De Blasio Dithers on Marijuana

BY NATHAN RILEY | Public officials in the city and state should suspend marijuana enforcement until Albany resolves the pressing question of legalization.

A new consensus is gaining momentum that the risks of marijuana can be controlled by public health measures. At its recent State Convention, New York State Democrats supported legal adult sales of recreational marijuana, declaring that weed is “is less harmful than alcohol and tobacco.”

Meanwhile, top health officials in New York City and New York State have endorsed a tax and regulate model for adult recreational use. It is a new era where health issues need no longer hinder legalization, and the debate centers on how to implement a new approach to marijuana.

Mayor’s supposed “advance” will still lead to arrests

In a report to Governor Andrew Cuomo made public last week, Dr. Howard Zucker, the state health commissioner, said he doesn’t subscribe to the theory that marijuana represents a gateway to harder drugs. Zucker’s conclusion has been widely held by other public health officials for years. The National Institute of Drug Abuse points to some rodent studies that indicate early use of marijuana could make the brain susceptible to an appetite for other drugs. Studies like this agree with epidemiological data that show that use of drugs in early adolescents is correlated with abuse as adults. But then there is a big qualifier here: “the majority of people who use marijuana do not go on to use other, ‘harder’ substances.”

Moreover, NIDA notes “cross-sensitization is not unique to marijuana. Alcohol and nicotine also prime the brain for a heightened response to other drugs.” This trio of drug are “typically used before a person progresses to other, more harmful substances.”

Given this pattern, NIDA offers “an alternative to the gateway-drug hypothesis.” Drug users “are simply more likely to start with readily available substances such as marijuana, tobacco, or alcohol, and their subsequent social interactions with others who use drugs increases their chances of trying other drugs.” You choose friends you are comfortable with and, in turn, you have shared activities.

From this perspective, the longstanding war on pot is not justified; use of marijuana may have a link to other drug use later in life, but it doesn’t necessarily cause it. Arrests are unwarranted, particularly given the high likelihood that legalization is on its way, but Mayor Bill de Blasio remains stubbornly resistant to this new reality.

With a great flourish, he recently announced that smoking in public would be greeted with a summons not arrests, arguing he was making a real concession.  But other member of the Democratic Party and advocates blasted his proposal.

The chairs of two criminal justice committees in the City Council joined advocates June 20 on the steps of City Hall attacking the mayor’s plan. Their critique burst de Blasio’s hopes of appearing progressive; the plan, they said, represented only the smallest of steps forward.

Queens Councilmember Rory Lancman, who heads up the Committee on the Justice System, blasted the mayor’s plan on the steps of City Hall and in a statement, saying, “No one should be arrested for smoking marijuana, period.” Calling the new plan a sham, he noted that a speeding ticket is a civil summons, but that de Blasio’s action on marijuana involves a criminal summons.

“The mayor’s policy does not attempt to reduce criminal summonses at all, still allows arrests in circumstances that cannot be justified by public safety,” Lancman said.

Then, in a thrust that must hurt a mayor whose political persona is defined by opposition to all forms of discrimination, Lancman predicted the plan “will likely make marijuana policing even more discriminatory toward people of color, continues to expose noncitizens to deportation, and takes no steps to eliminate the collateral consequences which are in the city’s control.”

Joining him was another Queens councilmember, Donovan Richards, who chairs the Committee on Public Safety that oversees the NYPD, as well as Brooklyn Councilmembers Antonio Reynoso and Jumaane Williams, the latter of whom is challenging Lieutenant Governor Kathy Hochul in the September Democratic primary and is aligned with Cynthia Nixon’s gubernatorial bid.

City Comptroller Scott Stringer, a likely candidate for mayor in 2021, joined the demonstrators, saying “too many live have been ruined, too many people of color have been targeted.” As he left the speaker’s podium, he reminded everyone that he is “the money guy. If you will legalize, you will actually create a $3 billion dollar industry” and tens of thousand new jobs. With more revenue, he said, “you will have an opportunity to invest more in the community.”

Kassandra Frederique, state director of the Drug Policy Alliance, called for a “clear-cut policy saying no arrests, no justification for putting people into the criminal system — period.”

Public defenders, organizations representing minority youth like Make the Road New York, and drug reformers like VOCAL-NY also stressed that New York must stop relying on criminal penalties.

Under the mayor’s plan, anybody stopped for marijuana who is not carrying identification can be arrested and fingerprinted and that could lead ICE to identify them for deportation, Legal Aid Society lawyers argued.

According to de Blasio, his plan will make things better because there will be fewer arrests.

But he avoids a basic ethical question. If marijuana will be legal in eight or nine months, how can enforcement be justified now? Campaigners for legal marijuana are eager to avoid any arrests for a drug that is less harmful than alcohol or tobacco. Keeping young people’s records clean means they can can qualify for better jobs and increase their earning potential — a factor particularly salient in low income neighborhoods and communities of color. This is one piece of the argument that legalization will be good for the state’s economy.

The case against arrests is implicit in the Democratic Party’s recent resolution. “Marijuana laws have not had a significant impact on marijuana availability,” the statement reads. If the law fails to curb use, then no individuals, much less poor black and brown youth, should be criminally punished in a futile exercise. That is why enforcement should be suspended and the Legislature be given time to create a new policy.

The mayor’s “advance,” meanwhile, continues major injustices. As Gothamist headlined its story about de Blasio’s announcement: “NYPD Will Stop Arresting SOME People For Smoking Pot.” Among those who will be arrested are parolees. It is hard to think of a crueler outcome for getting high than going back to prison after enjoying freedom. In fact, according to the Daily News, some federal judges are refusing to play along with this. Judge Jack Weinstein, a liberal lion on the federal bench in Brooklyn, made the news with “a remarkable 42-page ruling explaining why he would not send 22-year-old Tyran Trotter back to prison for three years — longer than his original sentence! — for smoking pot, a technical violation of his post-release terms,” according to the Daily News.”

In his years as mayor, de Blasio has displayed an uncanny talent for isolating himself politically. His ties to the drug reform movement were already frayed by his long delay in supporting safer consumption spaces that offer medical support to drug users during their time of greatest peril in the minutes after they inject. His months-long stall on the issue is now being followed by Cuomo’s own foot-dragging in giving the state’s go-ahead.

If de Blasio were to advocate for complete suspension of marijuana law enforcement pending action in Albany, he would become a leader with a national constituency and polish his fading progressive image. Instead, he is allied with the police, which will always show more loyalty to Cuomo than to him in any event. At a time when the mayor needs allies and a chance to reignite the initial enthusiasm he stirred, he is increasing his troubles by standing pat rather than making a bold move forward.

This article was posted on GayCityNews.com on July 19, 2018

Safe Consumption Delay Prompts City Hall Sit-In

 

BY NATHAN RILEY | Chanting “no more overdoses,” 75 angry New Yorkers packed the steps of City Hall on April 5 and then a smaller group staged a sit-in at the gates leading to Mayor Bill de Blasio’s office, forcing police to eject them. The demonstrators were making an emotional plea to the mayor that he release a feasibility study about safe consumption facilities that give drug users medical supervision while they are getting high.

In such spaces, users consume product they buy on the street under the watchful eye of an overdose prevention worker. Should a user slip into unconsciousness, these workers are only steps away and can administer naloxone, a public health wonder drug that reverses overdoses and restores normal breathing. There have been thousands of overdoses at such facilities in cities like Frankfurt, Sydney, and Vancouver, but nobody — as in zero — has ever died.

On February 5, Dr. Mary Bassett, the city health commissioner told a City Council budget hearing that “the public health literature is clear.” Despite that definitive statement, de Blasio has kept the health department study under wraps. Yesterday’s City Hall protesters charged that in the 59 days since Bassett’s testimony, there have been approximately 236 overdose deaths in New York.

Advocates demand de Blasio release study of facilities where drug users have medical support

Charles King, the CEO of Housing Works, an AIDS services group, opened the protest on a personal note.

“Today marks the 14th anniversary of the death of Keith Cylar, one of the co-founders of Housing Works and my life partner for some 15 years,” he said.

Then adding that he was speaking “not just on behalf of people living with AIDS and HIV, but also on behalf of people who use drugs,” King said, “Keith spoke with particular passion and urgency. He was not only a black gay man living with AIDS, he was also addicted to drugs his entire adult life. And whether it was long-term degeneration caused by AIDS or long time use of cocaine that caused his cardiomyopathy, and whether the heart attack would have happened anyway or was triggered by the crack he smoked that night, his death certificate says he died of a drug overdose. I will go to my grave knowing that if someone had been with him at that moment who knew how to intervene, he might well be standing here with us today.”

Also in impassioned remarks, Kassandra Frederique, the New York State director of the Drug Policy Alliance, said, “Safe consumption spaces are critical to saving lives. We don’t need a report to tell us what we already know, what we need is leadership.”

The mayor, she added, isn’t “leading the parade, he’s following it.”

As other speakers addressed the crowd, King and about a dozen others went inside City Hall and tried to enter de Blasio’s suite of offices. When refused at the gate leading to the mayor’s wing of the building, they sat down chanting “no more overdoses.” Police approached a limp Charles King and, with some difficulty, dragged him out of the building. Some others among the demonstrators were also carried out, while some stood up on their own. Police made no arrests either inside or out, and the rally on the steps lasted an hour and a half.

The mayor, arriving at City Hall in the middle of the demonstration, decided against walking through the protest.

In 2016, Corey Johnson, an out gay city councilmember who then chaired the Health Committee and is now Council speaker, put a $100,000 appropriation into the health department budget to pay for the safe consumption space feasibility study, at a time when overdose deaths in the city had reached 1,300 a year, more than the combined total from vehicle accidents, homicides, and suicides.

King said the report was finished in December, but the mayor has so far declined to release it publicly.

In an email, Johanne Morne, director of the AIDS Institute in the State Department of Health, said flatly, “Safe Consumption Spaces have shown success in other countries.” The idea, she continued, should be “an item of consideration” for “interventions in response to the opioid epidemic.”

In a strongly argued editorial in February, the New York Times declared the safe consumption space approach a “rigorously tested harm-reduction method” that has “proved incredibly effective at slashing overdose deaths.”

Councilmembers Mark Levine of Manhattan, chair of the Council Health Committee, and Stephen Levin of Brooklyn, chair of the General Welfare Committee, support the program.

The citywide coalition of treatment providers, medical professionals, and harm reduction activists are boiling over with anger at a delay that prevents drug users from gaining timely access to a life-saving medicine.

A drug user overdosing is helpless and depends on another person to help them regain normal breathing. Safe consumption spaces are specifically designed to meet this emergency and also allow health professionals to begin a constructive engagement with users about other means of reducing the harm caused by their drug habit.

This article was posted on GayCityNews.com on April 6, 2018

De Blasio Moves on Safer Consumption Spaces to Curb Overdoses

BY NATHAN RILEY | A multi-year push in New York City to offer drug users a safe place for consuming their drugs seems destined for success after Mayor Bill de Blasio announced his support for “overdose prevention centers.”

Public health advocates voiced enthusiasm as the news spread on May 3 that the administration had reached out to Dr. Howard Zucker, the state health commissioner, for a go-ahead to open four Safer Consumption Spaces in the Bronx, Manhattan, and Brooklyn.

Brooklyn City Councilmember Stephen Levin, the chair of the General Welfare Committee who was arrested the day before in a sit-in on Lower Broadway opposite City Hall to push de Blasio to act, tweeted: “Where others look down upon our most vulnerable we will show love and a path towards recovery.”

Thanking the mayor, Levin added, “This will save lives.”

After months of protests, mayor rolls out plan with significant political, health institution support

De Blasio’s action came in the wake of a city health department study of this approach toward curbing drug overdoses funded by the City Council in 2016 and completed this past December.

The mayor set conditions that likely will easily be satisfied. He sought support from the city’s district attorneys, and Manhattan DA Cyrus Vance, Jr., and Brooklyn DA Eric Gonzalez immediately signaled their endorsements via Twitter.

“In the midst of an overdose crisis, we cannot sit by and let ppl die when there are proven interventions that can save live,” Gonzalez wrote, while Vance said, “We are proud to support the Mayor’s proposal to establish Overdose Prevention Centers. Thanks for your leadership.”

Darcel Clark, the Bronx DA, has held meetings on the intervention but remains hesitant unlike her peers, saying only that she has an “open mind.” Clark faces the voters for reelection in 2019, while Vance and Gonzalez won four year terms this past November.

In a written statement, Corey Johnson, the City Council speaker who initially pushed the proposal in 2016 when he chaired the Health Committee and got $100,00 put into the budget to have the health department carry out the study, said, “We thank Mayor de Blasio for taking this brave, important, and necessary step.”

Johnson, who is gay and HIV-positive, often expresses sympathy for those who have died from drug overdoses, mentioning his own history with alcohol and drug use, from which he has been in recovery for years.

“Too many people have died from opioids and heroin,” he said. “These sites will save lives and connect addicts with treatment options and trained professionals that could lead them to recovery. This is an issue that has deep personal significance to me.”

The US Justice Department has issued quasi-official opinions that Safer Consumption Spaces are illegal, but the mayor, by establishing the sites as temporary research programs, believes Zucker has the legal authority to approve their operation.

In the de Blasio administration’s letter to Zucker, Dr. Herminia Palacio, the deputy mayor for health and human services, asked “for immediate steps under Public Health Law to license a pilot research study.” The license would “include the possession of controlled substances.” She cited as precedent the pilot research that authorized needle exchanges whose distribution of sterile syringes brought dramatic reductions in new HIV infections among injection drug users.

In examining the city’s request, Zucker can count on the strong support of Chelsea State Assemblymember Richard Gottfried, who chairs the Health Committee.

“The Mayor’s announcement is an important step and a testament to the hard work of public health advocates on this issue,” Gottfried said in an email to Gay City News, adding, “Supervised injection facilities are an effective harm reduction strategy and a place where people can be connected with appropriate health care and social services.”

A letter to de Blasio from Charles King, president of Housing Works, the AIDS services group, demonstrates the quiet persuasion — that was coupled with loud protests from advocates, as well — that got city leaders behind this project. King was writing in his capacity as chair of Research for a Safer New York, Inc., a consortium of syringe exchanges that have found themselves treating overdoses and assisting clients who have injected in their facilities’ bathrooms.

This consortium will be the contractor managing the overdose prevention centers, with Dr. Holly Hagan, an epidemiologist at NYU, overseeing the research effort. NYU has agreed to have its Institutional Review Board evaluate the study design.

The mayor acted after the four city councilmembers where the initial four overdose prevention centers will be sited had already endorsed the idea. Johnson and Levin, in particular, had voiced considerable frustration with de Blasio’s slow pace of acting on the issue.

In Upper Manhattan, the Washington Heights Corner Project has agreed to sign a contract with the consortium. Liz Evans, a founder of the Vancouver Needle Exchange in Canada that opened in 2003, is on staff there. Mark Levine, the chair of the City Council Health Committee and a supporter of SCS, represents the district that includes the Corner Project.

St. Ann’s Corner of Harm Reduction, where this writer was formerly chair of the board, participated in the Bronx Opioid Community Summit on April 21. At the meeting, Councilmember Rafael Salamanca, who represents the district where St. Ann’s is located, gave a moving talk about growing up in the Bronx where drug use was common and visible. He emphasized the opportunity to bring change to people’s lives through love and compassion. His remarks, which included his endorsement of Safer Consumption Spaces, drew a standing ovation.

The other participating needle exchanges are run by Housing Works, in Midtown West, in Johnson’s district, and VOCAL-NY, which has space within walking distance of Atlantic Avenue-Barclay Center subway complex. Levin is the councilmember for that district.

In testimony before the Council’s Budget Committee in February, Dr. Mary Bassett, the city health commissioner, said the scientific evidence that these facilities stop fatal overdoses is “clear.”

Drug users, especially those taking opioids, frequently overdose, but in Safer Consumption Spaces they receive assistance in breathing with doses of naloxone, a public health wonder drug. A plastic nozzle is used to squirt the medication into a user’s nostril and the opioid is inhibited and normal breathing is restored. In Safer Consumption Spaces worldwide — located in more than 100 cities — there have been no reported fatalities.

In upstate Ithaca, Mayor Svante Myrick and the City Council have already approved a Safer Consumption Space. Philadelphia and San Francisco are also moving forward on this approach, though no such facility is yet in operation in the US.

According to Politico, the number of overdose deaths in New York City hit a record 1,441 in 2017, with 80 percent of them from opioids.

Even as Housing Works’ King lauded de Blasio, he expressed frustration about how long it took to get to this day.

“Housing Works is thrilled that Mayor de Blasio has stepped up to do the right thing, and given the skyrocketing rates of overdose in New York City, we only wish this administration’s support for an intervention that we have long known to save lives had come sooner,” he said in a written statement, adding, “One thing we have learned from years of fighting the AIDS epidemic is that harm reduction works.”

This article was posted on GayCityNews.com  on May 4, 2018

As de Blasio Dawdles on Safer Consumption Spaces, Health Advocates Block Broadway Traffic

BY NATHAN RILEY | Outraged that Mayor Bill de Blasio continues to sit on a city health department study into the efficacy of establishing safe places for drug users to pursue their high — facilities that are in place all over Europe with proven track records of reducing fatal overdoses — protestors sat down in the middle of Broadway across from City Hall bringing downtown traffic to a halt.

Ten activists and City Councilmember Stephen Levin were arrested in the May 2 morning sit-in, as allies chanted slogans directed at the mayor, including “While you wait, we die” and “End overdoses now.”

The city study was finished in December and the mayor promised to release it in April, but then didn’t do so.

“I’m pissed off,” Asia Betancourt of VOCAL-NY said in an interview before joining a speakout that preceded the Broadway civil disobedience. “There’s absolutely no excuse. People are dying left and right.”

[Editor’s update: The day following this protest, de Blasio announced that four such facilities will be opened.] 

An average of three to four people die of overdoses every day in New York City, and those numbers would tumble if users could inject in supervised facilities where medication that interrupts overdoses, professionally delivered, is just steps away.

Called Safer Consumption Spaces among those pushing the issue here in New York, the facilities also provide sterile equipment that reduces the risk of hepatitis C, abscesses, and other ailments that come from using in public bathrooms, city parks, and parking lots. Overdose prevention workers are on hand to explain proper procedures for avoiding contamination and, should a user request it, provide information on sites offering drug treatment. They can also offer assistance on problems like evictions or arrests that often pose more pressing challenges to users than their drub habit.

Most importantly, should a user overdose, the health workers have naloxone at the ready. It’s a public health wonder drug, a nasal spray that is squirted into a person’s nostril to inhibit the effects of opioids and quickly restores normal breathing.

A Google search for Safer Injection Facilities — the phrase most often used when the concept first emerged — shows how far behind New York City is from the services offered in Europe and Canada. The very first article that appeared in the search was written in 2002, reporting that Germany had 13 SIFs operating in four cities; the Netherlands, 16 SIFs operating in nine cities; and Switzerland, 17 SIFs operating in 12 cities. Sixteen years ago, such facilities were regarded as an essential component in AIDS prevention.

Since then, these programs have expanded to 100 cities worldwide. Safer Consumption Spaces differ from needle exchanges “where clients generally visit briefly,” according to the article in the Journal of Drug Issues, and “allow for a more prolonged interaction” with health care staff. The facilities “place trained staff in direct proximity with injectors while they are waiting to consume their drugs, as well as after they have done so and returned to the waiting room to relax. SIFs that offer a café and other services give clients even more reason to remain on-site and interact with staff, during which time the clients become further stabilized.”

Levin, who chairs the Council’s General Welfare Committee, explained he was willing to be arrested to “make sure the mayor does the right thing. The science is clear.”

In a written statement, the Brooklyn councilmember elaborated, “There is a path we can take where fewer of our neighbors, our friends, and our family members lose their lives. That path is through a serious commitment to harm reduction and Safer Consumption Spaces in particular. The drug war has failed… Nearly two years ago, the Council commissioned a study on Safer Consumption Spaces. Today, our message to the administration is simple — release the study.

Council Speaker Corey Johnson, who as the Health Committee chair in 2016 initiated the study, released a statement saying, “I don’t know what the holdup is. Other cities are moving forward and we’re stuck in limbo. Meanwhile, the number of people overdosing continues to skyrocket. This is not a time for inaction. The mayor knows how strongly I feel about this, and we will continue to push for the study’s release.”

Support for Safer Consumption Spaces has widespread support in the medical and political communities. In February, Dr. Mary Bassett, de Blasio’s health commissioner, told a Council budget hearing that “the public health literature is clear” on the benefits of the approach, which has also been endorsed by the American Medical Association.

Former Mayor David Dinkins, a mentor to de Blasio, announced his support last week, as did former Manhattan Borough President C. Virginia Fields, now CEO of the National Black Leadership Commission on AIDS. More than 100 public health workers signed a letter of support for the program, and The New York Times gave the idea its strong endorsement.

But nothing seems to move the mayor.

Advocates at the speakout said that since the Council first authorized the study, 1,500 people have died in New York City from fatal overdoses. Any one of them who had been injecting in a Safer Consumption Space would still be alive. Nobody — as in zero —has ever died from an overdose in such a facility, a fact made even more profound when consideration is given to the millions of injections that have taken place in them all over the world.

Safe Consumption Delay Prompts City Hall Sit-In

BY NATHAN RILEY | Chanting “no more overdoses,” 75 angry New Yorkers packed the steps of City Hall on April 5 and then a smaller group staged a sit-in at the gates leading to Mayor Bill de Blasio’s office, forcing police to eject them. The demonstrators were making an emotional plea to the mayor that he release a feasibility study about safe consumption facilities that give drug users medical supervision while they are getting high.

In such spaces, users consume product they buy on the street under the watchful eye of an overdose prevention worker. Should a user slip into unconsciousness, these workers are only steps away and can administer naloxone, a public health wonder drug that reverses overdoses and restores normal breathing. There have been thousands of overdoses at such facilities in cities like Frankfurt, Sydney, and Vancouver, but nobody — as in zero — has ever died.

On February 5, Dr. Mary Bassett, the city health commissioner told a City Council budget hearing that “the public health literature is clear.” Despite that definitive statement, de Blasio has kept the health department study under wraps. Yesterday’s City Hall protesters charged that in the 59 days since Bassett’s testimony, there have been approximately 236 overdose deaths in New York.

Advocates demand de Blasio release study of facilities where drug users have medical support

Charles King, the CEO of Housing Works, an AIDS services group, opened the protest on a personal note.

“Today marks the 14th anniversary of the death of Keith Cylar, one of the co-founders of Housing Works and my life partner for some 15 years,” he said.

Then adding that he was speaking “not just on behalf of people living with AIDS and HIV, but also on behalf of people who use drugs,” King said, “Keith spoke with particular passion and urgency. He was not only a black gay man living with AIDS, he was also addicted to drugs his entire adult life. And whether it was long-term degeneration caused by AIDS or long time use of cocaine that caused his cardiomyopathy, and whether the heart attack would have happened anyway or was triggered by the crack he smoked that night, his death certificate says he died of a drug overdose. I will go to my grave knowing that if someone had been with him at that moment who knew how to intervene, he might well be standing here with us today.”

Also in impassioned remarks, Kassandra Frederique, the New York State director of the Drug Policy Alliance, said, “Safe consumption spaces are critical to saving lives. We don’t need a report to tell us what we already know, what we need is leadership.”

The mayor, she added, isn’t “leading the parade, he’s following it.”

As other speakers addressed the crowd, King and about a dozen others went inside City Hall and tried to enter de Blasio’s suite of offices. When refused at the gate leading to the mayor’s wing of the building, they sat down chanting “no more overdoses.” Police approached a limp Charles King and, with some difficulty, dragged him out of the building. Some others among the demonstrators were also carried out, while some stood up on their own. Police made no arrests either inside or out, and the rally on the steps lasted an hour and a half.

The mayor, arriving at City Hall in the middle of the demonstration, decided against walking through the protest.

Housing Works CEO Charles King being dragged out of City Hall by police after staging a sit-in. | JARON BENJAMIN/ HOUSING WORKS

In 2016, Corey Johnson, an out gay city councilmember who then chaired the Health Committee and is now Council speaker, put a $100,000 appropriation into the health department budget to pay for the safe consumption space feasibility study, at a time when overdose deaths in the city had reached 1,300 a year, more than the combined total from vehicle accidents, homicides, and suicides.

King said the report was finished in December, but the mayor has so far declined to release it publicly.

In an email, Johanne Morne, director of the AIDS Institute in the State Department of Health, said flatly, “Safe Consumption Spaces have shown success in other countries.” The idea, she continued, should be “an item of consideration” for “interventions in response to the opioid epidemic.”

In a strongly argued editorial in February, the New York Times declared the safe consumption space approach a “rigorously tested harm-reduction method” that has “proved incredibly effective at slashing overdose deaths.”

Councilmembers Mark Levine of Manhattan, chair of the Council Health Committee, and Stephen Levin of Brooklyn, chair of the General Welfare Committee, support the program.

The citywide coalition of treatment providers, medical professionals, and harm reduction activists are boiling over with anger at a delay that prevents drug users from gaining timely access to a life-saving medicine.

A drug user overdosing is helpless and depends on another person to help them regain normal breathing. Safe consumption spaces are specifically designed to meet this emergency and also allow health professionals to begin a constructive engagement with users about other means of reducing the harm caused by their drug habit.

This was posted on GayCityNews.com on April 6, 2018

Advocates Charge Homeless Shelters Lax in Supplying Narcan to Prevent Overdoses

first published on ManhattanExpressNews.nyc 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 GayCityNews.com 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 SIFNYC.org.