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December 7, 2022



GHC Reviews NYC Department of Health's Secret Injection Site Placement Roadmap

November 30, 2022 marked the first anniversary of the nation’s first safe injection site (SIS) - located in East Harlem. (The “soft” opening was the night of the NYC marathon, November 7, 2021 with the official opening at the end of November, 2021.)

This past August, New York City's Department of Health and Mental Hygiene celebrated their role in establishing the SIS with the release of "The Nation’s First Publicly-Recognized Overdose Prevention Centers: Lessons Learned in New York City" - a roadmap of “lessons learned to inform other jurisdictions considering offering such services.”

GHC has reviewed the report and highlights three critical areas of concern:

  • Political Engagement: The NYC Department of Health and Mental Hygiene notes that there was continuous engagement of local “stakeholders” including elected officials in a years-long effort to establish this first site.
  • Community Engagement: The DoHMH claims “critical” public engagement yet failed to engage or inform the East Harlem community or Community Board (who had specifically issued a moratorium on locating new addiction services in East Harlem eight months before the SIS opened).
  • Local Use of the Center: Finally, and perhaps most damning, the authors cite a 1999 report to support their position that erroneously claims that local addiction services are being used by local community members.

Who knew the site was coming to Harlem?

(And when did they know it?)

Political Engagement

The DoHMH report highlights that “Strong political engagement of local stakeholders—including the New York City Police Department (NYPD), District Attorneys, and local elected officials—was critical to not only mitigate risks of local enforcement against OPC [Opioid Prevention Center] operations, but also to ensure successful service provision.” And that their work began with the release of a feasibility report in 2018.

By 2021, the NYC Department of Health seemed to have identified locations for the first safe injections sites and begin its “local political engagement strategy” – targeting neighborhoods where leaders showed “at minimum, neutrality” and citing Department of Sanitation complaints of syringe litter:

  • “Following the City’s renewed commitment to OPCs in 2021, the NYC Health Department conducted briefings for a number of local elected officials and NYC District Attorneys to secure support for or, at minimum, neutrality towards OPCs… One significant component of the NYC Health Department’s local political engagement strategy was to consistently advocate for OPCs as the evidence-based, structural response to not only the overdose crisis, but also public drug use and syringe litter—neighborhood quality of life issues that were particularly salient during the summer of 2021.”

Community Engagement

Earlier that same year, Community Board 11 issued a moratorium in March on any new treatment facilities for the next 12 months noting that “the siting of drug rehabilitation, chemical dependency, or treatment centers across our district is often done with little or no notice to our community.” The moratorium also uses facts uncovered from GHC’s Freedom of Information Act requests that showed 82% of patients using those facilities were commuting into the neighborhood. And that the neighborhood hosts 15.4% of the City’s capacity, but “only has 4.1% of the need for these services.”

By the summer and early fall of 2021, the Department of Health seems to have identified sites and partners and claims to have conducted “critical” community engagement:

  • "As with any service provided to the public, we viewed community engagement and education as critical to the success of OPCs, particularly given the stigma that substance use providers and participants often face. Prior to implementation, the NYC Health Department conducted general educational briefings with local community groups and leaders in neighborhoods across the city, including those where the OPCs would be located. This entailed conducting broad public education and engagement about harm reduction as an approach to drug use and the overdose crisis, while incorporating information about OPCs as an additional public health strategy to prevent fatal overdoses. Similar to political engagement strategies, materials used for community engagement further emphasized the strong evidence supporting the impact of OPCs in improving public safety and addressing concerns about syringe litter and public drug use."

This community engagement did not include informing Community Board 11 that East Harlem was selected as the community to house the nation's first SIS as evidenced by months of planning.

Evidence that the Department of Health did not involve the local Community Board and local residents in their planning is referenced in 'Lesson Learned' where it is noted that the Community Board and others only expressed concern after the SIS opened: 

  • "Following launch, the City faced opposition from Community Boards and certain advocacy groups in East Harlem and Washington Heights. In East Harlem in particular, the local Community Board felt that the opening of an OPC in their community would contribute to an 'oversaturation' of social services in the area."

East Harlem's concern regarding the existing oversaturation of social services and addiction programs in particular, had been codified in a moratorium that had been delivered to elected officials eight months before the SIS officially opened. A significant amount of planning for locating the SIS in East Harlem, therefore, was conducted well after the community had approved a moratorium to attempt to address the structural oversaturation of East Harlem.

“...the siting of drug rehabilitation, chemical dependency, or treatment centers across our district is often done with little or no notice to our community.”

- Community Board 11

Local Use of the Center

Finally, the Department of Health in 'Lessons Learned' continues to claim that the site is being used by the local residents noting, “There is no evidence that OPCs draw people who use drugs from outside the neighborhood…” 

Given that this claim was made before objective researchers have been able to examine the SIS's users and usage, the authors cite a 1999 study on HIV/Aids needle exchange programs:

  • "4) OPCs are a place-based strategy to reduce overdose deaths in neighborhoods with high overdose burdens. They serve people who reside and spend time in the neighborhoods where they are located. There is no evidence that OPCs draw people who use drugs from outside the neighborhood; on the contrary, research from SSPs demonstrate that most people attend harm reduction services within a ten-minute walk of where they live.13"
  • "End note 13: 13 Rockwell R, Des Jarlais DC, Friedman SR, Perlis TE, Paone D. Geographic proximity, policy and utilization of syringe exchange programmes. AIDS Care. 1999 Aug;11(4):437-42. doi: 10.1080/09540129947811. PMID: 10533536"


The paper, 'Lessons Learned', raises a number of questions Harlem residents have for the Department of Health and Mental Hygiene:

  • Why Harlem was selected when 14 other communities have larger overdose death numbers?  
  • Why was Community Board 11 not fully briefed on the SIS plans?  
  • What constituted their community outreach to nearby neighbors and businesses? 

Ultimately Harlem wants to know why its own Department of Health hid their plans, misled Community Board 11, and failed inform the community in the DoHMH's plans to structurally reinforce the existing oversaturation of Harlem.

TAKE ACTION: Send a Tweet to DoHMH


From a Founding Organizational Member of GHC

Image description

OnPoint NYC

East 126th Street

New York, NY. 10035

Attn: Sam Rivera, Executive Director

Dear Sam and OnPoint Team,

Thank you so much for joining our Harlem Neighborhood Block Association (HNBA) November meeting. We really appreciate your time and now realize we should have held this meeting with you much earlier.

We are very interested in learning more about what can be done by your organization and the city officials who you regularly meet with, to address our main concerns – the open-air drug use and drug dealing which has exploded on our streets over the last year. As you heard from resident after resident at our meeting, HNBA is asking OnPoint to adopt a community health model, and incorporate us, as your neighbors, and simultaneously address our needs and concerns in addition to working to save lives and guide your participants to health.

Our support for OnPoint and the work you do, is profoundly impacted by conditions we experience when we leave our homes. We want a community where our children can play, where our seniors feel safe, and where everyone can enjoy the streets of Harlem. Saying that Harlem was always this way is not acceptable. We all need to do better, to expect more, and we hope OnPoint agrees this can’t be the excuse for the increased drug use and dealing we detailed to you.

Please let us know what steps OnPoint (and the city officials you meet with) intend to take. If you would like, we would be happy to invite you to give us a brief (10-15 minute) update at our January meeting.

Again, thank you for attending our meeting and we look forward to continued discussion for a resolve both beneficial to OnPoint constituents and HNBA Neighbors.


Hallia Baker, HNBA President

TAKE ACTION: Send a Tweet to OnPoint
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