost certainly need some kind of protection from liability and from the federal government.

Finally, there is a question of space. Where exactly would this facility exist? A private landlord might be wary, and neighbors might object. Insurance would undoubtedly be hard to come by. A city-run building would be logistically easier but that would mean the city would be responsible for operating the program as opposed to tacitly allowing one.

These are real but not insurmountable challenges, Curtis said, and are worth tackling to connect people who have been traditionally marginalized to care.

“Getting beyond the epidemiologic rationale, this represents the kind of caring city we want to live in,” he said.

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