This post was originally published on this site.
It takes a brave man – or maybe an exceptionally optimistic one – to spend time in prison on drug and gun charges and then start a new career that violates federal and state drug laws.
But this is what Sam Rivera does every day, without fear or hesitation or regret, because he is in the business of saving lives.
Rivera is the executive director of OnPoint NYC, the only safe injection site in the United States. It is a welcoming environment where drug users can receive sterile supplies and medical supervision from a trained staff, who stand by with Narcan in the event of an overdose and can connect the user to addiction services and social supports.
These facilities, also known as Overdose Prevention Centers (OPCs), are also against the law: The so-called “crack house statute” forbids the operation of any location for the purpose of using illegal substances, and for the first time since OnPoint opened in Nov. 2021, the US Attorney from the Southern District has threatened to shut it down.
But Rivera, a Teaneck resident who has been helping addicts recover for three decades, does not flinch — largely because he has marshaled the support of powerful people (including the mayor, health commissioner, and NYPD) and delivered stellar results: In 21 months of operation, OnPoint’s two Manhattan facilities have served 3,700 clients for a total of 83,500 visits.
Last week, it passed a milestone in overdoses prevented: 1,000.
The number of fatalities in that time: Zero.
That’s 1,000 lives that would have otherwise ended in an alley or abandoned warehouse, in a country where 109,000 Americans died of overdoses last year.
Little wonder why Time Magazine included Rivera among its 100 Most Influential Americans for 2023. We spoke with Rivera Tuesday.
Q. After 50 years of the failed war on drugs, more people and governments acknowledge that the best way to deal with addiction is harm reduction. What does that term mean to you?
A. To me, it’s synonymous with love. It acknowledges that harm exists, it’s about meeting people where they are at. It’s not telling people what to do, but giving them healthy options and smart choices — just as you do when you love someone. You mentioned the war on drugs: It was really a war on drug users, where government allowed drugs to come into Black and brown and poor white neighborhoods. So harm reduction also addresses that.
Q. Most people know of needle exchanges, which in our state is a cornerstone of the harm reduction strategy that helps keep drug users alive until they get themselves into treatment. What does your facility do that needle exchanges cannot do?
A. I was around syringe service programs since the beginning, when it was largely about HIV – the HIV movement is where harm reduction was born. But while they are critical and have some wraparound services, they’re not an OPC, and here is why: Right now, we have contaminated drug supply that is killing 109,000 people a year. So while it’s great to provide clean syringes when people need them, we don’t control the drug supply. The drugs they buy are tainted with fentanyl, they take them without supervision, and a syringe can’t prevent an overdose.
So having a safe space where people can get their drugs tested and consume them in an unrushed atmosphere, with staff ready to respond if there’s an overdose, is critical. It promotes healthier habits. It doesn’t always get them into treatment, but it is a place where change begins to happen. We have services like a full-time doctor four days a week for folks who would never get to see one, nutrition programs, case management, acupuncture, holistic health services, and more. You can even grab a shower or do your laundry.
Q. So when you decided to open OnPoint, what made you believe that you can do it without interference from the government, the community, and from law enforcement?
A. I’ve been doing this kind of work for 31 years, and when we were fighting for things – especially in the 90s — many of my colleagues would get arrested. As a person who had been in prison before, I’d reach a certain point and then back away. But it reaches a point where this was something I was willing to do, because too many beautiful people were dying. I know there are risks, but I feel comfortable with the cover provided by the city from New York – Mayor Adams, and before him, Mayor de Blasio – and from the two precincts where we work.
I’ll admit I wouldn’t have done this during the previous (Trump) administration. It would have been pointlessly risky. So now we’ve been open for a year and a half, and the results are obvious. It would be an outrage to end this now: The data shows that the thing to do is open more, and we hope to see that happen throughout the country.
Q. You told me in July that you haven’t received any calls from New Jersey, where we have spent $12 billion enforcing the war on drugs over the last decade. If someone like our health commissioner or a key lawmaker called for advice on OPCs in our state, where would you start?
A. I’d start by acknowledging their courage. We’re in a place where politicians make health decisions. So let’s admit that we have a health emergency here, and we’re not responding to it like we did with COVID. And that seems OK for too many of them, despite the souls we’re losing every day.
So if New Jersey called, I’d be elated. And I would emphasize this: Based on my lived experience, the opposition to OPCs is based on fear and not facts. Here’s the fact that matters: People are dying from overdoses, and we have an opportunity to not only reduce it, but to end it. In the United States today, someone who uses drugs never has to die of an overdose again. We can make 109,000 go down to zero. And many countries have learned that it goes down to zero wherever they open an OPC.
Also, it’s about earmarking funds. Every state received opioid settlement funds, and that’s a great place to start, because those are not tax dollars. So please tell anyone from New Jersey that we’d welcome a call and a visit.
Q. The vast majority of people who visit OnPoint have already been through treatment and detox. Is there data on how many of your clients gave treatment another try?
A. That data will be public in a few weeks. It’s true that 100% of our participants have been through treatment already. It doesn’t mean it doesn’t work, but for most people it takes several tries. And before they’re ready to try it again, we have a goal of wellness, which has many aspects to it.
This takes time and patience. I wish it was as simple as the just-say-no strategy of Nancy Reagan. But the reality is, people use drugs in our communities because they are self-medicating to remove pain, trauma, and mental health conditions. I don’t have one person who has entered our program and used drugs on our premises and said, “I feel great!” No, people invariably share their pain. And I ask the public to look at it through that lens – this isn’t a party. This isn’t people getting together to take Ecstasy in a club. These are people with mental health issues.
Q. You mentioned how the mayors enthusiastically support what you do. What has your relationship with law enforcement been like, particularly the local cops?
A. They are one of our best partners. We were talking to the NYC Health Department today, looking at some of the data you mentioned, and we realized that the reduction in drug use and the increase in participants were referrals from the NYPD. We were asking, “How did this person find us?” And in many cases, a cop saw a person that he used to arrest for public drug use, and instead of arresting them again, they’d walked him over to our facility.
You can’t get a better partnership than that. To have law enforcement participate in a health intervention is absolutely beautiful. So our relationship with them is amazing. It takes courage for law enforcement to do this. To not enforce a drug law because they recognize the root cause of a person’s pain, I think, is heroic.
Q. Conversely, the US Attorney appointed by President Biden has OnPoint in his crosshairs. He calls your operation “unacceptable” because it violates federal and state laws and said there needs to be legislation to legalize OPCs, or he’s prepared to shut you down. How worried are you about that?
A. I don’t read it the same way at all – seriously. I saw a man who said he has a job to do, and the focus of his comment was to tell the governor and others to step up and make OPCs legal. I choose to focus on him saying clearly that government must act.
So I agree with him. I respect his frustration, because he wants to see action. Remember, he could say the same thing about marijuana; that’s illegal on a federal level. But what he really said is, “Get off your butts and do something.” He’s putting the governor in his crosshairs. I see things through a different lens.
Q. Do you think OPC legalization can happen any time soon?
A. Only if people stop being political for a change. There is not one person in harm reduction, in the medical community, or in mental health who expected Gov. Hochul to do nothing the way she has. I know a politician who told me he’s going to finish his term and get out, because he can’t get his party to do the right thing on issues like this anymore. But inaction in this case means that lives are being lost. And if they forget that, I’m here to remind them.
Q. Have you ever had a conversation with Gov. Hochul?
A. Yes, two brief ones. I invited her to visit, but she hasn’t. And she told me that the city can take care of it, and that they don’t need her support. I tried to press upon her that it’s a broader issue, but she didn’t respond. But we’ll take every bit of support we can get. Her support would move people – and people just need to be led.
When that Times story about the US Attorney came out, there was an unintended benefit. We learned how many friends we have, people who care about the work we’re doing. And it was heartening to share that with our staff at OnPoint, the ones who take the risks and do the work and save lives.
Our journalism needs your support. Please subscribe today to NJ.com.
Bookmark NJ.com/Opinion. Follow on Twitter @NJ_Opinion and find NJ.com Opinion on Facebook.