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Saving Lives or Ruining the Neighborhood? East Harlem Locals at Odds as America’s First Safe Injection Site Turns One

The city says that the safe injection site in the neighborhood, the first in the nation, is reducing not just overdoses, but also nearby drug use and crime. But many locals and the NYPD disagree.

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A used syringe sat on an East 124th Street sidewalk near the Lexington Avenue subway station, Dec. 7, 2022.

Ben Fractenberg/THE CITY

A year after the nation’s first two government-sanctioned safe injection drug use facilities opened in Manhattan, some frustrated Harlem residents say their neighborhood has deteriorated — while others fiercely defend a system they say saves lives. 

Since last December, the nonprofit group OnPoint NYC has operated a storefront on East 126th Street off Lexington Avenue, invited by the city Department of Health and Mental Hygiene under former Mayor Bill de Blasio.

David D’Alessio has lived in Harlem for 10 years, just a few blocks away from OnPoint’s location. (It has another outpost uptown in Washington Heights.) He commutes with his daughter daily to her elementary school from the subway station at East 125th Street and Lexington Avenue and says he’s seen changes around the neighborhood since OnPoint opened, and not for the better.

“I have witnessed things I’ve never seen before,” D’Alessio wrote in an email to THE CITY: “including brazenly open dealing, people defecating (in broad daylight), users with needles openly using injection drugs … and even a man receiving oral sex between parked cars.”

He added that he saw all of that within “a radius of one block from OnPoint NYC during operating hours.” 

The injection site in East Harlem and the one in Washington Heights are both sanctioned by City Hall but run by OnPoint NYC — an amalgamation of the New York Harm Reduction Educators and the Washington Heights Corner Project — because using opioids remains illegal under federal law, even as President Joe Biden’s Justice Department has taken a hands-off approach. 

The injection sites are an extension of existing facilities that were already providing users with clean needles, test strips to check if narcotics had been laced with dangerous fentanyl, and other services. 

THE CITY reported in May that once OnPoint NYC closes for the day, the subway station nearby becomes a refuge for those who want a safe place to inject narcotics. The NYPD, the FDNY, the MTA and OnPoint NYC officials have labeled this a problem, with MTA CEO Janno Lieber and Mayor Adams both saying that OnPoint sites should remain open 24/7

Testing Ground

To musician and local resident Jermaine Armstead, this is the last thing the neighborhood needs. Armstead referenced the late Lou Reed’s lyrics from the 1967 Velvet Underground song “Waiting for the Man,” while discussing his dislike of OnPoint’s supervised injection center.

“He talked about coming up to Harlem, to Lexington 125, to cop heroin, right?,” said Armstead. “And that area is still the same. It’s because it’s overly saturated with these methadone clinics that don’t work, right? So I think that the safe injection site was like the icing or the tipping point for this particular area because now folks can legally go and shoot up.”

Xavier Santiago, chairman of Manhattan Community Board 11, which last March called for a 12-month ban on any new treatment facilities, told THE CITY that local government officials use their area as a testing ground for safe injection sites, but make the neighborhood unsafe for them in the process. He said that he approved of the facilities’ mission, but its execution is a different story.

“Not necessarily a fault of the community board or the community at large,” Santiago said. “I think it was more of they just took advantage of it because other neighborhoods were also suffering but didn’t want those services brought to their communities. I’m all for saving lives, but not this way.”

NYPD officers stood nearby an East Harlem safe injection site, Dec. 7, 2022.

Ben Fractenberg/THE CITY

Santiago did not foresee that his neighborhood would be “saturated” with methadone clinics. East 125th Street and Lexington Avenue already has one of the biggest concentrations of methadone and injection sites in the city, with 11 of Manhattan’s 38 opioid treatment centers located there, according to a 2020 map created by Shawn Hill of the Greater Harlem Coalition.

One reason why, and why the supervised injection site was located there, is that East Harlem has consistently been one of the neighborhoods with the highest rate of lethal overdoses. More New Yorkers die of drug overdoses — with 88% of those related to opioids, and most of those involving fentanyl — than homicide, suicide and motor vehicle crashes combined, according to the city’s Unintentional Drug Poisoning (Overdose) Deaths report issued in June 2022.

OnPoint NYC says its two supervised injection facilities were visited 48,284 times by 2,147 people as of Nov. 29, 2022, with 633 drug overdoses averted and countless needles and other pieces of paraphernalia safely discarded instead of ending up as litter on city streets. 

Keeping New Yorkers Alive

Narcan, a naloxone spray used to quickly reverse overdoses and prevent deaths, is also on hand at OnPoint NYC. But Senior Director of Programs Kailin See told THE CITY that the organization’s process “really de-emphasizes the use of naloxone and emphasizes stabilization of three main systems in the body, which are the respiratory, cardiovascular and the central nervous system” when someone overdoses at their safe injection sites. 

“The thing that allows us to respond in this way,” See said, “is our proximity to the event because we’re there the second the medical emergency starts to happen. We’re not playing catch-up with time, which is the reality of field-based response when you don’t know how long somebody’s been in the McDonald’s bathroom. You don’t know how long someone’s been overdosed on the subway bench.

“The objective is not full alertness,” See said. “It’s just that the person is medically stable. So because we’re not using it, we’re really de-emphasizing the use of naloxone” and using a minimal dosage of it only “if all of the other tools that the staff are trained to use are not eliciting the response that we need.” 

Sam Rivera, the executive director of OnePoint NYC, said that none of what’s happening outside of their location should be attributed to the safe injection site.

“The belief is that the drugs in the community are attracting people from around the city, but that has nothing to do with programs like mine. This has nothing to do with the neighborhood itself,” stated Rivera in an email to THE CITY. 

“I was born and raised on the Lower East Side of Manhattan so I know this. I know this better than anyone. I know what it’s like to live in a neighborhood and people from Connecticut and people from Long Island …I see the cars. I used to see the cars and I get it. The issue that I realized, as I got older, was that’s where people were selling drugs. So interestingly enough, when I was younger, we kind of wanted more treatment programs in the neighborhood to sort of address the users.”

And that, the Adams administration argues, is just what the injection site in East Harlem has done over the last year.

“Every three hours we lose a New Yorker to overdose, and this crisis compels us to pursue any and all solutions to help keep our friends and neighbors alive,” health department spokesperson Patrick Gallahue told THE CITY. “That said, OnPoint has been providing services to people who use drugs for years. Overdose Prevention Center (OPC) services are an additional service offered at existing syringe service programs, and are not considered to be new facilities.

“I’d also note that stigma is a shadow affliction that can drive people underground and away from lifesaving services,” Gallahue said.

Neighbors Notice

Neighbors say that OnPoint’s program has increased the crime rate in the area, and increased the police presence as well. Narcotics arrests for East Harlem’s 25th Precinct are up 229% for the week as of Dec. 4, 2022 (23 arrests, compared to seven in 2021) and are up 107% over just the last 28 days.

“The clinics and injection sites have had the unintentional side effect of bringing dealers around, which is why Lexington has plunged so badly,” said Jason Clinkscales, an editor, media analyst and researcher who’s lived in Harlem since 1997. “Lexington won’t change until the Second Avenue subway makes its way up here, but we may all be in the dirt by the time that happens.”

Patrol cars now regularly sit outside of the injection center, and an NYPD spokesperson emailed: “The Commanding Officer of the 25th Precinct is aware of community complaints involving drug and narcotic use in the confines of the precinct and is working to address them.”

The increase in enforcement came in response to concerns from people like lifetime Harlemite, Sherri Culpepper, an operating engineer who works with and surveys heavy machinery and equipment. 

“I was working on 125th Street, or 126th to be exact, for about a year, seven days a week, and I just saw the activity and it was horrifying. It was depressing,” Culpepper told THE CITY. 

“It was sad to see the people out there and I didn’t know what was happening because I’ve been working a lot for maybe the last seven years ... it didn’t really bring me into that area. I grew up on 124th Street and Seventh Avenue, but I’m 60-something years old now. So I was like, ‘What’s going on around here? What happened?’ It looked like something out of a zombie movie. And I don’t mean to be flippant.”

But Erin Eisenberg Blaz, 43, who’s lived in Harlem for 16 years and works for the Department of Social Services said that concerns about a drug market seem overblown to her (and noted that her views are her own, and do not represent her city employer).

“That’s fear kicking in, right?” Blaz said. 

“I’m a lifelong New Yorker so I’m inured to some of this stuff,” she said. “You can’t have it both ways: You can’t complain about shooting or seeing needles, and then say we don’t want a supervised injection facility here, because guess what? That’s the place you can go do it and you’re saving lives.”

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