Lessons from Opening the US's First Legally-Recognized Supervised Consumption Sites: Local Engagement

"NYC engaged in a series of discussions with local, state, and federal stakeholders to gauge the viability of opening OPCs in the absence of clear authorization. Strong political engagement of local stakeholders—including the New York City Police Department (NYPD), district attorneys, and local elected officials—was critical to not only mitigate risks of local enforcement against OPC operations but also to ensure successful service provision. Education and engagement of city agencies and elected officials have been ongoing since the release of the feasibility report in 2018. In the ensuing years, the NYC Health Department facilitated multiple visits to OPCs in Europe and Canada to allow local leaders, including senior NYPD officials and some district attorneys, to witness OPC operations and community health and safety impacts. Following the city’s renewed commitment to OPCs in 2021, the NYC Health Department conducted briefings for local elected officials and NYC District Attorneys to secure support for or, at minimum, neutrality toward OPCs.

"One significant component of the NYC Health Department’s local political engagement strategy was to consistently advocate for OPCs as the evidence-based, structural response to not only prevent overdose deaths but also reduce public drug use and syringe litter—neighborhood quality of life issues that were particularly salient for community members, local businesses, visitors, elected officials, and city agencies during the summer of 2021. For example, NYC framed OPCs as one intervention to address public drug use in the city’s “joint operations” initiativeFootnote4, a collaboration among the NYC Health Department, Department of Homeless Services, Police Department, health + hospitals, and the Department of Sanitation. By consistently citing the strong evidence base for OPCs, the NYC Health Department was able to develop buy-in across agencies in support of OPCs as an actionable strategy to address the overdose epidemic and reduce public drug use.

"In addition to discussions at the local level, extensive engagement with federal and state officials was necessary to assess and mitigate the risk of interference, particularly in the absence of clear endorsements of OPC operations from the federal and state governments. NYC Health Department and the de Blasio administration informed leadership at the NYS Governor’s Office, NYS DOH, and NYS Office of Addiction Services and Supports (OASAS) of NYC’s intention to implement OPCs in NYC as well as federal leaders at Health and Human Services (HHS), Substance Abuse and Mental Health Services (SAMHSA), and the Office of National Drug Control Policy (ONDCP)Footnote5. Ultimately, in response to the unprecedented number of fatal overdoses reported in 2020, Mayor de Blasio made the decision to endorse OPCs in NYC without explicit support or legal authorization from the federal or state government."

Source

Giglio, R.E., Mantha, S., Harocopos, A. et al. The Nation’s First Publicly Recognized Overdose Prevention Centers: Lessons Learned in New York City. J Urban Health (2023). doi.org/10.1007/s11524-023-00717-y