During his afternoons at work, Bryan Ortiz wraps tourniquets around the arms of intravenous drug users to help them find a good vein. If asked, he will even insert the needle and pull back the plunger, before letting the user push the drug in.
Mr. Ortiz, 29, is the “responsible person” — his official title — on late shift at OnPoint NYC in East Harlem, one of only two openly operating supervised drug use locations in the country. He oversees filling the ends of crack pipes with copper filters, checks paperwork detailing illegal drugs being consumed, and disposes of used syringes while wearing a puncture-resistant glove.
And most days, at least once, he brings someone back from an overdose, administering oxygen or naloxone to an unconscious user, and working at it until his eyes flutter open.
Mr. Ortiz was once an emergency medical technician on a city ambulance and now works in a liminal legal space. OnPoint is officially sanctioned by the city but threatened by federal authorities who say the services Mr. Ortiz and his colleagues are providing are illegal.
OnPoint appears to be in violation of federal law — its so-called crackhouse statute makes it illegal to maintain a premises where illegal drugs are consumed — and has also angered some of its neighbors, who fear the center will encourage even more drug activity. brought to an area. area where it was common long before OnPoint arrived.
“They don’t just do their drugs there or get what they need there and then leave,” says Hallia Baker, 64, a pastor who has lived on East 126th Street since 1976. “They just hang around, and here they are.”
Supervised consumption centers have also criticized what opponents say effectively enables drug use. And yet, as more than 100,000 Americans die each year in an opioid crisis that the country has struggled to contain, some leaders have embraced a movement known as “harm reduction” to help users use safer drugs.
Studies of more than 100 safe injection sites in other countries have shown that these reduce drug use in the public sector and lower mortality rates. A branch of the National Institutes of Health recently began funding a five-year study of the New York City centers, which OnPoint leaders say signaled at least tacit approval from the Biden administration.
For Mr. Ortiz, the calculation is simple: Compared to his job as an EMT, he feels like he can save more lives here, teach people how to use more safely, and watch over them when they get high.
“Here I just feel like I’m helping everyone,” said Mr. Ortiz. “Some of them are in treatment, some of them have detoxed 10 times and are coming back. But we know that on the road to a better life there will be falls and scrapes.”
While trying to encourage his clients to start treatment, he also wants to help them stay alive when they stumble, he said. He and other employees at OnPoint’s two Manhattan locations say they have acted on more than 1,000 overdoses since opening in November 2021, with no fatalities — a record that has received rave reviews from public health officials.
But it has also led to new scrutiny from federal law enforcement.
Local, state and federal officials knew about the center, which was approved in 2021 by former mayor Bill de Blasio, and it functioned despite the illegality of the street drugs people use there — heroin, crack, methamphetamine.
But a few weeks ago, the U.S. Attorney for the Southern District issued a warning to OnPoint NYC and the city and state policymakers who support the project, which surprised them.
“Currently, without action by policymakers, the supervised consumption sites in New York City are operating in violation of federal, state and local laws,” said Damian Williams, the U.S. attorney responsible for Manhattan, in a statement to The Times on August 7. “That is unacceptable. My office is prepared to exercise all options – including enforcement – if this situation does not change in the short term.”
Since then, OnPoint employees have tried to understand Mr. Williams’ words, even though they have promised to continue to function. The federal prosecutor has not approached OnPoint directly, said Sam Rivera, the organization’s executive director. Mr Williams declined to comment further.
Earlier this month, Mayor Eric Adams’s administration reiterated the city’s support for the center’s work, even after Mr. Williams’ statement. Some state legislators, who have been trying to pass a bill that would allow supervised consumption sites, have reached out to their contacts in the federal government to see if the policy has changed. For the time being, the center is open as usual, although the mood is a bit more cautious.
There are about 200 visits a day to the guarded consumption room in East Harlem where Mr. Ortiz works, the busiest of the two OnPoint centers (the other is in Washington Heights). Hundreds of clients also come in for other reasons, such as to exchange needles, test their medications, do laundry, get free food, massages or medical care, or simply watch television in a safe space.
In the blocks around OnPoint at Park Avenue and 126th Street, a concentration of drug treatment programs, drug users, and drug dealers leads to use that can be remarkably overt.
This worries downtown neighbors, some of whom have lived in the area for decades.
While OnPoint has failed to control drug activity, some argue that this has only made matters worse. “If you don’t have the resources to make sure people don’t get out into the community and harass themselves, then you’re not helping,” Ms Baker said.
The folks at OnPoint say the realistic choice isn’t between a drug-free neighborhood and OnPoint, but between people using their drugs outside, or inside, where someone is there to help if they overdose.
“We are going to do it; we’re going to do it somewhere,” says Ann, 39, who goes to support groups downtown and showers there. She asked not to use her last name because of family issues. “So would you rather have it here or somewhere else?”
This is how Mr. Ortiz views his work. He’s doing it, he said, because during EMT training he still remembers a day when his ambulance got a call about an overdose in Central Park. No exact location was given, making response difficult, and when the ambulance arrived at the park, none of the employees got out to begin the search. That upset him.
Last Wednesday, Mr. Ortiz Marc, 65, a former carpenter, injecting fentanyl into a vein in his hand. Marc is on suboxone, a drug that helps reduce opioid cravings, but he said it wasn’t enough.
Baeya Harris, 36, was also in the consumption room, rolling joints in one of eight mirror booths. She just came upstairs from the women’s support group and said she wanted to be able to smoke without being harassed in the street. She also colored a design given to her by a co-worker to keep her calm.
Mr. Ortiz, who was born and raised in the Bronx, oversaw the action. He had become an ambulance crew, he said, after witnessing a family member overdose as a teenager. Only the rescuers knew what to do to save his relative, and he wished he was the one to help.
In his new job he keeps in mind that he is not that different from the people he helps. One injury that leads to addiction, a series of different choices, and he could be in their shoes.
He uses that sense of belonging, he said, to bond with customers. Sometimes he finds out that they went to the same high school or are from the same neighborhood. He tries to teach them how to avoid infections, wounds and overdoses, even when OnPoint is closed.
“Even if you’re mean to me, I’ll be the nicest and sweetest guy, and we’re going to build a relationship whether you like it or not,” he said. “And it always happens. It always works.”
He cleaned the mirror booths and stocked the storage bins with free syringes, crack pipettes, and alcohol swabs. Every pipe or needle someone here uses and throws away, he reasons, is one less on the street.