Opinions

The effectiveness of safe-injection sites is questionable



New York’s two supervised drug-consumption sites have long suffered from the soft bigotry of low expectations. 

Proponents say the sites are vital, life-saving tools in the ever-expanding drug crisis.

Mayor Adams declared, “Overdose prevention centers keep neighborhoods and people struggling with substance use safe.”

But the evidence Adams and others use to support this argument almost always supports less than they claim.

Take a recent Journal of the American Medical Association paper that measures the effect of New York’s two supervised-consumption sites — also known as safe-injection sites — on crime and disorder in their vicinity.

Compared with “control” areas, the study finds, the sites did not cause a statistically significant increase in either outcome. 

The study is well-designed, a rarity for research on these sites. So its conclusion is certainly plausible. 

But there’s an important limitation.

The comparison areas aren’t random city blocks but the areas around New York’s 17 needle exchanges.

That means supervised-consumption sites don’t increase disorder any more than other drug services do. 

That’s an interesting finding. But knowing that supervised-consumption sites don’t make crime worse in service-saturated neighborhoods only tells us so much.

It does not inform us what would happen if, for example, such a site were set up in midtown Manhattan. 

Even more important than this limitation is another implication of the study, one that harm-reduction advocates would like to ignore.

Its results imply supervised-consumption sites may not increase crime, but they don’t reduce it, either. 

Advocates sometimes pitch supervised sites as a way to reduce visible public drug use by bringing it indoors.

State Sen. Gustavo Rivera, for example, claims that “public drug use, syringe litter and drug-related crime goes down” where such sites are used.

But in New York, that’s not happening.

Rather, the “null” finding of the JAMA study is just the latest example of an important trend: Wherever they’re tried, supervised-consumption sites don’t make things worse, but they also don’t make things better. 

The sites’ proponents like to say 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 vicinity.

Two studies of Vancouver, Canada, and Catalonia, Spain, found that those who used such sites more were no less likely to OD than those who used them less. 

An evaluation of the New South Wales, Australia, site found no statistically significant difference in overdoses near the site, compared with the rest of the state.

Most persuasive, two recent studies of 34 sites across British Columbia and Ontario using high-quality statistical methods find no effect on OD-death rates.  

Consumption sites were sold to New Yorkers as a means to stem the overdose-death crisis.

But death rates continue to rise in the neighborhoods near New York’s facilities.  

They also don’t seem to be getting people into treatment.

Data from New York’s sites show that only a small fraction of clients are getting referred for medication or counseling services.  

It’s not enough that supervised-consumption sites don’t make things worse — they need to make them better, too.

After all, sites like New York’s eat up valuable private funds that could be directed toward drug-treatment and -prevention services.

If site director Sam Rivera had his way, they’d also be getting a cut of the state’s opioid-settlement funds. 

If supervised-consumption sites want public funds for running 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 retool the approach — or scrap them altogether. 

Charles Fain Lehman is a fellow at the Manhattan Institute, a contributing editor of City Journal and a 2023-24 Robert Novak fellow with the Fund for American Studies.



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