Nearly five years in, are NYC's supervised drug-use centers helping?

NEW YORK — In a back room behind a colorful storefront in East Harlem, people are smoking crack while staff keep watch. A few feet away, cubicles are ready for heroin users to inject with sterile needles. The scene is part of OnPoint NYC, one of two overdose prevention centers that New York City has permitted to operate since 2021.

The centers occupy a contested place in American drug policy. The city has sanctioned them; the federal government has not, and federal "crack house" laws make supervised drug use legally fraught. Now, nearly five years in, the question is whether the experiment is working.

Supporters say the sites reduce overdose deaths and public drug use, remove barriers to healthcare, and offer a model for the rest of the country. OnPoint's executive director, Sam Rivera, says the data show it: more than 2,100 overdose interventions with no fatalities, roughly 7,000 registered participants, and about 250,000 visits since opening. "250,000 times people used inside with us, not in the parks, not in the street, not in the playgrounds, not in bathrooms," Rivera said during a tour of the East Harlem facility.

The site looks less like a traditional clinic than a community center. In addition to smoking and injection rooms, it offers primary medical care, addiction medication, art therapy, sleep rooms, laundry, massage, acupuncture and aromatherapy. Soon, it will add hair styling. Rivera described those services as "medicine." "Those things are reducing drug use, introducing people into an environment that loves them," he said. "Many of our folks haven't experienced that."

A part-time employee who first came to OnPoint as a participant said the approach has made a difference. "I did the acupuncture, for the first time my back feels better. I didn't believe it but it really works."

Outside the building, the reaction is less positive. "You couldn't pay me to walk down that street anymore," said Syderia Asberry-Chresfield, co-founder of the Greater Harlem Coalition. "The dealers don't even have to look for clients. Drugs are being sold in front of everyone's faces. It's a slap in the face."

An educator at a nearby school, speaking anonymously because they were not authorized to talk to the media, said children have to confront the fallout each morning. "It's scary for the kids walking into school in the morning, seeing people in that state."

Led Black, founder of the community media organization Uptown Collective, lives a few blocks from OnPoint's Washington Heights location. "I have three daughters. They're not little, but they're still young, they still shouldn't have to deal with this," he said. "You don't want the kids downtown to see it. Why is it OK for the kids up here to see it?"

The politics around the centers are just as charged. Saritha Komatireddy, a former federal prosecutor running as a Republican for New York attorney general, said the model is unethical, cruel and illegal. "The problem here is these sites take people in, they give them deadly drugs, and then they turn them right back out on the street and into the subways. That's not a solution," she told CBS News. OnPoint says users can stay indoors and be monitored while they are under the influence.

Rep. Nicole Malliotakis, a New York Republican, asked then-U.S. Attorney General Pam Bondi last year to shut the facility down, pointing to federal drug laws. "They're enabling addiction instead of actually getting people the treatment they need to get off drugs," she said. "They're also letting dealers know where their clients are."

OnPoint also has a powerful ally in City Hall. Two months after taking office, Mayor Zohran Mamdani visited the East Harlem site and later posted on X alongside Rivera and staff: "This weekend, the team at OnPoint NYC kept their doors open 24/7 so vulnerable New Yorkers had somewhere safe to go."

OnPoint runs on about $19 million a year from city, state and private sources, including opioid settlement funds. The city's contracts total about $17 million, but city rules prohibit using that money for direct supervision of drug use. The organization also lost more than $2 million in grants from SAMHSA, the federal Substance Abuse and Mental Health Services Administration, after President Trump issued an executive order in July 2025 barring federal taxpayer dollars from funding "drug injection sites" or "illicit drug use."

The centers are part of a harm-reduction movement that took shape in the 1970s, as public health officials sought to meet drug users where they were without judgment. Clean needles and drug testing became standard tools. But the approach did not stop the addiction crisis from worsening. Federal data show overdose death rates quadrupled between 2002 and 2022, and the CDC counted nearly 108,000 overdose deaths in 2022 before the numbers started to fall.

Supervised consumption sites have operated abroad for more than two decades, with more than 100 facilities worldwide, many of them in Europe. Vancouver's site, open since 2003, is the most famous — and even there, overdose deaths rose for years before peaking in 2022. The evidence about their impact is mixed. A 2021 review of international research concluded that overdose prevention centers "may help reduce overdose morbidity," while a Canadian study from British Columbia found "no evidence that they reduce local hospitalization or mortality rates." The National Institute on Drug Abuse, part of the NIH, says that after 20 years of international experience, "it is unclear whether such facilities reduce overdose death rates overall."

Efforts to open similar sites in Seattle, Portland, San Francisco and Chicago have all failed, though those cities still run needle exchange and other harm reduction services. Rhode Island remains the only other state with a supervised consumption program, at Project Weber/RENEW in Providence. The NIH is now funding a multi-year evaluation of all three U.S. sites. One of the lead researchers said he believes they have had a positive public health effect, though the mortality data are not complete. Initial findings from that evaluation have shown a largely neutral effect on local business activity and drug-related crime.

In New York, overdose deaths have fallen sharply since 2023, the worst year on record, a decline that tracks the national pattern. The city's health department, in a press release, credited "several years of increased investment in evidence-based overdose prevention strategies in NYC," without referring to OnPoint by name.

Not everyone sees the program as a success. Charles Fain Lehman, a senior fellow at the conservative Manhattan Institute, argues that supervised consumption diverts resources from treatments that actually work. "There is a lot of evidence that interventions of this type generally do not have an appreciable effect on overdose deaths," he said. "If you're spending the dollars on an intervention that doesn't work, like supervised consumption sites ... you're not spending dollars on addiction medication and evidence-based treatment."

A CBS News review of crime and 911 data found no clear verdict. In the 34th Precinct, which includes the Washington Heights site, felony complaints have risen steadily since OnPoint opened. In the 25th Precinct, which includes East Harlem, they peaked in 2023 and then fell, ending last year about 10 percent above pre-pandemic levels — a better record than the rest of the city, where complaints stayed near 2024 levels. Citywide, felony complaints rose over much of that period, but more slowly than in the 34th Precinct. Most 911 calls from the OnPoint addresses were for ambulances; relatively few required police response. A 2023 study found no significant changes in crime or disorder near the sites. Another study, in the Journal for Experimental Criminology, found property crimes increased near the Washington Heights location after a Target opened nearby, a finding the authors linked to the site's proximity to a retailer with easily shoplifted products. It found no similar increase in East Harlem and no increase in violent crimes at either site. "This is our major conclusion: your location matters," said John Hall, a retired NYPD officer and co-author of the study.

Brandon Marshall, one of the researchers evaluating the U.S. sites for the NIH, cautioned that overdose prevention centers are not a cure-all. "They can reduce public drug use, they can reduce 911 calls. They can help people access healthcare and treatment. They are not a panacea to all social problems in a neighborhood."

Johns Hopkins bioethicist Travis Rieder argues that the debate will not be settled by data alone. "I don't actually think it's why anyone believes what they believe," he said. "They have a view about what we should actually be helping people to do or not do, and then they find the evidence that best supports their view." He described the model in moral terms: "You are welcome here, and I will watch over you so that you don't die today, and you're worth that. You deserve that because you're a human being and you have dignity. And I think that's a really beautiful thing."

For Led Black, that message has not eased what his daughters see on their way to school. "Why should it be an addict-focused approach?" he asked. "I wish it were a community-focused approach."

Jamie Korenblat and Max Moore contributed reporting.