Support Safe Consumption Spaces for a Safe and Healthy New York

I stand with the SIF NYC Coalition in calling on New York City and New York State government to take all necessary steps to authorize and establish safe consumption spaces (SCSs, also known as SIFs) as a public health intervention to reduce HIV and viral hepatitis transmission and overdose deaths, promote access to drug dependency treatment and other supportive care, and increase public safety.

I stand with the SIF NYC coalition in calling on New York City and New York State government to take all necessary steps to authorize and establish supervised injection facilities as a public health intervention to reduce HIV and viral hepatitis transmission and overdose deaths, promote access to drug dependency treatment and other supportive care, and increase public safety. For more information on how supervised injection facilities can benefit New York, please visit www.SIFNYC.org Supervised injection facilities (SIFs) are controlled health care settings where people can more safely inject pre-obtained drugs in a hygienic environment with access to sterile injecting equipment and under the supervision of trained healthcare staff. SIFs provide an array of support including health care, counseling, and referrals to health and social services, including drug treatment. There are at least 98 SIFs operating in 66 cities around the world in ten countries (Switzerland, Germany, the Netherlands, Norway, Luxembourg, Spain, Denmark, Greece, Australia and Canada) – but none in the United States.[i] Numerous peer-reviewed scientific studies have proven the positive impacts of SIFs.[ii] These benefits include: * Increased access to drug treatment, especially among people who distrust the treatment system and are unlikely to seek treatment on their own. * Reduced public disorder, reduced public injecting, and increased public safety. * Attracting and retaining a high risk population of people who inject drugs, who are at heightened risk for infectious disease and overdose. * Reducing HIV and viral hepatitis risk behavior (e.g. syringe and other injection equipment sharing, unsafe sex). * Reducing bacterial infections (e.g. staph infection, endocarditis). * Successfully managing overdoses and reducing overdose deaths. * Cost savings resulting from reduced disease, overdose, and need for emergency medical services, and increased preventive healthcare and drug treatment utilization. * Not increasing community drug use. * Not increasing initiation into injection drug use. * Not increasing drug-related crime. New York City has been the epicenter of injection drug use in the U.S. for decades. Coupled with an exploding homelessness crisis in recent years,[iii] public injection drug use is an increasing problem. A recent scientific study found that nearly half of NYC syringe exchange participants reported having to inject in a public place like a park or building stairwell. Moreover, 60% had recently injected in semi-public locations, often restaurant and other public restrooms. Homeless people were more than 9 times more likely to report public injecting than those who were stably housed, and more than 4 times more likely to re-use injection equipment.[iv] Public injection drug use in NYC is leading to many negative consequences. The IDUHA study found that public injectors are twice as likely to have overdosed in the past year compared to injection drug users who do not inject publicly. They are twice as likely to not have a consistent supply of new, sterile injection equipment and more than 4 times more likely to re-use injection equipment, which can lead to permanent vein damage and HIV, viral hepatitis, and other infectious disease transmission.[v]-[vi] In relation to broader public safety and order, a recent study[vii] interviewed managers of businesses with public bathroom facilities. Fifty-eight percent reported having encountered people using drugs in their bathrooms in the previous six months, 34% had encountered discarded syringes, and 25% had called 911 because of drug use. Moreover, 44% had received customer complaints. Recommendations SIFs are a vital part of a comprehensive public health approach to reducing the harms of drug use. New York City and State governments should explore the implementation of authorized supervised injection facilities staffed with health professionals to reduce overdose deaths, increase access to health services including drug treatment, and further expand access to safer injection equipment to prevent the transmission of HIV, hepatitis C, and other infectious disease. SIFs, of course, cannot prevent all risky drug use or related harms. However, evidence demonstrates that they can be remarkably effective and cost-saving, and improve the lives of people who inject drugs and the safety and health of our communities. References [i] International Drug Policy Consortium, Drug Consumption Rooms: Evidence and Practice (2012), http://idpc.net/publications/2012/06/idpc-briefing-paper-drug- consumption-rooms-evidence-and-practice; Dagmar Hedrich el al., “Drug consumption facilities in Europe and beyond,” in Harm reduction: evidence, impacts and challenges (European Monitoring Centre for Drugs and Drug Addiction, 2010), http://www.emcdda.europa.eu/attachements.cfm/att_101273_EN_ emcdda-harm%20red-mon-ch11-web.pdf; and Nanna Gottfredsen, personal communication, Nov, 7, 2013. [ii] Lisa Maher and Allison Salmon, “Supervised injecting facilities: how much evidence is enough?” Drug and Alcohol Review 26, no. 4 (2007): 351 – 353; and Salaam Semaan et al., “Potential role of safer injection facilities in reducing HIV and Hepatitis C infections and overdose mortality in the United States,” Drug & Alcohol Dependence 118 (2011): 100– 110. [iii] Coalition for the Homeless. 2015. State of the Homeless 2015. Online at: http://www.coalitionforthehomeless.org/state-homeless-2015 [iv] Injection Drug Users Health Alliance. 2015a. Public Injection Drug Use in New York City. [v] Injection Drug Users Health Alliance. 2015b. Syringe Access in New York City. [vi] Injection Drug Users Health Alliance. 2015a. [vii] NDRI. 2015. Public Bathroom Drug Use in New York City.