New York City Opens First Safe Consumption Sites For Illegal Drugs In The U.S.

New York City is officially the first jurisdiction in the U.S. to open safe consumption sites where people can use currently illicit drugs in a medically supervised environment and receive treatment resources.

It’s a harm reduction service that advocates have long argued could serve a critical role in reducing the overdose crisis. Other cities like Philadelphia and San Francisco have moved to allow safe consumption sites, but legal and political challenges have kept the facilities from opening.

The first two sites will begin operating on Tuesday, located at existing facilities that provide syringe exchange services, Mayor Bill de Blasio’s (D) office announced.

For more than 29 years, we have dedicated our lives to ending #overdose deaths & the criminalization & stigma associated with substance use. Being the 1st OPC site in the US is an honor & incredible step forward in ending the #overdosecrisis#wearethemedicine#THISSITESAVESLIVESpic.twitter.com/3NuuDCSh9C

— NYHRE (@NYHarmReduction) November 30, 2021

“New York City has led the nation’s battle against COVID-19, and the fight to keep our community safe doesn’t stop there. After exhaustive study, we know the right path forward to protect the most vulnerable people in our city. And we will not hesitate to take it,” de Blasio said in a press release.

“Overdose Prevention Centers are a safe and effective way to address the opioid crisis,” he said. “I’m proud to show cities in this country that after decades of failure, a smarter approach is possible.”

According to an @nycHealthy study, these sites could save 130 lives a year from overdose. During 2020, over 2,000 people died of a drug overdose in New York City, the highest number since reporting began in 2000. https://t.co/ieZozFxyqz

— Commissioner Dave A. Chokshi, MD (@NYCHealthCommr) November 30, 2021

What remains to be seen is how the federal Justice Department will approach the novel centers. Under the Trump administration in 2019, DOJ sued to block a Philadelphia non-profit, Safehouse, from opening a safe injection site. In October, the Supreme Court rejected a request to hear a case on the legality of establishing the facilities.

The current secretary of the U.S. Department of Health and Human Services (HHS), Xavier Bacerra, recently signaled that the Biden administration would not move to block the establishment safe injection sites, stressing that “we are literally trying to give users a lifeline.”

But a department spokesperson later walked those remarks back, stating that “HHS does not have a position on supervised consumption sites” and the “issue is a matter of ongoing litigation.” In any case, it would be up to DOJ to decide whether to pursue operators of the facilities under the Controlled Substances Act.

Bacerra was among eight top state law enforcement officials who filed an amicus brief in support of the Safehouse’s safe injection site plan when he served as California’s attorney general.

Advocates have put the current situation in no uncertain terms. They say the harm reduction centers could mean the difference between life and death for countless Americans who consume currently illegal drugs.

In New York City specifically, the health department conducted a feasibility study that found the safe consumption sites could save as many as 130 lives per year.

“The national overdose epidemic is a five-alarm fire in public health, and we have to tackle this crisis concurrently with our COVID fight,” Health Commissioner Dave Chokshi said. “Giving people a safe, supportive space will save lives and bring people in from the streets, improving life for everyone involved. Overdose prevention centers are a key part of broader harm reduction.”

The nonprofits New York Harm Reduction Educators and Washington Heights Corner Project will run the operations with plans to merge and expand under the name OnPoint NYC.

The national overdose epidemic is a five-alarm fire in public health, and we have to tackle this crisis concurrently with our #COVID19 fight. Giving people a safe, supportive space will save lives. Overdose prevention centers are a key part of broader harm reduction.

— Commissioner Dave A. Chokshi, MD (@NYCHealthCommr) November 30, 2021

The Biden administration has generally promoted the concept of harm reduction as part of its drug policy, but it hasn’t formally weighed in on safe consumption sites in particular.

Chokshi told The New York Times that he’s had “productive conversations” with state and federal officials and feels the New York City facilities will be permitted to operate based on “a shared sense of urgency” to curb the overdose crisis.

Manhattan District Attorney Cyrus Vance Jr., meanwhile, said that “we have always been trying to strike the right balance between enforcement, rehabilitation and prevention.”

“I would rather have people who are going to shoot up do it in a safe and secure venue as opposed to a McDonald’s bathroom, an alleyway or a subway staircase,” he said.

The legal complication for these harm reduction sites is principally related to a so-called federal “crack house statute” that makes it a felony to use a location for the manufacturing, distribution or consumption of controlled substances.

“We applaud Mayor de Blasio for showing leadership in fighting deadly overdoses in New York City by moving to establish Overdose Prevention Center pilots amid the worst-ever year for overdose deaths in New York,” Kassandra Frederique, executive director of the Drug Policy Alliance, said.

“While other politicians have pointed to the lack of clarity in the Department of Justice’s position on overdose prevention centers as an excuse for inaction, the Mayor has clearly stated that saving lives is more important to New York City,” she said.

Yes. It’s real. We’re finally doing it! https://t.co/uHEADWHYE3

— CORNER Project (@cornerproject) November 30, 2021

Michael Botticelli, the former director of the Office of National Drug Control Policy (ONDCP) under the Obama administration, told the Times that “many cities have been waiting for someone to go first, particularly to see what the federal Department of Justice reaction is going to be.”

“It’s hugely important, not just from a public health perspective but for other communities around the country that have been contemplating this to be able to point to New York City and say we are doing this in the United States,” Botticelli, who was in a position to provide guidance on these harm reduction issues while in office, said.

The current ONDCP head, Rahul Gupta, has faced criticism from advocates over his harm reduction record. As commissioner for the West Virginia Department of Health and Human Resources Bureau for Public Health, he oversaw the decertification of a syringe access program that was designed to mitigate the spread of diseases like HIV and offer resources to people with substance misuse disorders.

As the national conversation around drug policy and substance misuse continues to evolve, support for harm reduction centers has expanded outside of traditional advocacy circles.

A coalition of 80 current and former prosecutors and law enforcement officials—including one who is Biden’s pick for U.S. attorney of Massachusetts—also previously filed a brief urging the Supreme Court to take up Safehouse’s safe consumption case.

While New York City is the first to open the harm reduction centers, the governor of Rhode Island did sign a historic bill in July to establish a safe consumption site pilot program.

Massachusetts lawmakers advanced similar legislation last year, but it was not ultimately enacted.

A similar harm reduction bill in California, sponsored by Sen. Scott Wiener (D), was approved in the state Senate in April, but further action has been delayed until 2022.

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Biden Budget Keeps Medical Marijuana Protections But Would Block D.C. From Legalizing Recreational Sales

President Joe Biden wants to maintain a long-standing policy that’s protected state medical marijuana laws from Justice Department interference as part of his fiscal year 2022 budget proposal—a notable administration decision given that previous presidents from both parties have called for its elimination in their annual plans.

But Biden wants to continue to block Washington, D.C. from using its own tax dollars to legalize adult-use marijuana sales, declining to recommend that current language barring such activity be eliminated.

The budget approach is raising questions about whether the president is drawing a line in the sand by supporting medical cannabis states but denying D.C. the right to implement sales as the mayor and local legislators want. If so, it would reflect his overall marijuana policy position: yes to medical cannabis, no to recreational marijuana.

The medical cannabis rider, which has been renewed in appropriations legislation every year since 2014, stipulates the the Justice Department can’t use its funds to prevent states or territories “from implementing their own laws that authorize the use, distribution, possession, or cultivation of medical marijuana.”

Past administrations—both Democratic and Republican—have proposed scrapping that language. President Donald Trump and President Barack Obama each called for ending the policy as part of their budget proposals. But Congress has consistently upheld it regardless.

During the 2019 appropriations season, the House approved an even more expansive amendment that would have provided protections for all state and territory marijuana programs, rather than just medical cannabis systems. But the Senate did not follow suit and the provision was not included in final spending bill sent to Trump’s desk.

When Trump signed that large-scale spending legislation in 2019, he attached a statement that said he is empowered to ignore the congressionally approved medical cannabis rider, stating that the administration “will treat this provision consistent with the President’s constitutional responsibility to faithfully execute the laws of the United States.”

Advocates were optimistic that Biden would propose removing the other long-standing rider, which has blocked D.C. from using local tax dollars to legalize marijuana sales—but that did not pan out. And that’s in spite of the fact that he did push to remove separate, D.C.-specific language blocking the city from using its funds to provide abortion services.

“It’s seriously concerning that the will of District of Columbia residents who voted to legalize cannabis years ago continues to be ignored, despite immense support in the city,” Queen Adesuyi, policy manager for the Drug Policy Alliance’s (DPA) Office of National Affairs, told Marijuana Moment, adding that local officials should be allowed to “deliver on the promises of equity and justice for those disproportionately impacted by racially-biased enforcement of cannabis laws in the District.”

The inconsistency with which Biden’s budget approaches D.C. is all the more interesting given that while the president has said repeatedly that states should be empowered to make their own decisions regarding adult-use legalization—and he also supports statehood status for the District—he wants to prevent it from having that same right.

“The president’s budget is simultaneously positive and concerning. On one hand, unlike his predecessors from both parties, he is the first sitting president to call for continued protections for medical cannabis programs,” NORML Political Director Justin Strekal told Marijuana Moment. “But on the other hand, unlike President Obama, this budget denies the right of self-determination to D.C. citizens when it comes to the overwhelming desire of the public and local government to regulate cannabis for adults.”

Mayor Muriel Bowser (D) said in April that local officials are prepared to move forward with implementing a legal system of recreational cannabis sales in the nation’s capital just as soon as they can get over the final “hurdle” of congressional interference.

The ongoing blockade is the result of an amendment that was first added by Rep. Andy Harris (R-MD) when Republicans controlled the House and has since been continued in annual appropriations legislation.

“It is incompatible to support D.C. statehood and simultaneously support the reauthorization of the Harris Amendment,” Mike Liszewski, principal with the Enact Group and a policy advisor to Students for Sensible Drug Policy, told Marijuana Moment. “President Biden’s decision to reinclude this provision in his budget is a slap in the face of every District resident. D.C. voters should not have to beg the federal government to allow us to set up our own marijuana regulatory system.”

The Biden administration is being closely watched by advocates when it comes to any marijuana policy development—especially since the president has maintained an opposition to adult-use legalization even as multiple bills to end federal prohibition are being drafted and introduced.

Perhaps unsurprisingly, Biden did not propose gutting the Office of National Drug Control Policy (ONDCP) as Trump did. The former president called for a roughly 90 percent cut in the agency’s budget in his proposals, but Congress did not follow suit. Biden, meanwhile, helped establish the drug czar’s office during his time in the Senate.

BREAKING: The Biden-Harris FY22 Budget request calls for historic levels of funding to prevent and treat #addiction and #overdose. Full details: https://t.co/jCgN4ug0F8

— ONDCP (@ONDCP) May 28, 2021

Biden’s budget also includes $17 million in funding to support industrial hemp production.

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