A nurse holds equipment for an intravenous drug addict at Insite, a supervised-injection facility in Vancouver, B.C. Darryl Dyck/The Canadian Press/AP

Perhaps, according to new research on drugs and public restrooms in the city.

There are about 100 facilities worldwide that allow addicts to legally and safely inject drugs, from Vancouver to Barcelona to Sydney. Might New York be next to embrace this strategy for reducing disease, public blight, and drug overdoses?

Some emboldened form of intervention is needed in New York, where overdose deaths, mostly from opioids, jumped 43 percent from 2010 to 2014. But the political will has so far been lacking for a supervised injection site, where users have clean equipment, social workers, and medical staff poised to administer naloxone and other overdose antidotes. (Heroin-swamped Ithaca, New York, is arguably more progressive on the matter.)

A new study in International Journal of Drug Policy suggests the city could benefit from one. Addicts often inject in concealed public spaces like alleys and business restrooms, a quick-and-dirty process that jacks up the risks of disease transmission and overdosing alone and out of sight. Researchers from New York University wanted to see how people were employing bathrooms as injection havens, so they surveyed 86 business managers about whether they’d encountered drug use in their toilets in the past six months.

Fifty said yes. Here’s what the researchers learned from them, according to a university press release:

The research team found that managers reported a median of three encounters with drug use per month. Fourteen percent (7 managers) called 911 due to encounters with unresponsive users. Nearly half of managers who called 911 requested both law enforcement and EMS, suggesting the calls were not solely made because of disruptive behavior, but out of concern for the individual’s health. Additionally, over a third of managers found improperly disposed syringes in their business’ bathrooms, putting PWID, community members, and staff at risk of needle sticks and potentially HIV, HCV, and HBV infection.

“These managers, by default, are first-responders in the event of a drug overdose and thus of intrinsic interest during the current epidemic of opioid-related overdoses in the U.S.,” said [lead author Dr. Brett] Wolfson-Stofko.

The survey found that only 10% of these managers reported some type of overdose recognition and naloxone training. Unsurprisingly, 64% thought this training would be useful and is something Dr. Wolfson-Stofko is currently pursuing.

Of course, it’s not the job of your typical Starbucks or Wendy’s manager to act as first responders. But they sometimes do, a dismal fact that might be remedied in New York by opening supervised injection sites, which have a reportedly perfect score in preventing overdose deaths. “Supervised injection facilities and drug consumption rooms are practical, cost-effective strategies,” says Wolfson-Stofko, “that would more than likely reduce public injecting and overdose mortality in New York City and assist in linking this population to health services and drug treatment just as they have in other cities throughout the world.”

About the Author

John Metcalfe
John Metcalfe

John Metcalfe is CityLab’s Bay Area bureau chief, based in Oakland. His coverage focuses on climate change and the science of cities.

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