According to a study by the American Medical Association, New York City’s first drug overdose-prevention centers (OPCs), where people could use illicit substances under medical supervision, have not increased crime. This is despite a significant drop in arrests, as police reprioritize their enforcement.
The study published in JAMA Public health says that the “initial data” from NYC does not support this concern. This is based on previous research that found that OPCs were able to reduce overdoses.
Researchers at the University of Pennsylvania, Brown University and University of Connecticut looked at crime trends around the city’s first two government-sanctioned overdose prevention centers that opened in 2021, comparing them to areas near 17 syringe service programs that don’t offer overdose prevention resources.
Comparing the crime and disorder changes around 2 syringe services programs that began offering overdose prevention service to 17 other programs around the city who didn’t convert, we compared the change in crime and disorder around 17 other programs around the city. No statistically significant effect was observed. The number of calls for homeless people decreased. pic.twitter.com/jHJqKSF0yh
— Brandon del Pozo, PhD, MPA, MA (@BrandondelPozo) November 13, 2023
They found that during the period of review from January 2019 until December 2022 “there was no significant increase in the number of crimes reported by the police, or the number calls for emergency services in NYC neighborhoods with 2 OPCs.”
The authors noted that “large, statistically significant decreases in police enforcement of narcotics around OPCs” were consistent with the city’s desire to ensure clients could use these centers without interference from law enforcement. These findings indicate that fears about crime and disorder are still significant barriers to the expansion and use of OPCs by US cities. Initial data from NYC does not support this concern.
These observations indicate that the expansion of OPCs could be managed without negative outcomes in terms of crime or disorder.
The new findings confirm what we know from previous studies in Europe and Canada. When they are opened near areas where there is a high demand for services, the sites have not shown any negative effects. pic.twitter.com/riB9VN5juP
— Brandon del Pozo, PhD, MPA, MA (@BrandondelPozo) November 13, 2023
The study included an analysis of drug and weapon arrests, 911 calls and 311 calls about crime, summons from police for criminal infractions or public nuisances, and medical events.
Researchers found that violent or property crime did not increase statistically near OPCs. This is despite the fact that arrests by police for drug possession in the vicinity of OPCs fell by 83 per cent. This decrease could be partly due to the city’s desire to not deter customers from using the centers by fearing arrest for drug possession, according to the study.
The study concluded that “Evaluating an politically controversial public health initiative requires assessing effects in a community beyond its proximate outcomes” More research is needed to determine that the two OPCs in NYC are not associated with localized increases of crime and disorder for a longer period of time.
It says that “Our initial observations from this cohort study do not necessarily support objections to the implementation of these initiatives that are based on these concerns.” Our findings suggest that a collaborative relationship between the police and OPCs could enhance their effectiveness as lifesaving interventions while minimising behaviors that might erode public acceptance of such initiatives.
This study supports arguments made by harm reductionists about the limited risks and utility of setting up overdose prevention centers as a policy intervention to reduce the risk of deaths due to overdose during the opioid crisis.
In a separate JAMA report published last year, it was found that in just two months of the first year after implementation, the trained staff of New York City’s OPC had intervened 125 times to reduce overdose risks by administering naloxone, oxygen, and other services in order to prevent death.
In August, however, a federal prosecutor with jurisdiction in Manhattan told The New York Times that the sites were illegal and that “he was prepared to use all of his options – including enforcement – if this situation did not change quickly.”
In the background to this research, the federal Justice Department has asked a federal judge to dismiss a suit filed by a non-profit in Philadelphia that is seeking to establish a site for safe consumption in the city. In its arguments, DOJ cites existing statutes that prohibit facilities that allow illicit drugs use.
The Justice Department declined to submit a brief in order to express its position regarding harm reduction, and asked the court to give additional time to respond to the “complex case. The department stated last year that it was evaluating potential “guardrails” for safe consumption sites.
The Supreme Court has rejected a request to hear an case regarding the legality of the establishment of the facilities in 2021.
Last year, researchers from Congress highlighted “uncertainty”, or the position of the federal government, on the safe consumption sites for drugs. They also pointed out that legislators could resolve the issue temporarily by passing an amendment similar to the one which has allowed the medical marijuana laws be implemented without Justice Department intervention.
Nora Volkow, Director of the National Institute on Drug Abuse, has implicitly endorsed the idea to authorize safe consumption sites . She argues that evidence has shown that these facilities are effective in preventing overdose deaths.
Volkow refused to specify what she thinks should be done with the lawsuit. However, she did say that research on safe consumption sites “has shown that they have saved a significant (percentage) of patients from overdosing.”
Rahul Gupta is the White House Drug Czar. He has stated that the Biden administration is reviewing proposals for harm reduction in drug policy. This includes the authorization of sites with supervised consumption. Rahul even went as far as suggesting possible decriminalization.
In December 2021, the National Institutes of Health issued two requests for applications to examine how harm reduction policies and safe consumption sites could be used to address the drug epidemic.
Gupta is the director of White House Office of National Drug Control Policy. He has stated that it’s important to explore “every option” in order to reduce the number of overdose deaths. This may include allowing the consumption of illegal substances at safe sites if there are evidence to support their effectiveness.
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Image courtesy of Jernej furman.
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