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Brian Lehrer: It's The Brian Lehrer Show on WNYC. Good morning again, everyone. Now, we continue our election series, 30 Issues in 30 Days. We're in the final stretch of our series with issue number 28 today. Should New York City keep, expand, or eliminate its so-called "safe injection sites"? Now, those sites are intended to allow people to use certain illegal and dangerous drugs in a supervised setting. Currently, the city has two such sites, which were established after the pandemic under Mayor Eric Adams. Here are all three candidates from last week's mayoral debate, answering a question from my co-moderator, Errol Louis of NY1, during a lightning round.

Errol Louis: Would you expand, decrease, or keep the same number of so-called "safe injection sites" for drug users in the city, Mr. Mamdani?

Zohran Mamdani: Can you say the options again?

Errol Louis: Expand, decrease, or keep the same.

Zohran Mamdani: Keep the same.

Errol Louis: Mr. Cuomo?

Andrew Cuomo: Keep.

Curtis Sliwa: Close them down.

Brian Lehrer: Republican candidate Curtis Sliwa speaking last there, saying, "Close them down." The breakout news was that Democratic candidate Zohran Mamdani, a longtime supporter of expanding the sites, now seems to agree with independent candidate Andrew Cuomo to keep the number the same, just two. Now, we'll cover issue number 28 by first explaining what services these safe injection sites provide, and then breaking down the conflicting politics surrounding them, and specifically why Mamdani's view may have shifted on the subject.

With us first is Sam Rivera, executive director of OnPoint NYC, a nonprofit in East Harlem with a sister location in Washington Heights. OnPoint is one of the providers of what is sometimes referred to as harm reduction services for opioid users. Also on the line is Ethan Geringer-Sameth, healthcare reporter at Crain's New York Business, who has covered this topic. Sam and Ethan, welcome to WNYC.

Ethan Geringer-Sameth: Brian.

Sam Rivera: Good morning, Brian. Thank you.

Brian Lehrer: Ethan, we'll get to you and your reporting in a few minutes, but we'll start with Sam. Sam, tell us a little bit about OnPoint, where your services are located, and what you provide.

Sam Rivera: Sure. OnPoint is a well-rounded, fully-funded health intervention wellness hub. [chuckles] It's a long title, but it's the best way to explain what we do. We provide an array of services, both in East Harlem-- actually in East Harlem, brick-and-mortar in East Harlem, Washington Heights, and then we provide services in the South Bronx as well. We are known as a harm reduction organization. We've been in the community for over 33 years.

It's important to share that because people tend to confuse us. Yes, we provide an array of health services specifically around folks who use drugs. Not only folks who use drugs, but primarily folks who use drugs. Case management, food and nutrition, showers and laundry, holistic health, which includes acupuncture, acupressure, massage, et cetera, mental health services, and a bunch of other services.

Of course, we also have a very large footprint in the community through our outreach and public safety team. Just the last thing I want to say, we have OPCs, overdose prevention centers, not injection sites. Part of that is intentional. That language is intentional. We want to make sure people are clear that they're not just injection sites. The primary goal, excuse me, is to keep our folks alive.

Brian Lehrer: Right. Errol, in the lightning round question, used the term, so-called "safe injection sites." Other articles mentioned "harm reduction centers." You just used the term that you use. You cited multiple sites that OnPoint has, but the reporting I've seen says there are only two of these, what are referred to as "safe injection sites." Are there some where you offer that service and some where you don't?

Sam Rivera: Yes, so our two brick-and-mortar locations. One is in East Harlem on 126th Street, and the other is in Washington Heights on 181st Street. Those are the two places where you offer those services. The other services are provided through our outreach and public safety teams.

Brian Lehrer: Earlier this year, to give listeners some context, the health news site STAT News reported on OnPoint. They wrote, OnPoint began offering supervised consumption services. That's how they describe it, supervised consumption services in 2021. It says, in that span, its records show it has reversed over 1,700 overdoses without a single participant death. That from STAT News. That number was reported even higher in a good way by our guest from Crain's. You want to make your pitch to our listeners? How does OnPoint reduce the number of deaths caused by drug overdoses? Why would you argue, I presume, to expand the number of such sites?

Sam Rivera: Yes. I go back to before we opened, and what was happening around the United States was this narrative that spoke to not having enough evidence throughout other countries. Now, we're here, and we're coming on our fourth year. Exactly what we expected is happening. It's exciting. If you hear some emotion in my voice, it's because we're keeping beautiful New Yorkers alive.

It impacts me in this work. Something I've been committed to for over 30 years. I think about our amazing staff who provide these services. Yes, coming up on year four, we have almost 7,000 registered participants, who specifically use the overdose prevention centers. We are close to 2,000 overdose interventions. That number has increased since that article. Yes, zero deaths, still. Always exciting to look at that number, which has been consistent around the world.

Then two other things, two other very important numbers. Over 7,000 units of hazardous waste. We talk about expanding. These are just two New York City-- in fact, two Manhattan neighborhoods. Can we imagine? We could. We can imagine what it would look like if we had sites throughout the city. The impact would be amazing. The other thing is over 230,000 utilizations, Brian.

What that means is 230,000 times people used inside with us in a safe environment, keeping the community safe, keeping the community clean and clear of hazardous waste, supporting beautiful people who want to stay alive, and really impacting the community also financially. When we look at those responses to overdose within our two programs, we look at the cost. It's over $50 million saved in just four years.

The other thing that we don't talk about enough is the impact on a global scale. What this means that, now, we have interventions we can measure in the United States and, specifically, in New York, so it's an exciting time. Expansion is something we need. It's known we need it. It's not an easy thing for folks to respond to, but it's clear we need them. I look forward to us expanding this health intervention, which is also evidence-based.

Brian Lehrer: Before I let you go and move on to our other two guests on this topic, I will note that STAT News did report on some of the opposition to this. It says, "Some opponents cast supervised consumption sites as places of hopelessness, a white flag in the war on drugs, a decision to enable and even encourage drug use rather than oppose it." Of course, others bring up the potential or reality. You can give a reaction to that, and our reporter guest will, too, whether it's real crime and disorder around these consumption sites. What do you say to the critics?

Sam Rivera: Right, so a couple of things. Crime and disorder, it's actually there. There's already been a couple of studies which disprove that, and actually prove that crime has been reduced in the two areas where we're located. I'm really glad you're asking this at this moment.

Brian Lehrer: Here, by the way, is a text that just came in. Listener writes, "It doesn't keep community safe or clear. Drug use is blatant, open, and quite aggressive," but go ahead.

Sam Rivera: Yes. Well, I obviously don't agree with that. There's a tremendous reduction. I just told you and shared with your listeners how many hundreds of thousands of utilizations have happened. No, we do not. We're not able to get everyone to come in, which is why we have such a strong outreach and public safety team. When we look at that, crime is down. The health of the community is up. I understand and have always respected the view of community members, and the way they see it from their lens.

I do understand that. Our goal is this. Many people say, "Send these people into treatment and detox. That's where they belong." Brian, of the 6,800, over 6,800 participants, they have all been to detox and treatment more than five times. What we're trying to figure out with them is what's missing, what's missing for them in between, what's missing for them when they come to us and they get their first visit to see a doctor or nurse in our program. Something is missing in the system.

What we know is being there for them in that moment is what matters. We do not get new people coming and using drugs. Encouraging people to use drugs makes zero sense. In fact, all of our participants are people who have used drugs for a long time. The thing is, too, the assumption that we don't do anything to help them stop using, it's really sad and quite painful, especially when we have had lots of recent success with long-term medically-assisted treatment provided in our sites.

Brian Lehrer: Just about the neighborhood effects, and I'll note that we have callers and text messages coming in with enthusiastic support and whatever the opposite of enthusiasm is in opposition, but that same listener writes, a little more from that person's text message, "Since the so-called 'safe injection site' opened in Washington Heights," so I guess that's yours, "our neighborhood is overrun with drug addicts shooting up all over the place. It's truly terrible that young children have to witness and normalize and possibly mimic this behavior." What do you say to people who feel like that?

Sam Rivera: Again, I respect what they feel. I don't agree. I don't agree what I mean by-- Wait, let me be careful. What I mean by what I don't agree is that it's rampant, as they say, because we know, factually, it isn't. The reality that us opening these sites brings people in. It's really what prevents them from being outside. The reporting, again, I get the vision, and the people walk in the community. I totally get that and respect that, and the organization does.

The reporting doesn't support that at all. It just doesn't. We always go with that because we're not a part of the reporting. We're not the researchers. We have other folks who do that part of it. The numbers I'm giving are facts. They're not made-up. They're not theories or opinions. These are true facts. Again, Brian, we respect the community. I hear them anytime and every time they share this.

The other thing I'll just say quickly, people tend to talk about when we opened four years ago. The reality is we were providing similar services for over six years prior. When I ask people that question, it's clearly based on when they found out when our services became public in that way. To look at it from that lens, I get it. I understand it. I'm a person from the low east side. I grew up in the low east side and understand and respect that process. I also ask people to look at the reality. The other thing is we allow people to tour and visit. Community members should tour and visit and see what we're offering and understand what we're doing a lot better. We want to continue to be supportive in the community.

Brian Lehrer: Thank you very much, Sam Rivera, executive director of OnPoint NYC, a nonprofit in East Harlem in Washington Heights. It's one of the providers of what's sometimes referred to as harm reduction services for opioid users, including what is sometimes referred to as safe injection sites. What was the alternative term to safe injection sites that you said you prefer?

Sam Rivera: Overdose prevention centers. Its primary goal is to keep people alive. The other thing I forgot to mention very quickly is something we cannot measure, and that's the number of overdoses we actually prevent simply by people being indoors with us, not rushing and injecting in a park where we don't want them, in an alley where we don't want them, in a public bathroom. Being inside with us, one of the things I struggle, and I really want to give the staff so much credit but we can't measure an actual number, are the numbers of overdoses we've actually prevented by creating a space that's safe and healthy in every way possible. Lastly--

Brian Lehrer: Let me leave it there because we're short on time, and you've been on for a while, but I really appreciate you coming on and talking about that. Certainly, the reporter from Crain's, who we're going to talk to now, does back up the last thing that you said about preventing a lot of overdoses and citing the number 1,900 of those since you went online a few years ago. Sam, thank you very much.

Sam Rivera: Thank you. Thank you for allowing us to share from our perspective.

Brian Lehrer: Again, listeners, we're doing this in the context of Issue 28 in our 30 Issues in 30 Days election series. Should so-called safe injection sites be expanded, kept the same, or shut down in New York City? In the debate last week, Cuomo and Mamdani said, "Keep the same number." Curtis Sliwa said, "Shut them down." It was newsworthy because Mamdani used to advocate expanding the number. Now, we turn to Ethan Geringer-Sameth, healthcare reporter at Crain's New York Business, who has covered this topic. Ethan, was that a surprise to you to hear Mr. Mamdani say, "Keep the number the same," in the debate last week?

Ethan Geringer-Sameth: Hi, Brian. Yes, that was a surprise. Mamdani has supported the expansion of these, at least in his public statements. As recently as the primary, he answered a questionnaire with the news outlet The City, saying that he supported the expansion of these sites to be equitably distributed across the city, along with other substance use treatment programs.

I believe the debate was the first time I had heard him say publicly that he wanted to keep the number the same, that is, not expand them, but also not decrease them. He's also long sponsored a bill or been a co-sponsor of a bill at the state level to create a state-level program for these overdose prevention centers. He's been a co-sponsor on that bill since his first term in office.

Brian Lehrer: You wrote on a possible reason for Mamdani not calling now for expansion. You wrote, "Since becoming the Democratic nominee, Mamdani has increasingly become a target of President Donald Trump, who has threatened to withhold federal funding and deploy troops to the city if he's elected mayor. A month after the primary on July 24th, Trump targeted the sites explicitly," from one of your articles. What has Trump said about these sites?

Ethan Geringer-Sameth: In that July 24th order, the President instructed the attorney general to review whether the sites are operating legally and bring civil or criminal action against them if they're not. It also instructed the HUD secretary to review whether these sites are using federal housing dollars and if those are being used appropriately. If not, they should be frozen as well, according to the executive order.

Brian Lehrer: On Cuomo's record, you note he supported the creation of overdose prevention centers, but resigned from office amid sexual harassment allegations before they opened. You were in touch with a Cuomo spokesperson, I see, after the debate last week. What's his logic regarding keeping the number of centers, two in total, the same?

Ethan Geringer-Sameth: The argument from the Cuomo campaign was basically that there needs to be a balance between the public benefit of saving lives at these centers that Sam mentioned and the concerns of the community, which was reflected in the text message you read.

Brian Lehrer: Let's take a phone call from somebody in support and somebody more not in support. Keisha in the Bronx, you're on WNYC. Hello, Keisha.

Keisha: Hi, how are you? Good morning.

Brian Lehrer: Good morning.

Keisha: Thank you for letting me come on. Hi. [chuckles] Yes, I am a Bronx resident, East Tremont section of the Bronx. I am in support of the OPCs. Just from my experience of dealing with folks in my area, especially folks who live in encampments in some of our parks, and seeing their situations, where a lot of them, they do use in the park. A lot of them, from my experience of seeing them, try to be as discreet as they can.

I think a lot of them, just even speaking to some of them, they don't want to use openly in front of people in the public. A lot of them try and be private. They try and be discreet, but a lot of them are homeless and have no place else to go because a lot of these shelter systems are just not the best places that they want to be for different reasons. I believe that OPCs would be better, not just for them, but for the community, because, yes, as a resident, I understand a lot of people don't want to see the open usage in public areas, especially because of children.

I totally understand that perspective. I believe that if the community understood how beneficial these OPCs would be in especially neighborhoods like where I live in the Bronx, and just other areas where you want to keep them in a place where they have their privacy to do what they need to do because of their situation, and not be out in the open, exposed to the view of the public.

I see that as a benefit, but also these OPCs also provide other services. They provide services. These people are in deep pain and trauma. A lot of them come from very, very traumatized backgrounds. It's not just a place for them to go and use, but it's also a place where they can get services, where they could get counseling. They can get medical services.

Brian Lehrer: Keisha, I'm going to leave it there and get to another caller. We really appreciate you calling in. Again, listeners, the initials OPC stand for overdose prevention centers, if you didn't get the initials there. Daniel in Manhattan, more of a skeptic, in Washington Heights. You're on WNYC, Daniel. Hi.

Daniel: Yes, hi, Brian. Yes, I'm against the way they've been run. None of us citizens here were even told about these centers until it opened. I live here in Washington Heights. I also have a business down in Harlem. It's all over the streets on 125th. You can't believe people passed out.

Brian Lehrer: These are locations of the two sites, right?

Daniel: Yes.

Brian Lehrer: The only two in the city.

Daniel: Yes. Well, why aren't there some in Astoria and Bushwick or Gramercy Park? Why is it always Washington Heights and Harlem is the dumping ground? They want to close down Riker. Guess where they want to put the new prisons? Up here in Washington Heights. Now, I have three children. I have seen people injecting right in 181st in Fort Washington, right outside my favorite bodega, and across street from a Starbucks just shooting up. I've asked them, "Please don't do that. My children are with me." I get a big "F off," okay?

These people, I believe, who are coming around these sites are just collating or gathering around these sites because that's where maybe drugs can be found outside of the site. It's going to become a political issue because we're not being represented. We don't have a seat at the table. Just the average citizen. Now, where I'm at up here where they call Hudson Heights, we've exploded with families of children and everything.

Suddenly, over the last year, we have all these people injecting down on the subway. There's needles all over the place. We also have beggars like we've never had before, people asking for money, standing outside our grocery store, standing at the 183rd entrance, standing at 181st, going over to 190. They're in Fort Tryon Park. It's like everybody has gravitated to this area. When we talk to citizens, nobody has any-- it feels like they have any say in it. Go ahead.

Brian Lehrer: Daniel, I'm going to run for time, but I hear you, all those things. We hear the caller before you making cases for. Ethan from Crain's, have you been able to verify as a journalist that conditions are as bad as Daniel says?

Ethan Geringer-Sameth: I think the studies that are often cited by the harm reduction community say that open-air drug use actually decreases around the site. I haven't witnessed myself the drug use that some of your callers have mentioned. Obviously, at least the perception of this has been a factor in the campaign. As I said earlier, the Cuomo campaign is responding to that perception.

I should also note that the tune of the federal government, while more targeted in that executive order that President Trump signed, hasn't changed a whole lot under President Biden. There was also concerns raised by the Southern District that these sites were operating illegally, and federal dollars have never actually been allowed to be used for the safe injections or overdose prevention work.

Brian Lehrer: Very briefly, because we have one other guest on this, State Senator Gustavo Rivera, standing by. The caller asked, "Why always in Harlem and Washington Heights," or, in this case, why only in Harlem and Washington Heights? Why not Astoria is one place he mentioned, or other neighborhoods that he mentioned around the city? Why only two, and why these two, in 30 seconds?

Ethan Geringer-Sameth: Well, one of the arguments for expansion is that it would put less pressure on these few sites. As Sam said, there's been more than 200,000 visits just to these two sites alone. That has been one of the arguments for expanding the program, as well as bringing the benefits that Sam described to other neighborhoods.

Brian Lehrer: Right, but as to why they started only there? If you're not sure, that's okay.

Ethan Geringer-Sameth: Yes, I'm not exactly sure. I think it might have to do with the demand. Manhattan has the second-highest opioid overdose rate in the city after the Bronx, so these are concentrations of people using--

Brian Lehrer: A couple of people have texted to say, "Mamdani isn't the only one who changed his position on this. We should also be saying Cuomo changed his position on this." Did he change in some way? Listener writes, "For example, you keep framing things as Mamdani changing his mind, but Cuomo does, too. He changed his mind in 2021 on safe injection sites for no other reason than he hated de Blasio." Your reporting was Cuomo supported the creation of overdose prevention centers, so has Cuomo changed on this, too?

Ethan Geringer-Sameth: Yes, there was some reporting in 2021 from The City and from New York Focus about how Cuomo had made commitments to harm reductionists that he would have his commissioner sign off after the 2018 election. By 2021, he still hadn't done that. I'm not sure that, publicly, he had said that he no longer supported the centers. At least privately and to harm reductionists, he had, according to these reports, said that he was no longer sure that he supported them.

Brian Lehrer: Oh, but then I guess you could say he changed again because in the debate last week, he did support maintaining the two that have already opened.

Ethan Geringer-Sameth: That's true.

Brian Lehrer: My guest for this portion of the conversation has been Ethan Geringer-Sameth, healthcare reporter at Crain's New York Business, on Issue 28 in our 30 Issues in 30 Days election series, safe injection sites and other opioid harm reduction measures as an issue in the New York mayoral race. Ethan, thank you very much.

Ethan Geringer-Sameth: My pleasure, Brian. Thank you.

Brian Lehrer: Finally, briefly with us now is State Senator Gustavo Rivera from the Bronx. He's been an advocate for safe injection sites as well. Senator, hi, welcome back to WNYC.

Senator Gustavo Rivera: Pleasure to be with you, Brian. I actually have answers to most of the questions that you asked, by the way. I can get right into it if you'd like.

Brian Lehrer: Well, tell me why this has been an interest of yours. Is it a particular problem in your district? I guess one of the things that our last caller would be wondering is, if so, why isn't there a safe injection site in your district?

Senator Gustavo Rivera: That's very important to say. First of all, the reason why there's only two sites is because those were the sites that were approved under the de Blasio administration as he was going out. There is a bill that I've had for years in the state to actually authorize them and regulate them across the state of New York. It is not passed. What de Blasio demonstrated could be done by an executive order.

These organizations were on point, was ready to put them together. They were ready at that point, so that's why these two sites exist. To their credit, as much as I have criticized Eric Adams, they have always been supportive of the sites remaining there. That's the reason why there's only two sites. I want one in the Bronx. I am openly advocating for one in my community. There's all sorts of complications related to the organization being ready, the space being correct, community involvement, et cetera, but there's all of that.

By the way, as far as Cuomo, Cuomo is, you will not be surprised to learn, full of it. He said that he was supportive during most of his tenure, and he consistently dragged his feet throughout all of it. He was talking out of both sides of his mouth, as he usually does, to harm reductionists and to folks saying he was going to put them together, and they never actually happened.

Brian Lehrer: Am I right that Mamdani, in the legislature, has been a co-sponsor of your Safer Consumption Services Act?

Senator Gustavo Rivera: I believe he is a supporter of the bill, yes.

Brian Lehrer: Were you surprised to hear him say that he only supports keeping the two sites that already exist now in the debate?

Senator Gustavo Rivera: Well, I will tell you this. I support Zohran fully. I look forward to talking to him at length about this after he becomes mayor next week. I think that what's important here is two things. First of all, there is the Department of Community Safety, which he is certainly going to focus a lot of his energy on. There has to be an inclusion of people suffering from drug addiction and overdoses, et cetera, in that plan of the community safety department, because the reality is that there's so much criminalization that happens because of drug use. That has to be addressed there.

Actually, in relationship to this, and actually to answer a question you asked earlier in relation to one of your earlier callers, if criminalization and stigmatization worked, we would not have an overdose problem. We would not have an addiction problem. Addiction is not a moral failing. It is a medical problem. Therefore, it must be dealt with as a medical issue. By the way, one more thing. There are so many folks who are criticizing, and many of them do it in good faith. Many of them do it in bad faith because they're not even willing to visit and see what works there, see what happens there. This is not a chaotic place. It is a place where good work happens and where a lot of services are available, as Sam says all the time.

Brian Lehrer: You heard what a couple of listeners chimed in about how chaotic they perceive it to be in their neighborhoods.

Senator Gustavo Rivera: I would say to many of them just like I do with people in my district, I've actually taken them to tour the location so they can see the actual work that happens there so that your listeners can understand this. As Sam says all the time, this is Sam Rivera, who you just had on, the least interesting thing that happens in those places is the room where the actual drug use occurs, everything else that happens around it, the medical care, the mental care, the counseling, the food available, folks who need it, et cetera, et cetera. These services that surround the place where people use are actually-- Again, internally, it doesn't happen outside. It actually means that they're connected to services to actually get better, and one thing--

Brian Lehrer: Let me ask you one last question in our last minute. I have a feeling I know what you're going to say, but how do you feel about the Trump administration's efforts to cut down on the amount of fentanyl in the United States in the first place? That's one of the topics of his negotiations with Xi Jinping, who he's going to meet with this week. Of course, there are the attacks on the suspected drug boats now coming up from Latin America.

Senator Gustavo Rivera: Well, that's obviously a large question that has to do with international relations and abuse of power in international waters, et cetera. What I will say, just to underline this, if criminalization solved drug use, solved drug addiction, and solved overdoses, it would have happened already. To some of the listeners who might be opposed to these overdose prevention centers, I would say to them, you can't have it both ways.

I don't want your child to see somebody shooting up in the street. I don't, which is the reason why I support a place where they can use our medical supervision and with care around them, so they can get connected to services that actually will get them to not use anymore, or to be in a better place. I believe in them, I will continue to support them, and I will do so under the next administration as well.

Brian Lehrer: State Senator Gustavo Rivera from the Bronx, Riverdale, Pelham Parkway, Van Nest, Belmont, Norwood, Van Cortlandt Park, Bronx Zoo, and Botanical Garden area, a lot of the Bronx represented in the state Senate by Gustavo Rivera. Thank you for joining us on this.

Senator Gustavo Rivera: Thank you for having me, Brian.

Brian Lehrer: That's Issue 28 in 30 Issues in 30 Days. Tomorrow, Issue 29, the school funding formula as an issue in the New Jersey governor's race.

 

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