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“Safe consumption” sites need far more scrutiny. September 30, 2022
Politics and law
The Social Order

The supervised drug-injection nonprofit OnPointNYC, which runs city-authorized sites in East Harlem and Washington Heights, trumpeted its first-year results last week, claiming 500 lives saved from street-drug overdoses. Now that the Justice Department is weighing whether to permit other such establishments—drug czar Rahul Gupta has already signaled his support for the idea of “safe consumption”—it’s crucial that the impact of these two sites, the first in the nation, be examined.

No one argues that addicts dying from overdoses is not bad news. If such sites help save lives, the people spared may go on to better choices and spare their families grief.

But the OnPointNYC sites require far more scrutiny. Credit to CBS2 New York reporter Jessi Mitchell for pressing OnPointNYC executive director Sam Rivera on exactly this point last week. “How are you tracking the actual reduction of drug use?” he asked. Rivera’s response revealed how limited the evaluation of the site has been so far. “That’s difficult. It really is. It’s a challenge. So for us, it’s anecdotal,” he said. That’s simply not good enough for what advocates are touting as a potential nationwide model.

A serious evaluation of the program would include figures on drug use and overdoses in the immediate area and citywide, since the sites signal to the community that drug use is tolerated. We would need to follow the lives of all those who use the site: 1,700 over the past year. How many have quit drugs? Gotten jobs? Do they pay child support? If we really want to know whether such sites “work,” we would need to gather as much personal information as possible on the drug users who frequent them.

We would also need to consider the effects of safe-injection sites on the quality of life in surrounding neighborhoods. Washington Heights resident Led Black told CBS of increased drug use in and around Fort Washington Park, including at a 179th Street sidewalk encampment and a subway tunnel that has required multiple syringe clean-ups. “My question is harm reduction for who?’” said Black. “Is it only about drug addicts not dying? But what about our community dying?”

It’s just these sorts of questions that prompted no less a liberal than California governor Gavin Newsom last month to veto a bill that would have legalized safe-injection sites in that state. The approach, he said, lacked “well-documented, vetted, and thoughtful operational and sustainability plans.” The sites could, he added, lead to a “world of unintended consequences.”

“We know that people change sometimes through environments, through access, through believing they’re cared for in different ways,” Rivera told CBS. This view sums up the problem with advocacy of safe-consumption sites: their effectiveness is an article of faith for proponents. But that faith overlooks the possibility that this de facto legalization of street-drug use will indeed lead to a world of unintended consequences: an even larger flow of fentanyl across U.S. borders; syringes scattered on the sidewalks that kids use to walk to school; and addicts encouraged to use, not to reform.

A powerful signaling effect is at work here—a signal of defeatism. The city health department, which has authorized and promoted the safe-consumption sites, is telling us that drug use can be a “safe,” or at least low-risk, choice. These sites, along with marijuana legalization, put young lives at risk by delivering a message that no public-health authority should send.

Philadelphia is currently negotiating with the Justice Department to determine whether drug law can be interpreted to permit it to open a long-planned safe-consumption site. (The Trump administration had vigorously opposed such sites, winning a major court case against them last year. The fact that the Biden Justice Department has permitted the OnPointNYC sites to operate freely, in violation of federal controlled-substance law and without serious ongoing program evaluation, is hardly a good sign.) The Justice Department’s decision, which could come soon, will be another signal—this one regarding whether “safe consumption,” like pot legalization, will sweep the nation without caution and scrutiny.

Photo by Kent Nishimura / Los Angeles Times via Getty Images

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