As Opioid Settlements Arrive, Neighbors of Harm Reduction Clinics Voice Sympathy, Concerns

The intersection of Eighth Avenue and West 37th Street in Manhattan is the type of Midtown location that people hurry through. Situated between Port Authority Bus Terminal and Penn Station, the area is filled with bikes, commuters, taxis, tourists and, at times, people in distress. A 7-11 convenience store had a line of panhandlers loitering outside on a recent Sunday afternoon. Unhoused individuals sit in doorways of vacant retail stores and outdoor dining sheds. And occasionally, there were loud outbursts from pedestrians in the street.

This intersection is also home to The Positive Health Project, located inside the Housing Works 37th Street Health Center. The project is a state-funded program that offers a variety of services, including treatment for drug users. Housing Works is an advocacy group fighting homelessness and aids in New York City and funds itself through entrepreneurial businesses, like their well-known thrift stores and book stores.

In April, New York State began to receive and distribute some of its $1.5 billion settlement from a class action lawsuit against manufacturers, distributors and sellers of opioids. In June, New York City Mayor Eric Adams announced plans to invest $150 million, the first installment of settlement money, into boosting existing harm reduction and treatment services for New York City clinics. The New York State Opioid Settlement Fund made their most recent recommendations on November 1st. Those recommendations were encompassed in a 652-page document detailing ten areas as top priorities for funding. Of the ten, the top three were harm reduction, receiving 22% of the funds, medical treatment to receive 12% and investments across service continuum to receive 16%. Within the 22% allocated to harm reduction – the largest of any recommended allocation – was extending funding to existing service providers, like Housing Works.

Health experts are supportive of the city’s plan to invest the opioid settlement funds into existing treatment clinics. But residents and employees near The Positive Health Project, while understanding of its mission, feel they pay a price for being located in such close proximity to the program.

“We are catching hell out here,” said Lionel Peterson, a security guard who works for a residential building on West 37th Street. Peterson said he “gets cussed out all the time by the addicts and the homeless.” His job is to make sure the scaffolding in front of his building at 337 West 37th St. is free of people lingering around. Although Peterson is supportive of the health center, he said that he has seen drug transactions take place less than 100 feet from the clinic’s entrance.

According to police data, officers have been 16 arrests within two blocks of the Housing Works Center on West 37th Street from mid-September to mid-October. The Manhattan South Police Precinct has the second highest number of arrests in the borough, with 3,099 this year.

“Cops do not do anything because they just do the paperwork and then they let them out,” said Angel DeJesus, a manager at a Dunkin’ Donuts on West 37th Street. He described the area as “chaos.” DeJesus now locks the store’s refrigerators and keeps the bathroom closed to the public.

Layan Fuleihan, the director of education for The People’s Forum, a community gathering space and coffee shop on West 37th Street, said she has sympathy for people who go to the clinic. “We need more community projects and programs that can support people, that can help people recover their way of living.”

The Positive Health Project provides health education, overdose prevention, case management, benefits counseling and syringe exchange, where drug users can receive medically cleaned equipment. The Positive Health Project did not respond to an interview request.

“New York City really is leading the way in the U.S. in a lot of ways with the most cutting edge, scientifically proven intervention systems,” said Aidan Pillard, a medical resident at Mount Sinai Hospital and volunteer for On Point NYC, a non-profit that provides medical treatment to drug users. But these programs are often seen as “politically unacceptable in a lot of places,” he added.

The medications most used in these programs, which Pillard said are safe and effective, are methadone, buprenorphine and naltrexone, all of which assist with withdrawal and craving symptoms, and help users move on from dependency.

There have been numerous studies cited by advocates that highlight the efficacy of these programs. The New England Journal of Medicine published an article highlighting a federal court case in Philadelphia, where a judge ruled that it was not only legal to operate overdose prevention centers, but he found them to be “a legitimate public health measure.”

The article’s authors concluded that the case was a shift away from an “ideology of punitive drug control to deprive people with substance use disorders of the benefits of a tested, sensible public health service.”

Silvia Martins, the director of the Substance Use Epidemiology Unit at Columbia University Mailman School of Public Health, praised Mayor Adams’s plan for more treatment centers. “It seems largely comprehensive. It sounds like a really good plan and a really good use of the resources,” she said.

Part of the plan would be to invest in the city’s two existing overdose prevention centers in East Harlem and Washington Heights. Both are run by On Point NYC, who is at the forefront of combating the opioid crisis, opening two of the first overdose prevention centers in the United States in November 2021. The centers are medically staffed locations for drug consumption, and to-date, On Point NYC has intervened and prevented nearly 500 overdoses.

“There are lots of stigmas, so part of the work is convincing people that we need more of these centers,” said Martins.

Despite the contentious relationship that harm reduction centers have with some Midtown neighbors, there are supporters in the area.

Max Nuñez works at a Verizon store that faces the Positive Health Project. “We have a clinic in front of us, so there are a lot of people with these problems that are living around us,” he said. “But if you understand it better, if you’re around it more, it helps you not to be so scared of it.”

Nuñez believes that marginalized people haven’t had access to help. “Everyone is just a normal human being like us going through their own problems,” he said, adding that “instead of casting judgment, we should help them out.”