On Point NYC operates two supervised Overdose Prevention Centers (OPCs) in New York City where individuals are permitted to consume illicit injectable drugs they bring to the sites using sterile equipment under the supervision of trained staff. The organization offers facility users case management, clinical care, hot meals, showers, and referrals to addiction treatment. Its outreach teams distribute clean syringes to homeless addicts. ^{1 2}

History

On Point NYC is the result of a corporate merger between the Washington Heights Corner Project and New York Harm Reduction Educators. ³ The Washington Heights Corner Project and New York Harm Reduction Educators were Syringe Services Programs (SSPs) located respectively in the Washington Heights and East Harlem neighborhoods of New York City. They provided links to drug rehab, vaccination, testing for disease, access to and disposal of sterile injection equipment, and counseling for injection drug users. They were approved by the federal Centers for Disease Control and Prevention (CDC) and by the U.S. Department of Justice. ⁴

Negotiations between On Point and the New York City Health Department and Mayor’s office resulted in the opening of the City’s first two OPCs on November 20, 2021, in the merged organization’s two existing SSP facilities. The planning process began in 2018 during the administration of Mayor Bill de Blasio (D) in response to the worsening opioid crisis. ⁵

The sites face opposition from local political leaders who maintain that they exacerbate drug use and crime and are mostly frequented by people from outside the neighborhood; and from federal law enforcement opposed to drug decriminalization. ⁶ However, during the Biden administration, the U.S. Justice Department signaled openness to including such centers in an approach to harm reduction and public safety. ⁷

Services

On Point NYC offers injection drug users a place to privately consume their own illicit drugs using sterile equipment under the supervision of staff trained to spot and treat overdoses. On Point also offers case management, clinical care, mental health services, supportive services such as hot meals and showers, and referrals to addiction treatment. Its outreach teams distribute food, clothing, sterile injection supplies, and educational materials to homeless addicts in East Harlem, Washington Heights, and the Bronx. ⁸

On Point’s website does not disclose 2024 statistical information on clients. ⁸ According to the publication The City, during its first six months of operation, it served 1,133 clients, treated 283 potentially fatal overdoses, and summoned an ambulance five times. No one died within the facilities although three clients died from overdoses in subway stations and on the street during the hours when On Point was closed. ⁹ By the end of the year, 2,841 individuals had used site services. ¹⁰ Mayor Eric Adams (D) has called for funding to support 24-hour operation at On Point. ¹¹

Funding

Nearly all of the organization’s income is derived from grants and contributions. The total dollar amount of these sources doubled between 2021 and 2022. Private supporters have included the left-of-center funders Vocal NY Action Fund ($291,000), the New York Health Foundation ($81,250), and the Van Ameringen Foundation ($75,000). ¹²

As of 2022, the organization was not receiving government funds and was wholly supported by private contributions. ¹³

Controversies

Right-of-center opponents of overdose prevention centers allege that such programs perpetuate destructive behaviors that harm both individuals and society, and programs that permanently wean addicts from drugs are preferable. ¹⁴ They argue that OPCs have no impact on drug-taking behavior, that they are in violation of federal law, ¹⁵ and that they normalize deviancy, keep people from seeking help, and are associated with an increase in crime and disorder. ¹⁶

Proponents counter that harm reductions, such as the preservation of life and health, halting the spread of disease, lowering medical expenditures, and preventing nuisance threats to the community, are valuable accomplishments of these programs. They point to preliminary research that demonstrates that OPCs save millions of dollars in medical costs, keep people alive, prevent the spread of diseases such as Hepatitis C and HIV, and do not result in an increased burden of crime surrounding the sites. ¹⁷

Research conclusions remain tentative, in part because most studies were conducted on programs abroad due to the legal difficulties of operating such centers in the U.S. An article published by left-of-center National Public Radio affirmed that research results are equivocal but tentatively support the benefits of the sites in reducing healthcare impacts and costs. ¹⁸

A federally-funded four-year study by New York University Langone Health and Brown University, begun in 2023, aims to definitively determine the impact of such programs. On Point’s two locations and one other group in Rhode Island are the targets of research. ¹⁹

Leadership

Executive director Sam Rivera has led On Point since 2021. He has 29 years of experience in social services. ²⁰ He was the executive director of New York Harm Reduction Educators, associate vice president of housing at the Fortune Society; president of the Will Castro Foundation, executive director of the Urban Coalition for HIV AIDS Prevention Services, and executive vice president and chief operating office of Exponents Inc. ²¹ A self-described Afro/Taino New Yorker, he was raised by a single mother on the Lower East Side and spent time in prison. ²²

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4. CDC. “Syringe Services Programs.” Syringe Services Programs (SSPs), June 20, 2024. Accessed November 1, 2024. https://www.cdc.gov/syringe-services-programs/php/index.html
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14. “The Dangerous Illusion of ‘Safe’ Drug Injection Sites | Hudson Institute,” October 10, 2024. Accessed November 3, 2024. https://www.hudson.org/domestic-policy/the-dangerous-illusion-of-safe-drug-injection-sites
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16.  Rufo, Christopher. “‘Safe Injection Sites’ Aren’t Safe, Effective or Wise. Just Ask Canadians.” The Heritage Foundation. Accessed November 3, 2024. https://www.heritage.org/public-health/commentary/safe-injection-sites-arent-safe-effective-or-wise-just-ask-canadians
17. Finke, Jorge, and Jie Chan. “The Case for Supervised Injection Sites in the United States.” American Family Physician 105, no. 5 (May 2022): 454–55. Accessed November 3, 2024. https://www.aafp.org/pubs/afp/issues/2022/0500/p454.html
18. Gordon, Elana. “What’s The Evidence That Supervised Drug Injection Sites Save Lives?” NPR, September 7, 2018, sec. Health Reporting in the States. Accessed November 3, 2024. https://www.npr.org/sections/health-shots/2018/09/07/645609248/whats-the-evidence-that-supervised-drug-injection-sites-save-lives
19.  Kaufman, Maya. “NYU Langone, Brown launch NIH-funded study of overdose prevention centers.” Politico. May 8, 2023. Accessed November 3, 2024. https://www.politico.com/news/2023/05/08/nyu-brown-overdose-prevention-centers-00095651
20. NYC, Ethical. “Sam Rivera: The Impact of Overdose Prevention Centers | The New York Society for Ethical Culture,” April 10, 2022. Accessed November 3, 2024.  https://ethical.nyc/rivera-platform/
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