Advocates of so-called safe-injection sites are seizing on a new study that finds crime has apparently not increased in East Harlem and Washington Heights neighborhoods featuring overdose-prevention centers. The decline in arrests is welcome news, of course, but not necessarily proof that crime has lessened; the study found a rise in 311 calls about drug activity, for example. What’s more, the fact that arrests have gone down doesn’t prove that the safe-injection sites, which remain illegal under federal law, are the cause.

This first serious study of “harm reduction” experiments falls short for other reasons. It does not address key questions about the long-term effects of these sites on addicts, on overdose deaths, and on social norms. Until we know more, we should remain skeptical that they are good for neighborhoods or the city.

OnPoint NYC, which operates the facilities, claims to have prevented some 1,100 overdose deaths since it opened its doors in November 2021. But administering naloxone to an addict whose heroin has been spiked with fentanyl does not tell us anything about the fate of that addict over time—“longitudinally,” as the social scientists say. Do these addicts go on to seek treatment? Do they recover? Do they get jobs? Or do they just die somewhere else? Unless the harm-reduction crowd can find ways to answer these questions, we will have no clear idea about the value of the sites.

Beyond questions about outcomes for individual drug users at these sites, what effect does harm reduction have on overdose deaths citywide? Harm-reduction advocates have good reason to be cautious. Safe-injection sites have legally operated in Vancouver since 2003, yet overdose deaths there are soaring. In July, CBC News reported that British Columbia had set a dubious new record, with 1,455 overdose deaths in the first seven months of the year. More than 190 BC residents per month overdosed for 13 consecutive months. Most who did so lived in Vancouver, a city with a population of about 675,000. Unless overdoses decline not just in the safe houses but citywide, how can harm-reduction advocates claim success?

Nor can one minimize the study’s findings of increased 311 calls in and around the OnPoint NYC sites. Even if crime around the sites has declined, neighborhoods are right to be concerned. The sites do more than serve addicts; they broadcast the message that using hard drugs is normal. Children stepping over syringes on the sidewalks understand that the city is acquiescing to addiction. It’s no wonder that in Philadelphia, which has seen a concerted campaign to open a safe-injection site in its Kensington neighborhood, a city council member led a charge to ban such sites citywide—a policy the council approved in September.

Before the hearing, District 7 councilwoman Quetcy Lozada, who introduced the legislation in May, addressed the public outside of City Hall with a group of councilmembers standing behind her. “It is not fair to the children in that community to have to walk by what they walk by every day,” she said, stressing her commitment to “finding real solutions” for those suffering from addiction, and to “a better quality of life to the Kensington-Harrowgate community.”

Oregon residents, too, have discovered that accepting the use of hard drugs is no answer. The state legislature there voted to decriminalize hard drugs in 2020 and to replace arrests with traffic-ticket-like citations and referral to a treatment program. The Wall Street Journal reports that police have issued some 6,000 tickets for drug possession, but that only 92 drug users have sought treatment. The streets in Portland remain filled with homeless addicts. Repeal of the decriminalization law seems likely.

It’s easy to take a snapshot of the OnPoint NYC harm-reduction sites and assert that they are effective in preventing overdoses when drug use is supervised by a nurse or doctor. But the true metric of success for any drug policy should be addicts recovering and overdoses declining citywide. If we continue to send the message that illegal drug use is a manageable habit, we will put future generations at risk.

Photo by Spencer Platt/Getty Images


City Journal is a publication of the Manhattan Institute for Policy Research (MI), a leading free-market think tank. Are you interested in supporting the magazine? As a 501(c)(3) nonprofit, donations in support of MI and City Journal are fully tax-deductible as provided by law (EIN #13-2912529).

Further Reading

Up Next