Overdose Prevention Centers, Crime and Disorder
Updated: Nov 20
Research by: Aaron Chalfin, PhD; Brandon del Pozo, PhD, MPA, MA; David Mitre-Becerril, PhD. Image by: Brown University
TO SET THE SETTNG
Overdose Prevention Centers (OPCs), also known as Safe Injection Sites or Safe Consumption Sites, are
facilities where individuals can consume illicit drugs under the observation of trained staff to mitigate risk
of fatal overdose. Drug policy advocates have reams of data from other countries that show how these sites saves lives - and not many people dispute that fact. But in the United States, there are persistent concerns that they openly sanction criminalized activity and that people who use drugs at OPCs might generate additional crime and nuisance conditions. These concerns result in significant political opposition.
The first two government-sanctioned OPCs opened in New York City in 2021 amid concerns that they may increase crime and disorder. Well, it's been 2 years and we now have data analyzing statistics on crime, residents’ requests for assistance for emergencies, nuisance complaints, and police enforcement in the vicinity of NYC’s 2 OPCs, relative to the 17 Syringe Service Programs that did not offer overdose prevention services (so that we are comparing areas with similar needs).
No significant changes were detected in violent crimes or property crimes recorded by police, 911 calls for crime or medical incidents, or 311 calls regarding drug use or unsanitary conditions observed in the vicinity of the OPCs. Where estimates were significant, they pointed to modest decreases in crime reports and medical calls.
The 2 OPCs reversed 700 overdoses and recorded no fatalities. These centers saved lives and interrupted the cycle of trauma that are perpetuated when someone overdoses. Given that 36.9%of the OPC’s clients reported being homeless and 75.9% of all clients state they would have used drugs in public or semipublic places in the instances where they had consumed them at the OPCs, it's fair to suggest that the OPCs absorbed behaviors that would have generated 911 calls, 311 calls, and resulting police activity.
This was the result that drug policy advocates expected; it matches the findings from all of the studies across Europe, Canada and Australia. Even though some aspects of the study have very limited data (low base rates), the study design using a difference-in-differences cohort model and Poisson regression is statistically valid.
IMPLICATIONS & MY POINT OF VIEW
Many people turn to unregulated, illicit and unsafe drugs in an attempt to cope with the crippling dehumanization of experiencing homelessness. I see it here in San Francisco every day and I recognize there is no silver bullet; that so many interrelated factors are at play. Homelessness, often compounded by drug use, is becoming a bigger issue all over the country.
Opening more Overdose Prevention Centers will not solve everything, but they will help solve one thing: people using drugs on the street in unsafe and unsanitary conditions, which carries a much higher risk of death. The arguments against these centers (that they would result in more assault, property crime, weapons, noise complaints, unsanitary conditions, etc.) simply isn't supported by data.
My nagging suspicion is that, deep down, some people in society have a spiritual block from making compassionate choices out of fear and scarcity mindsets. Their belief is that people that are suffering from drug abuse don't deserve our compassion, as if they don't have the discipline to seek treatment to disrupt their cycle of trauma. I believe they're letting their own trauma impede the clear sightedness required to help others heal.
I believe we should open more OPCs in the areas hardest hit by poverty and the war on drugs, continue collecting data to drive evidence-based policy, and consider compassionate solutions that save money and interrupt vicious cycles of intergenerational trauma.
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