De Blasio Moves to Bring Safe Injection Sites to New York City

NEW YORK — Mayor Bill de Blasio is championing a plan that would make New York City a pioneer in creating supervised injection sites for illegal drug users, part of a novel but contentious strategy to combat the epidemic of fatal overdoses caused by the use of heroin and other opioids.

Safe injection sites have been considered successful in cities in Canada and Europe, but do not yet exist in the United States. Leaders in San Francisco, Philadelphia and Seattle have declared their intention to create supervised sites, although none have yet done so because of daunting obstacles to such an endeavor. Among them: The sites would seem to violate federal law.

The endorsement of the strategy by New York, the largest city in the country, may give the movement behind it special impetus.

For the sites to open, New York City must still clear some significant hurdles. At a minimum, the plan calls for the support of several district attorneys, and, more critically, the State Health Department, which answers to Gov. Andrew M. Cuomo.

Although Cuomo and de Blasio are Democrats, they have engaged in a yearslong feud that has seen few examples of cooperation. Cuomo, who is facing an energetic primary challenge from Cynthia Nixon, has not said whether he supports injection sites, although state health officials have been open to the possibility.

The plan calls for four sites to open after a 6- to 12-month period of outreach to the communities where they will be located. They would operate as pilot programs for a year.

At the sites, which would be called Overdose Prevention Centers, trained staff would be available to administer medications, such as naloxone, to counteract drug overdoses. Social workers would also be on hand to possibly counsel drug users in the hope that they could be steered into programs intended to help them with their addiction.

The sites would be financed and run by nonprofit groups authorized by the city, and may be located within social service providers that already operate needle exchange sites.

“After a rigorous review of similar efforts across the world, and after careful consideration of public health and safety expert views, we believe overdose prevention centers will save lives and get more New Yorkers into the treatment they need to beat this deadly addiction,” de Blasio said in a statement.

De Blasio has faced pressure from activist groups who support safe injection sites, and who have staged demonstrations at City Hall that have included civil disobedience, with numerous protesters, including City Council members, arrested.

But even as the mayor unveiled his plan, he seemed to be doing so at arm’s length. On Thursday morning, he held a news conference on the sunny Brooklyn waterfront to discuss ferry service, with no mention of the injection sites.

A public announcement of the injection site plan had not been expected until Thursday evening at the earliest. City Hall officials declined to make de Blasio available for an interview.

The plan is based on a report commissioned in 2016 by the City Council and pushed by the Council speaker, Corey Johnson, when he was chairman of the health committee. The report was completed months ago but its release was delayed by City Hall as the mayor weighed his decision.

Deputy Mayor Herminia Palacio sent a letter on Thursday to Howard A. Zucker, the state health commissioner, asking him to authorize or license four injection sites. The letter said that Zucker had the authority to permit such sites if they were part of a “research study.”

“You are authorized to license research studies that may include the possession of controlled substances,” the letter said. It cited as a precedent the authorization by the state health commissioner of needle exchanges in the early 1990s. Those exchanges began as an effort to halt the spread of HIV among drug users who shared needles.

Palacio said in an interview that she has not previously discussed safe injection sites with Zucker.

The most serious obstacle to the safe injection sites may be the federal government. A section of federal law known as the crack house statute makes it illegal to own, rent or operate a location for the purpose of unlawfully using a controlled substance.

The enforcement of the statute in the case of safe injection sites, however, would be up to the discretion of federal authorities. Advocates for the sites point out that needle exchanges were considered illegal when they began, and they are now commonplace.

“We don’t believe a president who has routinely voiced concern about the national opioid epidemic will use finite federal law enforcement resources to prevent New York City from saving lives,” Eric F. Phillips, the mayor’s press secretary, said in a written statement.

The mayor’s office said the centers would be located in Washington Heights and Midtown West in Manhattan; the Longwood section of the Bronx; and Gowanus, Brooklyn.

There were 1,068 drug overdose deaths in New York City in the first nine months of last year, which officials said was more than the combined total of murders, suicides and vehicle crashes. Brooklyn, the most populous borough, had the greatest number of overdose deaths with 260. The Bronx, with a much smaller population, was second with 250.

The Bronx and Staten Island have the highest rate of overdose deaths. In 2016, the Bronx saw 32 overdose deaths per 100,000 residents, and Staten Island had 30 deaths per 100,000.

San Francisco may be on track to be the first U.S. city to open a safe injection site. Rachael Kagan, a spokesman for the San Francisco Department of Public Health, said that officials expected to open two centers in the late summer or the fall — although officials there had previously said they hoped to open them by July. She said officials were “addressing the legal and siting issues.” San Francisco’s program would place the injection centers in existing social service facilities.

Philadelphia announced in January that it expected to open at least one site within 18 months.