Advocates Charge Homeless Shelters Lax in Supplying Narcan to Prevent Overdoses

first published on on Oct 5, 2017

BY NATHAN RILEY | Advocates for the homeless are pressing the City Council to mandate that shelter staff from the Department of Homeless Services (DHS) as well as their clients have ready access to medicine that reverses overdose poisonings, allowing the victim to breathe unassisted almost immediately.

Nobody disputes the need for making Narcan available at the shelters. Overdoses are the leading cause of deaths among the homeless. Minimal training is required; Narcan can be administered by a person after a single training session. Also known as Naloxone, it is sprayed into the nose and, in most cases, after one or two squirts normal breathing is restored.

Narcan use in city shelter facilities is up, according to records supplied by DHS.

“We support the HealingNYC goal” of “increasing Naloxone training,” said Isaac McGinn, the department’s spokesperson, referring to the city’s multi-agency effort at preventing opioid deaths .

Despite such assurances, Vocal-NY, the Legal Aid Society’s Homeless Rights Project, and the Coalition for the Homeless are pushing for legislation to make this training mandatory for the staff at shelters and to require that their homeless residents be taught how to administer Narcan.

These advocates are angry because in their view the city is not making public health its priority in the battle again opioids. The NYPD receives the lion’s share of the new funding, with additional detectives hired and every overdose investigated as a potential homicide. For groups representing the homeless and others who use drugs, an approach based on actions after a person has died is callous. Users are at risk from overdosing, but it need not be fatal. Narcan will save their lives, and a public health approach based on prevention must be prioritized, advocates say.

The HealingNYC initiative was announced in March, and it calls for homeless shelters to make Narcan available. Public health experts see it as an indispensible tool in bringing down a death toll that reached a new record last year. In 2016, there were 1,374 overdose deaths in all settings citywide, a 46 percent increase over the previous year.

The bill advocates are pressing for was introduced on Jan. 17 by Bronx Councilmember Ritchie Torres, and its 22 co-sponsors include Upper West Side Councilmember Helen Rosenthal, East Councilmember Ben Kallos, and Health Committee Chair Corey Johnson from Chelsea. Despite the wide co-sponsorship, the measure has languished and was a bit player at an April 20 Council hearing.

Angered by the delay, advocates and residents from homeless shelters held a news conference on the steps of City Hall on Sept. 27 blasting both the Council and DHS.

“What have you been doing for nine months?” demanded Kassandra Frederique, the New York State director of the Drug Policy Alliance.

Joshua Goldfein of the Legal Aid Society’s Homeless Rights Project summed up the groups’ frustrations by saying there is “not a medical reason, not a legal reason, not a policy reason” to oppose Torres’ legislation.

Their complaints are being heard.


Councilmember Ritchie Torres’ office said he is negotiating the fine points of legislation he authored with DHS and expects his measure to pass this month. | Photo by Donna Aceto

Torres’ office said negotiations are proceeding with DHS about the legislation’s fine points, and he expects a bill will pass this month. McGinn, speaking for DHS, confirmed that agency officials “are collaborating closely” with the Council.

At last week’s press conference, shelter residents claimed that staff there are slow to respond to overdose incidents and prevent residents from using their own kits to reverse overdose crises.

Whatever may have happened in the past, DHS says it has adopted new procedures and has now trained all staff members. Shelter residents at City Hall last week, however, voiced skepticism about those claims.

With overdose deaths mounting across the city, DHS recently filled a long-time vacancy by hiring a medical director, Dr. Fabienne Laraque, a public health specialist with a background in HIV and hepatitis C prevention who formerly worked at the city health department. Laraque has taken the lead in training DHS police and staff in the use of Narcan, tapping medical school students from NYU late last year in “a massive effort” to get all agency staff up to speed on overdose prevention.

OD reversals are increasing at DHS shelters, with the agency boasting that it intervened successfully on more occasions in the first eight months of this year than in all of 2016 — 99 versus 97.

Each use of Narcan is reviewed the DHS medical staff, which can offer suggestions for follow-up. The agency may recommend, for example, that a homeless person who has called an ambulance for an overdosing partner be trained in the use of Narcan to enable immediate help if another incident arises.

The city health department’s goal is to have drug users, their friends, and families all have Narcan readily accessible. In addition to homeless shelters, needle exchange programs, the Harm Reduction Coalition, and Vocal-NY offer training in properly administering the medication.

According to health department statistics, overdose deaths among homeless New Yorkers rose 13 percent in 2016 over the previous year to 239, though most of those deaths occurred outside the shelter system. The city medical examiner has found that many of the deaths that occurred in shelters were due to multiple causes, such as a heart attack occurring along with an overdose.

DHS voiced confidence this week that its new procedures can reverse more than 90 percent of ODs among shelter residents. Those residents who joined advocates at City Hall last week, however, remain convinced that deaths are higher than acknowledged and that legislation is needed to make certain that Narcan is available when needed in every city shelter.

Advocates Press de Blasio to Release Safe Drug Use Study

This article was posted on the website on January 25, 2018

BY NATHAN RILEY | Advocates are demanding that Mayor Bill de Blasio release a city health department feasibility study on safer consumption spaces where users take their drugs in the presence of an overdose prevention worker.

Nearly 100 such facilities are operating around the world, but New York City has delayed moving forward on this solution even though a person dies of an overdose every seven hours, according to VOCAL-NY, a drug user advocacy group that decades ago grew out of an action committee of ACT UP.

“Mayor de Blasio made headlines this week when he joined a national effort and filed a lawsuit against manufacturers and distributors of opioid prescriptions,” said Jeremy Saunders, co-executive director of VOCAL-NY in a news release as the issue was pushed to the top of the mayor’ agenda both by that action and by news reporting. “The truth is, that action was politically easy. If he wants to prove his progressive commitment to saving lives, he won’t just release this report, he will take immediate action to create safer consumption spaces in New York City.”

Philadelphia will start such a program, and a story this week in the New York Post disclosed that the NYPD and the health department were reviewing such a program. While the NYPD hasn’t endorsed the program, comments from the department encouraged drug law reformers.

“This is about the sanctity of human life, keeping people safe, making sure that people stay alive,” Police Commissioner James P. O’Neill told the Post, adding that the department is considering the issue thoughtfully but does not yet have a position.

Asked if the dam had broken, Kassandra Frederique, the New York State director of the Drug Policy Alliance, an umbrella organization devoted to decriminalizing drug use, said, “I think so. We are not talking about whether to do it, but about how to do it.”

But an informed conversation between advocates and city agencies is impossible without the feasibility study, funded with a $100,000 grant pushed by City Council Speaker Corey Johnson when he was chair of the Health Committee. These funds were made available more than a year ago, but the report was never released.

Gay City News sent a request under the state’s Freedom of Information Act for the study and, on January 11, was told it wasn’t yet finished.

“This has never been solely about drug consumption; we’re calling for spaces that facilitate health and enable healing from trauma, stigma, and marginalization,” said Daniel Raymond, deputy director for planning and policy at the Harm Reduction Coalition. “Mayor De Blasio’s leadership would send a strong signal of hope and compassion.”


City Council Speaker Corey Johnson funded the safe injection study as Health Committee chair more than a year ago. | DONNA ACETO

The life-saving impact of safer consumption spaces is striking. After buying drugs on the street, users can shoot up at these facilities. The staff is equipped with naloxone, the drug that restores breathing when a user gets poisoned by opioids. After millions of injections of the life-saving medication, not one overdose death has been documented. Though overdoses occur frequently at safe consumption space, naloxone intervention stops these poisonings from turning fatal. Outside of such facilities, deaths are frequent.

Here in New York, where nobody injects in a supervised facility, overdose deaths have escalated and kill more persons than homicides and automobile accidents combined. According to the advocates’ press release, New York City saw more than 1,300 overdose deaths in 2016 alone — a 46 percent increase from 2015 and the sixth straight year of an increased overdose death rate.

San Francisco plans to open facilities this year, and Saunders, the VOCAL-NY leader, taunted the mayor for his cautious response to the epidemic.

“Despite an AIDS epidemic ravaging our city, syringe exchange was still illegal 25 years ago during the height of AIDS deaths,” he said. “Any rational and compassionate politician today will admit that was a mistake. Mayor de Blasio’s action will define how history will judge him.”

For more background on the campaign for supervised injection facilities, visit