Overdose deaths in New York City have risen steadily over the past 15 years, growing to the crisis we now face. In 2017, provisional data confirmed 1,441 overdose fatalities in New York City—the deadliest year on record. 1 Someone dies from a drug overdose in New York City every seven hours, and more people died from overdose in New York City in 2017 than from suicide, homicide, and motor vehicle accidents combined. Since 2014, fentanyl, an opioid 50 to 100 times more potent than morphine, has driven the dramatic increase in overdose deaths.
The opioid overdose epidemic in New York City persists despite current efforts, which include availability of treatment services, collaborative interventions between public health and law enforcement, and increased access to the emergency overdose rescue medicine naloxone. Recognizing that opioid-involved overdose deaths are preventable, the City has redoubled its efforts with a broad, multi-agency cross-sector approach known as HealingNYC. This comprehensive strategy aims to reduce opioid overdose deaths by 35% by 2022. Key components of HealingNYC include: expanded access to effective treatment; innovative methods of overdose prevention that reach individuals at high risk; education aimed at clinicians and communities to prevent substance misuse before it starts; and using new methods to reduce the supply of drugs.3 As HealingNYC moves forward, the City maintains its commitment to deploying strategies grounded in science and to considering all evidence-based interventions that could prevent people from dying in the present overdose crisis.
Supervised injection facilities (SIFs) are one public health strategy to reduce overdose deaths, infectious disease transmission, and public drug use. Supervised injection facilities offer hygienic spaces for people to inject drugs obtained offsite using sterile equipment under medical supervision. There are 100 SIF locations worldwide, including a recent expansion to three cities in Canada. In the United States, SIFs have not been implemented but are under consideration in at least five cities. Through co-location or referral, SIFs also provide people who inject drugs access to a range of health, substance use, and social services. As such, SIFs serve as an early entry point along the continuum of care for people with substance use disorders. Finally, SIFs have garnered support and endorsement from a range of professional health bodies, including the American Medical Association,4 the American Public Health Association, the International Drug Policy Consortium,6 and the European Monitoring Centre for Drugs and Drug Addiction.