In New York City, the opioid crisis is seen every day in the lines outside methadone clinics and needles exchanges across the city. At the Lower East Side Harm Reduction Center, the record numbers of drug-overdose deaths has brought into focus the need for additional resources for combating opioid abuse.
Last week, President Donald Trump declared the opioid crisis a “public health emergency” but requested no additional funding to address the epidemic, frustrating health workers at the LESHRC, which called on Trump to expand funding for syringe programs, naloxone and other treatment programs.
“While our president has branded the epidemic ‘a public health emergency,’ in order for our country to become, as Mr. Trump said, ‘the generation that ends this crisis,’ we need the president and secretary of health to earmark additional funding,” said Sharen I. Duke, executive director of The Alliance for Positive Change, which operates the LESHRC and five other sites in the city.
The LESHRC first started operating an underground needle exchange program in 1990, when the programs were still illegal under state law. It began operating officially in 1992, after the laws were changed. Today, the center offers syringe exchanges, HIV testing, substance abuse counseling and other services.
In New York City, the opioid crisis has been been felt acutely in recent years. In 2016, there were 1,374 overdose deaths, a 46 percent increase from the previous year – more than twice the 22 percent increase in drug-related deaths that was seen nationwide during the same time period.
Anyone in need of sterile needles can drop into the center and, after a 10 minute enrollment process, anonymously receive syringes for free, said Reilly Glasgow, community services manager at LESHRC. “We have an average of 50 to 80 people that come in each day.”
In 2016, the LESHRC distributed 195,930 sterile syringes, collected 141,755 used syringes and served 1,992 unique participants, said Mitch Case, a spokesman for The Alliance for Positive Change.
In addition to syringe exchange services, the center also conducts training on the use of naloxone. The medication, also known by the brand name Narcan, is designed to rapidly reverse the effects of opiate overdose.
“What an opiate does is represses their breathing – it relaxes the person,” Glasgow said. “When the overdose happens, they have too much in their body where it represses their breathing to the point where they simply stop breathing. When someone overdoses, naloxone brings them back.”
To solve the opioid crisis in the city, there was a need for more funding to expand the LESHRC and the Alliance’s work, Reilly said, adding that naloxone and syringe exchange were the most urgent. “We need to get naloxone in more people’s hands,” said Glasgow.
At the LESHRC, there has been an increase in naloxone use. Between July 2016 to June 2017, staff at the center performed 146 overdose reversals compared to 97 reversals between July 2015 to June 2016.
During the June to September 2017 quarter, the center trained around 250 people in how to use naloxone, said Glasgow. The center trains both addicts and non-addicts in how to administer naloxone.
In August 2017, New York announced a program to provide no-cost or lower cost naloxone at pharmacies across the state.
On Wednesday, the White House opioid commission, headed by New Jersey Governor Chris Christie, called for the expanding of drug courts to all 94 federal court jurisdictions. The courts would push addicts accused of crimes into drug treatment programs as part of their sentences. Currently, drugs courts are available in roughly half of the federal court jurisdictions.
Glasgow said LESHRC appreciated the focus on the opioid crisis but didn’t believe the federal government was doing enough or moving as quickly as needed. “I believe more needs to be done,” he said. “In the past, from other emergencies like HIV-AIDS, they said it was an epidemic but things move kind of slow.”