Inside America’s First Overdose Prevention Center

CHRISTIANE AMANPOUR: Over 107,000 people died of a drug overdose in the United States in 2021. That is one overdose death every five minutes for a full year. One man attempting to change that is Sam Rivera. Executive director of OnPoint NYC. The organization tries to prevent drug-related deaths by providing safe spaces where people can use illegal drugs under staff supervision. New York City is the first to allow such centers but under federal law, they remain illegal. Sam Rivera joins Hari Sreenivasan to discuss the life-saving work taking place at OnPoint.

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HARI SREENIVASAN, CORRESPONDENT: Christiane, thanks. Sam Rivera, thanks for joining us. So, Sam, tell me — for someone who doesn’t know it OnPoint does, what is it?

SAM RIVERA, EXECUTIVE DIRECTOR, ONPOINT NYC: So, we’re a full-fledged harm reduction organization who provides, you know, who really work with people, specific people, at a time in their lives when there’s little left. People who’ve been dehumanized. People who are judged for what they do and not who they are. And most people who are really self-medicating trauma and traumatic pain and mental health conditions. Oftentimes not even knowing that’s what they’re doing. Because when I asked them, who are you? They’re identified by the names people call them. You know, I’m a loser. I’m a junkie. I’m lazy. And when I — when we get the opportunity to talk about what the roof of that pain and why they’re using drugs, we see a change. And in these, coming up on six months, I’ve watched some of those beautiful people change their lives and stay alive. Because we opened the safe — the overdose prevention program, safe consumption programs, people want — people tend to focus on that only. Now, that’s one element of what we do. What we know is, it’s important to have that program that is really, really crucial to have services collocate. So, we have medical services collocated. Case management, food and nutrition program, holistic health, acupuncture, acupressure, self-therapy, healing opportunities for our folks who have never, truly never had the opportunity. We not only offer that to the participants who come here. It’s also an offer we make to the community in general because we have to be a part of the community to be a part of this answer.

SREENIVASAN: Give me an idea of who is coming to your centers and what kinds of people are walking in there?

RIVERA: Yes, we’re getting folks who are active users. They’re not learning here. These are people who have been using a while. Most of our folks have been using for many years. And we have younger folks, a younger population who’s really starting to come in more often. People use a variety of drugs. And then in the other program, in Harlem, we have this older crowd who’s been around for a while. The people who come to our program have all, 100 percent of them, have been in treatment in the past, have tried detox in the past. 100 percent of them. So, you know, when people say, Sam, just send them to treatments. What are you doing? They’ve all tried it. And when I say, it doesn’t work. What we know is that most people do not stop using their first try or their fifth try. It takes work. It takes time. It takes love and compassion. Which is what we’re offering them in the interim. The other amazing thing happening which has shocked me a little, our drug treatment providers coming in and working with us. We changed the way we work. Our treatment providers are changing the way they work. Our medical providers are changing the way they work. It’s really coming to this beautiful place where we’re meeting for what it really is, which is this lifesaving health dimension.

SREENIVASAN: I think people might be familiar with needle exchanges or harm reduction programs that maybe don’t go as far as you do. I want, for our audience to understand, how do you prevent overdoses? Walk me through.

RIVERA: Sure.

SREENIVASAN: If somebody comes into your facility and they’re carrying drugs. What happens?

RIVERA: So, what happens is this — so, someone comes in and they’re going to come use drugs that they bring in themselves We don’t provide. Oftentimes, the perception is, when you walk in and open the door, there’s just a bunch of people using drugs and this space, and that’s what it is. It isn’t at all. It’s a very structured program. When you come into the facility, you’re walking into our drop-in center. You’re going to see people using a computer, having a meal, watching a movie. That’s what’s happening when you enter our drop-in center. Maybe 100 people sitting around, supporting each other. A mental health service provider, one of our mental health providers, sitting with them, talking to them about mental health conditions. Maybe waiting to see a medical staff or going up to our holistic program. Someone who comes into use drugs says, I’m here. This is what I’m here for. They receive a — if it’s their first time, they go to a full intake, which could be pretty long. So, we try to go through it as quickly as possible, but the data matters. Getting that information is crucial. We meet with them. We ask them what they’re using, how much, how, et cetera. We ask them if they weren’t here, where would they be? It’s a key question. Because what we know is before we opened, and even in many parts of the city and in this country, people use in hiding. They use in alleys. They use parks. They use some places also where the communities are impacted. And then we say, did you have any police contact? What was that like? We go through a process. And then they go to the back of the room, which is where they would meet yet with another person who, before they enter the room. At that point, the staff is screening them again. What are they using, how, or anything else? And then they enter the actual OVC, the safe consumption room. They go to the rear, wash their hands, et cetera. Pick up the paraphernalia they’re going to use whatever drug they’re using and how. How it’s being administered. We check in, if they’re OK, fine. If we see nod and we walk over and see — shoulders fall, now we check in a lot quicker on what’s going on? At that point, if their overdose is kicking in, we go into action. And we’re only using Narcan about 15 percent of the time. So, it’s kind of like, what are these people doing. So, we go to agitation. First, body movement and then we go to oxygen barrier. We use oxygen in every overdose or actually known as removing the opioid from the brain. Taking that off the brain so that person can come back, basically to life, and breathe on their own. But we’re monitoring them throughout that process. Five times, only five times, I’m proud of it, we called an ambulance for assistance. And of those five times, only two people, I believe, one or two actually left with the ambulance.

SREENIVASAN: So, how many times? You’ve only been open about six months now. How many times have you prevented someone from overdosing and dying?

RIVERA: We’re coming up on 300 times. 300.

SREENIVASAN: And those would be 300 dead people if you are not there?

RIVERA: Yes. 300 times in a city where we see 2,000 deaths. I think we’re having an impact. What we know is, anyone who dies of an overdose don’t have to. They just don’t. Yesterday, our region and public safety team was returning from a park from doing their work in the community because we also clean the community, we clean syringes, we pick up syringes, we monitor folks in the street as well. They were returning, stopped a Burger King to use the restroom, and a man was laid out for 20 minutes. The security person at Burger King said he’s dead. Tongue out, blue. And this amazing team brought him back to life. You know, it’s — to have staff who are willing to step in like that, you know, come in and — I’m praising them and giving them this credit and they’re like proud to have been in that moment. It’s just — it’s painful to think that this guy, this was a well-dressed man, healthy, who, we what understand went in there to take a quick — what we call a quick bump of cocaine, and it had fentanyl. He would’ve gone home to his family that night. You know, this was a man who had a job nearby. Just decided to run in their very quickly. You know, the reason isn’t important. What’s important is if he had access to a place, then we would’ve been in that room with him that he would’ve have gotten to basically die and come back to life. I’m proud of what we are doing. I’m proud of the — you know, the courage we have to do it, the way we are doing it. I have to say too, very important, the City Health Department, our previous mayor, our current mayor, have stepped up, has stepped up. Our state officials have stepped up. And it’s important because if they don’t, I hold them accountable. When they do, I really want to acknowledge that. Harm reduction in this world have been amazing and we just know, people don’t have to die if someone is there with them with the appropriate skills or NARCAN to respond to the overdose.

SREENIVASAN: Are these operations technically legal? I mean, isn’t there a law, at least, in federal books, that says, you can’t be doing this?

RIVERA: Yes. So, technically, these services are illegal, federally. There’s something called a crack house statute. When you take cocaine and call it crack, you make it a black and brown (INAUDIBLE) issue. For me, that’s intentional. We have a president who proudly, in the past, has probably talked about creating the crack house statute. What I remind the president often, I’m trying to get it to him, is we’re blessed to live in America, the land of second chances. And we want to see him basically get rid of the crack house statute. It is preventing hundreds, thousands of lives, how about 107,000 of lives from being saved. The crack house statute prevents us from running this program federally. The crack house statute prevents us from receiving funds. I am running these two programs from unrestricted funds, from donations. We’ve got a few people to step up and donate money because they know this is the right thing. We’ve had people step up to donate money because they lost loved ones. And so, yes, federally, it’s illegal. It’s a risk that I’m willing to take. It’s a risk my board is willing to take. And what I mean by that is, we can be arrested for running this program, which is a shame. It’s really a shame. So, I look forward to Rahul Gupta, the head of ONDCP and Joe Biden, our president, to step up and make this change. They know it’s right. They know it’s working. They have peeped in. And we are going to stand. We’re going to stand continue to provide these lifesaving services.

SREENIVASAN: Sam, the — when I hear about how your people are coming into this and what they are doing in terms of the types of drugs that they are using, I hear automatically one of the sorts of baked in critiques, that you’re essentially enabling someone to continue, perhaps even push the limits of that drug because they know that, guess what, I’m not going to die. So, I can do this at this facility. What do you say to that?

RIVERA: We’re enabling people to stay alive. That’s what we are doing. People who us, will use until they are ready to stop. The reason why they come in here is because there’s a level of safety, there is a level of compassion and support. There is a community building for them. People who use in the street are hiding, are treated differently, are physically abused. Women who use in the street are often attacked sexually and physically abused as well. So, creating the safe environment for them to use — if we close tomorrow, they are going to keep continue using. Please, I tell people often, talk to people who you know use drugs or have used drugs, it’s not about what we can do necessarily to stop that, it’s really about them experiencing life in a very different way, in a very loving, compassionate, supportive way. That’s really what it is. And when someone is ready, we want to be, and we are ready to take them to this next place. So, it’s — I understand that. I will say this, if I wasn’t the one running it, I would probably have similar questions.

SREENIVASAN: You know, setting up the center like this often provokes a little bit of, not in my backyard backlash. And how has the reception been? Here you are into neighborhoods in six months. What has changed?

RIVERA: Yes. So, initially there was backlash. There was a lot of as well. We got grouped into concerns regarding an oversaturation of programs in certain neighborhoods, and specifically in Harlem. And we had to remind people, we’ve been here 22 years and we’ve been doing this work as an organization for 30. So, we weren’t new to the community. So, people were like, we don’t want any new programs. We’re like, we are not new. What we are is improved, not a new. The other thing was really to give people access. So, once people came and were concerned — and I get it. I get it. This is — you know, this is from 30,000 feet away, from 20 feet away. It’s like what is really going on? This doesn’t — this sounds way out there. It’s radical. No, it’s righteous. This is righteous. This is healing — this is a healing community. Good medicine, as we say in the native community. So, we brought people in. We have walked them through. We introduced them to how we are doing it. We got rid of the perceptions of what it looks like. And now, the very people — and this is another problem, the very people who are questioning us are partnering with us. The police department are our partners. They asked us to create a card that they could give to someone when they see them using and say to them, we’re not going to arrest you. Please come inside and use here. Use that OnPoint NYC where they can take care of you and protect you. So, people who questioned us, we have politicians who questioned us, and now, believe in us, they are our partners. So, it’s really about embracing the concerns, acknowledging their concerns are legit, 100 percent. And then, introducing them to the process. And so, really, exposure is a big one, opening our doors and being as transparent as possible is what helped us and got us through really through the (INAUDIBLE).

SREENIVASAN: Look at five years, 10 years, what’s your best-case scenario?

RIVERA: So, the war on drugs is really about a war on the individuals who use drugs. They are the ones paying for it through drug use, being criminalized, having to go to prison because of that. Having to be forced into treatment and then, believing the system, believing it worked well for them because they stopped using while they were treatment when the alternative is, if you don’t complete this treatment, you are going to prison. That’s being held over their heads. So, yes, I definitely — this country needs many more of this immediately. And in my dream world, we will have to close them, that service, not all the other services. But in my dream world, we wouldn’t need them. We wouldn’t need them.

SREENIVASAN: Sam Rivera, executive director of OnPoint NYC, thank you so much for joining us.

RIVERA: Thank you. Appreciate it.