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‘It keeps us safe’: An NYC bathroom set up to stem overdoses

  • In this Tuesday, July 3, 2018, photo, Evelyn Milan, right, director of services at VOCAL-NY, prepares a package with sterile injecting equipment for a member at the organization's headquarters in the Brooklyn borough of New York. VOCAL-NY runs a needle exchange and harm reduction services, as well as overdose prevention and other services for people who use drugs. (AP Photo/Mary Altaffer) Mary Altaffer

  • In this Tuesday, June 19, 2018, photo, Jeremy Saunders, co-executive director of VOCAL-NY, speaks as he stands next to a safe needle disposal container in a bathroom at the organization's headquarters in the Brooklyn borough of New York. VOCAL-NY runs a needle exchange and harm reduction services, as well as overdose prevention and other services for people who use drugs. (AP Photo/Mary Altaffer) Mary Altaffer

  • Laura Levine, health educator and naloxone coordinator at VOCAL-NY, gives a volunteer instructions on how to administer naloxone, at the organization’s headquarters in the Brooklyn borough of New York. ap photo

  • In this Tuesday, July 3, 2018, photo, a Narcan nasal device, which delivers naloxone, lies on a counter as VOCAL-NY health educator and naloxone coordinator Laura Levine gives a volunteer instructions on how to administer it at the organization's headquarters in the Brooklyn borough of New York. VOCAL-NY runs a needle exchange and harm reduction services, as well as overdose prevention and other services for people who use drugs. (AP Photo/Mary Altaffer) Mary Altaffer

  • In this Tuesday, July 3, 2018, photo, VOCAL-NY harm reduction coordinator Paula Santiago, left, and peer educator Chris Marshal walk through a park near the organization's headquarters in the Brooklyn borough of New York, during a tour of places where they do outreach. VOCAL-NY runs a needle exchange and harm reduction services, as well as overdose prevention and other services for people who use drugs. (AP Photo/Mary Altaffer) Mary Altaffer

  • In this Tuesday, July 3, 2018, photo, a used syringe and empty liquor bottles are discarded in the bed of a sidewalk tree near VOCAL-NY headquarters in the Brooklyn borough of New York. VOCAL-NY runs a needle exchange and harm reduction services, as well as overdose prevention and other services for people who use drugs. (AP Photo/Mary Altaffer) Mary Altaffer

  • In this Tuesday, July 3, 2018, photo, VOCAL-NY peer educator Alfredo Padilla removes a used syringe left in the bed of a sidewalk tree near the organization's headquarters in the Brooklyn borough of New York. VOCAL-NY runs a needle exchange and harm reduction services, as well as overdose prevention and other services for people who use drugs. (AP Photo/Mary Altaffer) Mary Altaffer

  • In this Tuesday, July 3, 2018, photo, a used syringe removed from the bed of a sidewalk tree near VOCAL-NY headquarters in the Brooklyn borough of New York is seen in a disposal container. VOCAL-NY runs a needle exchange and harm reduction services, as well as overdose prevention and other services for people who use drugs. (AP Photo/Mary Altaffer) Mary Altaffer

  • In this Tuesday, June 19, 2018, photo, activists and newlyweds Levele, right, and Nilda Pointer are seen during an interview at VOCAL-NY headquarters in the Brooklyn borough of New York. VOCAL-NY runs a needle exchange and harm reduction services, as well as overdose prevention and other services for people who use drugs. (AP Photo/Mary Altaffer) Mary Altaffer

  • In this Tuesday, July 3, 2018, photo, peer educator Chris Marshal, left, takes a nap as a member signs in before using the bathroom at the VOCAL-NY headquarters in the Brooklyn borough of New York. VOCAL-NY runs a needle exchange and harm reduction services, as well as overdose prevention and other services for people who use drugs. (AP Photo/Mary Altaffer) Mary Altaffer

  • In this Tuesday, July 3, 2018 photo, Evelyn Milan, right, director of services at VOCAL-NY, buzzes a member into the bathroom at the organization's headquarters in the Brooklyn borough of New York. VOCAL-NY runs a needle exchange and harm reduction services, as well as overdose prevention and other services for people who use drugs. (AP Photo/Mary Altaffer) Mary Altaffer

  • In this Tuesday, July 3, 2018, photo, a member enters the bathroom at VOCAL-NY headquarters in the Brooklyn borough of New York. VOCAL-NY runs a needle exchange and harm reduction services, as well as overdose prevention and other services for people who use drugs. (AP Photo/Mary Altaffer) Mary Altaffer

  • In this Tuesday, June 19, 2018, photo, a safe needle disposal container hangs in the bathroom of VOCAL-NY headquarters in the Brooklyn borough of New York. VOCAL-NY runs a needle exchange and harm reduction services, as well as overdose prevention and other services for people who use drugs. (AP Photo/Mary Altaffer) Mary Altaffer

  • In this Tuesday, June 19, 2018, photo, a timer placed on a sign-in sheet counts down the 10 minutes members are allowed to use the bathroom at VOCAL-NY headquarters in the Brooklyn borough of New York. VOCAL-NY runs a needle exchange and harm reduction services, as well as overdose prevention and other services for people who use drugs. (AP Photo/Mary Altaffer) Mary Altaffer

  • In this Tuesday, June 19, 2018, photo, peer educator Jeffery Foster stands outside as a member uses the bathroom at VOCAL-NY headquarters in the Brooklyn borough of New York. VOCAL-NY runs a needle exchange and harm reduction services, as well as overdose prevention and other services for people who use drugs. (AP Photo/Mary Altaffer) Mary Altaffer



Associated Press
Friday, July 13, 2018

NEW YORK — At an unassuming storefront on a busy Brooklyn street, people sign up to use a bathroom outfitted to try to curb an overdose crisis.

Waiting his turn, a man named Robert is frank about why he’s there, instead of one of the stairwells, parks, rooftops or porches where he has used heroin in the past.

“It keeps us safe. It keeps us from getting arrested. You feel secure here,” says Robert, who discussed his drug use on condition that his last name not be used because he fears arrest and damage to family relationships. “You know that someone’s paying attention if you fall out in there. ... You know they’re not going to let nothing happen to you.”

As communities debate trying to stem overdose deaths by allowing safe havens for people to take heroin and other narcotics, places like this needle exchange program are quietly providing a model of sorts: bathrooms monitored by intercom, so someone can intervene to stop an overdose.

Officially, they aren’t the more full-fledged and controversial facilities — often called safe injection sites — that cities including New York, Philadelphia, San Francisco and Seattle are seeking to open and that already operate overseas. At the same time, some counties and cities have pre-emptively banned injection sites, and federal officials have said they’re illegal.

While the discussion plays out, Robert and about a dozen other people turned up on a recent afternoon to use the bathroom off the green-and-orange drop-in room at VOCAL-NY, where work includes needle exchange, support groups and advocacy campaigns.

A sign on the bathroom allows 10 minutes “to take care of business.” But every three minutes, a staffer checks in by intercom. If there’s no response, the staffer will release the door lock and come in, ready to administer anti-overdose medication. In eight years, a few people have overdosed but all have been rescued, VOCAL says.

If not official, the restroom isn’t exactly underground, either. State Health Department policies suggest that needle exchange programs bathrooms have such safeguards.

“This bathroom is literally a response to hundreds of overdose deaths in bathrooms and streets across the city,” Jeremy Saunders, VOCAL’s co-executive director. “You can say we’re enabling people, but what we would say is: At what point do you want us to stop caring?”

Opioid drugs — including pain pills, heroin and the heavy-duty painkiller fentanyl — have spawned the deadliest epidemic of drug overdoses in U.S. history. It has killed over 47,000 people nationwide in the 12 months that ended in November, the most recent federal data.

About 100 supervised injection sites have opened in Canada, Australia and Europe over the past 30 years. At least one has been operating under the radar somewhere in the U.S. since 2014, according to a research paper .

The mayor of the college town of Ithaca, New York, proposed a supervised injection space in 2016. Now New York is seeking state and community approval for a one-year test of four “overdose prevention centers” at privately run syringe-exchange programs, and Philadelphia is looking for organizations interested in running or funding injection sites.

San Francisco initially hoped to open two sites this summer or fall but now isn’t setting a timeframe while working through legal issues. Seattle has budgeted $1.3 million this year to work toward launching a site, while opponents have been trying for a public vote on banning it.

A typical site would go well beyond VOCAL’s bathroom, offering a space with tables or booths set up with sterile syringes, alcohol swabs and other accoutrements.

As people injected themselves, staffers would watch for trouble signs and jump in with overdose-reversing drugs if needed. Workers would look for opportunities to discuss treatment, and advocates argue the caring-but-not-coercive approach helps people make changes. But the main goal is simply survival.

“You can’t detox if you’re dead. You can’t treat someone if they’re dead,” says Kassandra Frederique, New York state director of the Drug Policy Alliance, which advocates for less restrictive drug laws.

There has never been a reported overdose death at a supervised injection site, according to studies that say the facilities also reduce HIV infections and 911 calls for overdoses, among other problems. Researchers estimated New York’s City’s proposal could prevent 130 deaths and save $7 million in health care expenses per year.