East Harlem’s Supervised Injection Site Saves Lives. It’s Also a Public Safety Concern, Residents Say

Kat Rachon used to enjoy walking her daughter to school in East Harlem. The pair would pass by certain buildings around Halloween and Christmas to admire the holiday decorations and pick out their favorites.

These days, Rachon carefully plans their route before leaving her apartment, making sure to avoid specific blocks and street corners that she says have become hotbeds for public drug use. The detours have added time and anxiety to a commute that once took less than 20 minutes.

“I have to zig zag through my own neighborhood just to drop off and pick up my 5-year-old,” says Rachon, a stay-at-home mom who’s lived in East Harlem for two decades. “But she still sees people shooting drugs day in and day out… and uncapped needles everywhere.”

For the past 12 months, the Rachon family has been living four blocks from an authorized supervised injection site—controversial facilities that allow people to bring in drugs from the street and use them under controlled conditions. The site, located on 126th Street and Park Avenue, has delivered impressive results so far, averting hundreds of overdoses since staff began supervising substance use last November, according to internal data.

But many local residents say the facility has eroded public safety in East Harlem, fueling a wave of drug activity in a neighborhood without the resources to address it. Residents have also criticized the city’s decision to approve a safe injection site in an area already overburdened with substance use programs.

“It’s adding insult to injury,” says Rachon. “Why are they adding more services to Harlem when there are plenty of other neighborhoods that need help?”

The opioid crisis has caused fatal overdoses to skyrocket in New York City. Deaths climbed from roughly 1,400 in 2016 to more than 2,000 in 2020, according to Health Department data. The surge prompted the local government to enter uncharted waters and authorize the first two publicly recognized supervised injection sites in the country.

The facilities have sought to create a safe environment for substance users, pairing them with trained staff who can administer the overdose-reversal drug naloxone at the first sign of danger. Visitors also have access to clean syringes, testing for HIV and other chronic diseases, and a range of addiction treatment services. The sites are an extension of needle exchange programs run by OnPoint NYC, a nonprofit with locations in East Harlem and Washington Heights.

According to city officials, OnPoint was chosen to operate the safe injection sites because of its longstanding presence in neighborhoods with exceptionally high overdose rates.

“East Harlem has been greatly affected by the overdose epidemic, and OnPoint was ready to go,” Michael McCrae, the Health Department’s acting deputy commissioner, said during a Community Board 11 meeting on Sept. 12. “These are people who’ve been part of the community for a very long time.”

Local organizations counter that overdoses alone don’t justify placing a safe injection facility in East Harlem, which already has one of the highest concentrations of opioid treatment programs in New York City. They point to Health Department metrics showing that 14 neighborhoods across the city had higher numbers of overdose deaths in 2020—the most recent year for which data has been published. These hard-hit neighborhoods include Union Square in Manhattan, which was 67% white and had a median household income of about $150,000 in 2019, according to American Community Survey data. That same year, East Harlem’s population was 14% white and had a median household income of $34,000.

“The myth of addiction is that it is a Black, working-class problem,” said Shawn Hill, co-founder of the Greater Harlem Coalition, which has spent years documenting the oversaturation of drug treatment services in the neighborhood. “And that myth has meant that, as a society, we’ve sought to contain that crisis in communities of color by packing them with programs.”

OnPoint’s services go beyond those offered at more conventional drug treatment programs. In addition to supervising substance use, its facilities provide mental health counseling, acupuncture and aromatherapy, as well as showers and laundry services for visitors without permanent housing.

The East Harlem location has also expanded its health care offerings in recent months, adding a pharmacy and on-site physician to facilitate medication prescribing.

“These facilities recognize the lived realities of people who use drugs,” said Emma Roberts of the National Harm Reduction Coalition, a nonprofit backing supervised injection sites. “We’ve been taught that the only answer to addiction is complete abstinence from any and all substances, but that’s not a realistic recovery path for some people.”

For Grant Nelson, a computer science enthusiast and longtime crack cocaine user, OnPoint’s East Harlem facility has been a second home since before it was cleared as a safe injection site.

“They’ve got hot meals, couches and a tv inside,” said Nelson, who’s been visiting the facility for more than two decades. “I would go to jail for a couple of nights, and they’ve always been here when I got out.”

Both supervised injection sites have vastly outperformed the city’s expectations since launching on Nov. 30, 2021. As of Nov. 27, the centers had reversed a combined 603 overdoses and provided services to 2,085 New Yorkers, according to OnPoint NYC. Staff has also collected thousands of discarded syringes from public areas near the two sites.

But OnPoint hasn’t released any data on the number of visitors who’ve reduced their drug consumption or initiated treatment after visiting its facilities, an omission that East Harlem residents have been quick to point out.

“We have yet to see evidence from OnPoint that this site has helped move people away from the scourge of addiction,” said Hill, adding that the organization’s reported overdose reversals haven’t been independently verified.

Residents have plenty of anecdotal evidence to draw from when describing the safe injection site’s impact on East Harlem. They say drug users have poured into the neighborhood since the facility became operational last year, congregating in parks and other public spaces and leaving trails of used needles in their wake.

“It’s gotten to the point where I can’t wear sandals or slippers outside anymore,” said Eva Chan, a manager at the Harlem East Block Association and longtime neighborhood resident.

The safe injection center has also become a hub for drug dealers, many of whom travel from distant parts of the city to set up shop near the facility and profit off of its visitors. Their presence has coincided with an uptick in violence around the injection site, most recently a gunfight that left one bystander injured. Overall, the police precinct that covers OnPoint’s facility has responded to more shootings this year than in 2021, according to a New York City Police Department report.

In response to escalating drug activity in public settings, OnPoint has extended its operating hours and deployed additional staff to safely dispose of syringes. To neighborhood residents like Xavier Santiago, this amounts to putting a Band-Aid on a gaping wound.

“What’s been created in the past year is a nexus for the narcotics industry to thrive and profit off addiction,” said Santiago, who chairs Community Board 11. He recalls watching people buy drugs near the supervised injection site and then head toward the nearby MetroNorth station without ever setting foot in the facility.

Like many parents in East Harlem, Santiago worries about the consequences of exposing children to drug use on a near-daily basis. The safe injection site is located across the street from a daycare center, and some parents have been forced into painful conversations with their sons and daughters after witnessing users laying comatose on the sidewalk.

“Kids are traumatized,” said Chan. “How can children raised in this environment grow up to compete with kids from safer, wealthier neighborhoods?”

Neither OnPoint NYC nor the Department of Health responded to multiple requests for comment.

Despite being at odds over the safe injection site’s location and impact, city officials and East Harlem residents agree that the best way forward is to make supervised drug consumption more widely available in the five boroughs.

During Community Board 11’s meeting in September, McRae described supervised injection as a “citywide strategy” that the Health Department hopes to replicate at other needle exchange programs.

The Greater Harlem Coalition, meanwhile, has advocated for locating community-focused drug treatment programs in every New York City neighborhood. According to Hill, this approach would divert users and dealers away from East Harlem and challenge enduring stereotypes about addiction.

“Addiction impacts every class, gender and race in every geographic part of this country,” he said. “We can begin to destigmatize it by not concentrating drug treatment services in communities of color.”

Over the summer, New York lawmakers considered legislation that would authorize safe injection sites at the state level and allow the facilities to receive public money. OnPoint’s facilities are currently funded through private donations and foundation grants. Though the bill was narrowly defeated during the legislative session, supporters are hopeful that more injection sites will open as long as the existing facilities keep averting overdoses.

Rachon is less optimistic. During a recent visit to East Harlem’s Bernard Family Playground, she spotted an uncapped needle next to the swings, a short distance from her children’s arts and crafts lesson. The discovery was particularly distressing because it was one of the last playgrounds in the neighborhood that felt safe, she says.

Rachon isn’t planning to wait for supervised injection sites to launch in other neighborhoods. After more than 20 years in East Harlem, she’s seriously considering moving her family to the suburbs.

“I can’t keep exposing my kids to this,” she said. “Harlem was vibrant and up and coming for so long, but the current drug and crime situation has set us back years.”

Rachon says it would take a dramatic redistribution of substance use programs across New York City to get her to stay in the neighborhood. Still, the prospect of leaving makes her sad.

“You can’t really find the city in the suburbs,” she says.

About the author(s)

Illan Ireland is a student at the Columbia Journalism School covering East Harlem and health care around New York City.