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New York City’s first drug overdose prevention centers (OPCs) where people can use currently illicit substances in a medically supervised environment have not led to increased crime, despite a significant decrease in arrests as police reprioritize enforcement, according to a new study published by the American Medical Association (AMA).
While opponents have argued that establishing the harm reduction centers would drive crime, the study in JAMA Public Health says that “initial data from NYC do not support these concerns.” This builds on prior research on the OPCs that showed early promise in their ability to reduce overdose deaths.
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.
We compared changes in crime & disorder around the 2 syringe service programs that started offering overdose prevention services to those around 17 other programs in the city that didn’t convert. There were no statistically significant effects. Calls for homelessness decreased. pic.twitter.com/jHJqKSF0yh
— Brandon del Pozo, PhD, MPA, MA (@BrandondelPozo) November 13, 2023
During the time period reviewed from January 2019 to December 2022, they found “no significant increases in crimes recorded by the police or calls for emergency service in NYC neighborhoods where 2 OPCs were located.”
“Consistent with the city’s commitment to ensuring clients could use the centers free from law enforcement interference, large, statistically significant declines in police narcotics enforcement around the OPCs were observed,” the authors wrote. “These findings suggest that concerns about crime and disorder remain substantial barriers to the expansion of OPCs in US cities, and initial data from NYC do not support these concerns.”
“These observations suggest the expansion of OPCs can be managed without negative crime or disorder outcomes.”
These new findings echo what we already know about these sites from studies in Europe and Canada: when they are opened in areas with a strong existing need for services, they have yet to show a marginal negative effect. pic.twitter.com/riB9VN5juP
— Brandon del Pozo, PhD, MPA, MA (@BrandondelPozo) November 13, 2023
The study involved an analysis of drug possession and weapons arrests, 911 and 311 calls concerning crime, police summons for criminal infractions, public nuisances and medical events.
Researchers said that there was no statistically significant increase in either property or violent crime near OPCs. That’s in spite of the fact that police arrests for drug possession near the centers fell by 83 percent. That decrease may partly be related to the city’s “desire not to deter clients from using the sites by fear of arrest for drug possession,” the study says.
“Evaluating a politically controversial public health intervention requires assessing effects on a community that go beyond its proximate health outcomes,” the study concludes. “More research is required to conclude that the 2 OPCs in NYC will not be associated with localized increases in crime and disorder over a longer span of time.”
“However, objections to their implementation that rest on these concerns are not necessarily supported by our initial observations in this cohort study,” it says. “Our findings also suggest that a cooperative relationship between police and OPCs can enhance their effectiveness as a lifesaving intervention while minimizing behaviors that would erode public support for such initiatives.”
The study is the latest to bolster arguments from harm reduction advocates about the utility and limited risk of establishing overdose prevention sites as a public policy intervention that can mitigate the risk of overdose deaths amid the opioid crisis.
A separate JAMA study published last year found that, over the course of two months in the first year of implementation, trained staff at New York City’s first OPC intervened in 125 instances to mitigate overdose risk, administering naloxone and oxygen and providing other services to prevent deaths.
Even so, a federal prosecutor who has jurisdiction over Manhattan emphasized in a statement to The New York Times in August that the sites are illegal and that he is “prepared to exercise all options—including enforcement—if this situation does not change in short order.”
Also in the background of this research, the federal Justice Department is asking a federal court to dismiss a lawsuit from a Philadelphia non-profit that’s seeking to establish a safe consumption site in the city. In its arguments, DOJ has cited existing statute prohibiting facilities that allow illicit drug use.
The Justice Department had previously declined to file a brief to offer its position on the harm reduction issue, and it asked the court for more time to respond in the “complex” case. Last year, the department said that it was in the process of evaluating possible “guardrails” for safe consumption sites.
The Supreme Court rejected a request to hear a case on the legality of establishing the facilities in October 2021.
Last year, congressional researchers highlighted the “uncertainty” of the federal government’s position on safe drug consumption sites, while pointing out that lawmakers could temporarily resolve the issue by advancing an amendment modeled after the one that has allowed medical marijuana laws to be implemented without Justice Department interference.
Meanwhile, National Institute on Drug Abuse (NIDA) Director Nora Volkow has tacitly endorsed the idea of authorizing safe consumption sites, arguing that evidence has effectively demonstrated that the facilities can prevent overdose deaths.
Volkow declined to say specifically what she believes should happen with the ongoing lawsuit, but she said safe consumption sites that have been the subject of research “have shown that it has saved a significant [percentage of] patients from overdosing.”
Rahul Gupta, the White House drug czar, has said the Biden administration is reviewing broader drug policy harm reduction proposals, including the authorization of supervised consumption sites, and he went so far as to suggest possible decriminalization.
The National Institutes of Health (NIH) put out a pair of requests for applications in December 2021 to investigate how safe consumption sites and other harm reduction policies could help address the drug crisis.
Gupta, the director of the White House Office of National Drug Control Policy (ONDCP), has said it’s critical to explore “any and every option” to reduce overdose deaths, which could include allowing safe consumption sites for illegal substances if the evidence supports their efficacy.
Photo courtesy of Jernej Furman.
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