Drug overdose deaths in New York City have hit a record high and it comes, tragically, as no surprise. As reported by the city Department of Health last week, 2,668 New Yorkers died from overdoses in 2021 – the logical (and deadly) result of a failed approach by “public health” authorities to the City’s fentanyl epidemic. While the data does not reveal every cause of this spike, this wave of death makes clear that the city’s endorsement of safe drug use, or harm reduction, has failed.
Indeed, acquiescence and acceptance are leading to death. Because anyone looking for public health campaigns that actually discourage drug use — similar to the high-profile prime-time ads warning against cigarette smoking — would have looked in vain this past year in New York City.
Instead, last May, passengers on subways and buses were treated to the city’s “Let’s Talk Fentanyl” campaign. It was less a warning than a tutorial. “Start with a small dose and go slowly,” one placard urged. Make sure to have naloxone, the overdose antidote, on hand, the posters noted. That nodding junkies high on fentanyl might fail to act prudently apparently did not occur to public health “authorities”.


The campaign followed the opening, with city approval, of two so-called “safe injection sites” — pseudo-health clinics to which opioid users may bring illegal street drugs and shoot up under supervision. These sites, one in East Harlem and another in Washington Heights, are illegal under federal “controlled substance” law; but still the city has approved and funded them.
Most crucially, these sites do little to actually discourage drug use or encourage drug treatment — the most effective measures against rising drug deaths. As CBS2 New York reporter Jessi Mitchell uncovered at the supervised injection site OnPointNYC in Harlem, there are no serious effort to monitor any decline in drug consumption. “How are you tracking the actual reduction of drug use?” he asked director Sam Rivera. “That’s difficult. It really is. It’s a challenge. So for us, it’s anecdotal,” Rivera responded.

This has been a pilot program without clear checks or balances. City officials report, as if a proof of concept, that 585 people have registered at the sites and have used the locations 4,974 times. What we don’t know is how many would have chosen not to inject themselves without these city-approved shooting galleries. What we don’t report is the effect on the quality of life of the surrounding neighborhoods, which have become magnets for open-air drug use, often in front of school children passing by on their way to school.
Yet the city’s arbiters of culture, as well as its officials, appear to be on board with this institutional lack of accountability. In its empathetic reporting of a Harlem woman who has used heroin for 40 years, the New York Times essentially endorsed the safe injection approach, reporting that South Bronx grandmother Rennee Jones felt ostracized from her “community” of drug users during periods of recovery. “When I sit around people that are getting high and I’m clean,” she said, “I feel like the outcast.”

No serious consideration of the subway campaign — or safe injection sites — could fail to connect them to the rise in overdose deaths. And those deaths, say city officials, will continue to surge. This trajectory is particularly worrisome considering what’s happened in San Francisco, a once-shining city where drug-addicted homeless now line the sidewalks and safe-injections sites have morphed into full-fledged encampments.
Pot advocates, of course, distinguish between weed and fentanyl – and they should. They miss the point, however: That the pursuit of pleasure is not necessarily the same thing as the pursuit of happiness — the latter often the product of achievements such as holding a job and building a family.

We should also connect the dots between overdose deaths and the bungled rollout of legalized cannabis in New York state. By legalizing weed before granting legal licenses, the state allowed hundreds of unregulated pot shops to spring up city-wide. Not only do these businesses impact quality of life, their proliferation also reflects, again, state approval of drug use — in this case in pursuit of increased tax revenues.
Messages sent by authorities matter — and can prove effective. Back during the Bloomberg Administration, the city’s Human Resources Administration mounted a subway and bus campaign warning against teen motherhood in 2013, which it linked to a life of poverty for families and even prison for children. Is it little coincidence that between 2000 to 2015, during a pair of socially conservative mayoralties, the pregnancy rate among New York City residents ages 15 to 19 declined 60% and the number of teen-pregnancies dropped by more than 16,000.

Ending New York’s fentanyl epidemic won’t be easy, but the City seems to be doing all it can to make this process even harder. The Department of Health has all but preordained that drug overdose deaths will reach record numbers in 2023. It’s not a record for which any city should feel proud.
Howard Husock is a Senior Fellow in Domestic Policy Studies at the American Enterprise Institute.