‘Safe injection’ sites are actually of no use
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New York’s two supervised drug consumption sites have long suffered from the gentle bigotry of low expectations.
Advocates say the sites are vital, life-saving tools in the ever-expanding drug crisis.
Mayor Adams stated, “Overdose prevention centers keep neighborhoods and people struggling with substance use safe.”
But the evidence that Adams and others use to support this argument almost always supports less than they claim.
Take a recent Article from the Journal of the American Medical Association which measures the effect of New York’s two supervised consumption sites, also known as safe injection sites, on crime and disorder in their surroundings.
Compared to “control” areas, the study finds that the sites did not cause a statistically significant increase in any of the outcomes.
The study is well designed, something unusual in research at these sites. Therefore, his conclusion is certainly plausible.
But there is an important limitation.
The comparison areas are not random city blocks, but the areas around New York’s 17 needle exchanges.
That means supervised consumption sites don’t add to the mess. more than other drug services do.
That’s an interesting finding. But knowing that supervised consumption sites don’t worsen crime in service-saturated neighborhoods doesn’t tell us much.
It does not tell us what would happen if, for example, such a site were established in midtown Manhattan.
Even more important than this limitation is another implication of the study, one that harm reduction advocates would like to ignore.
Their results imply that supervised consumption sites may not increase crime, but they do not reduce neither.
Supervised sites are sometimes proposed by advocates as a way to reduce visible public drug use by bringing them indoors.
State Senator Gustavo Rivera, for example, claims that “public drug use, syringe waste, and drug-related crime decrease” where such sites are used.
But in New York that is not happening.
Rather, the JAMA study’s “null” finding is just the latest example of an important trend: Wherever they are tested, supervised consumption sites don’t make things worse, but they don’t make them better either.
Proponents of these sites like to say that their support is “evidence-based.”
But the overwhelming conclusion of the scientific evidence is that they have no effect on overdose death rates in their surroundings.
Two studies of vancouverCanada and Catalonia, Spain, found that those who used these sites more were no less likely to overdose than those who used them less.
Evaluation from the New South Wales, Australia site, found no statistically significant differences in overdoses near the site, compared to the rest of the state.
Most persuasive are two recent studies of 34 sites across British Columbia and ontario The use of high-quality statistical methods found no effect on overdose mortality rates.
Consumption sites were sold to New Yorkers as a means to curb the overdose death crisis.
But death rates continue to rise in neighborhoods near the New York facilities.
They also don’t seem to get people into treatment.
Data from the New York sites show that only a small fraction of clients are referred for medication or counseling services.
It’s not enough that supervised consumption sites don’t make things worse: they must also make them better.
After all, places like New York consume valuable private funds that could be used for drug prevention and treatment services.
If site director Sam Rivera had his way, they would also get a portion of the state’s opioid settlement funds.
If supervised consumption sites want public funds to run a federally illegal service, they need to actually save the lives they claim to save.
That they don’t is a good reason for New York to modify the approach or scrap it altogether.
Charles Fain Lehman is a fellow at the Manhattan Institute, a contributing editor at City Journal, and a 2023-24 Robert Novak Fellow at the Fund for American Studies.