Hochul rejects using opioid settlement money for safe injection sites

NEW YORK — Gov. Kathy Hochul is opposing the use of the state’s billions of dollars in opioid settlement funds for overdose prevention centers where people use drugs under the supervision of staff.

It’s a notable shift from her long noncommittal stance, and it puts her at odds with a state opioid board that recommended Wednesday that money go to the centers.

Hochul told reporters Monday that the opioid settlement funds must go to initiatives that would “withstand a legal challenge,” referencing a recent warning by the U.S. attorney for Manhattan that he might soon shut down the city’s two overdose prevention centers.

She also refused to pledge support for state legislation that would authorize the operation of the centers across New York, while questioning their efficacy.

“We are engaging in harm reduction strategies,” Hochul said, referencing a public health approach that targets the adverse effects of drug use. “There’s not only one. The ones that we’re doing are proven to be successful but also legal.”

The moderate Democratic governor said in February she was exploring the benefits and limitations of a statewide policy on overdose prevention centers.

But her newly clear political opposition to using settlement dollars for the centers effectively forestalls their expansion in New York beyond the two that operate in the city, which are privately funded.

Organizations that serve New Yorkers struggling with opioid addiction typically operate on thin margins, cobbling together government funding to provide treatment and other resources. That makes the state’s $2.6 billion from opioid-related legal settlements a crucial spigot that they’ve long been hoping to tap.

Experts and providers of substance-use related services argue the centers are now imperative to prevent fatal overdoses, given the escalating potency of the illicit drug supply. Overdose deaths in New York have skyrocketed over the last several years, surpassing 6,300 in 2022, according to preliminary state data.

Hochul’s health commissioner James McDonald publicly backed the model in his previous role as medical director of the Rhode Island Department of Health. In 2021, Rhode Island became the first U.S. state to legalize safe injection sites.

“We want to make sure that people who have a chronic disease, whether it’s opiate use disorder or substance dependence, have a safe place to consume their drugs,” McDonald told the Brown Daily Herald at the time, referencing the Rhode Island law. “What we’re doing is not working quickly enough.”

In his capacity as New York’s health commissioner, McDonald has not explicitly advocated for authorization and funding of overdose prevention centers.

“It took years to get where we got [in Rhode Island]; it was a lot of conversations,” McDonald said in an interview Monday. “And what I have found is that it’s really helpful to have conversations with lots of people, hear their points of view and then try to see what makes sense.”

International research out of Europe, Canada and Australia shows that overdose prevention centers, also known as supervised or safe injection sites, are associated with reduced crime and public drug use. They also produced lower demand for health care and emergency response services and increased access to substance use treatment in countries where they operate.

Not one person has died of a drug overdose while at a center, including the two in New York City, experts said.

The Hochul administration will soon be forced to detail its position in writing when it comes to using opioid settlement funds for the centers: The state’s 21-member Opioid Settlement Fund Advisory Board, established in 2022, is recommending for a second time that New York devote some of the settlement proceeds to overdose prevention centers.

The board on Wednesday sent its latest set of recommendations to state officials. Under state law, the governor’s administration must provide a written explanation within 14 days of any decision to reject a recommendation by the board.

“At this point, the omission of OPCs from the state’s strategy and the silence around their existence is embarrassing,” Toni Smith, New York state director for the Drug Policy Alliance, said during a board meeting Tuesday.

Chinazo Cunningham, commissioner of the state Office of Addiction Services and Supports and a Hochul appointee, rejected the board's proposal last year to direct funding to overdose prevention centers, arguing that it would violate state and federal laws.

Federal law makes it a felony to knowingly open or maintain any place for the purpose of using controlled substances, although in New York City, law enforcement agreed not to interfere with overdose prevention centers’ operations or bring any related criminal actions.

“One of the things that would really help us is if the federal government would be perhaps a little more vocal about what their position on this is,” McDonald said in an interview. “Sometimes when the federal government is more transparent, it gives states more comfort. And I think that’s what states are looking for.”

Members of the Opioid Settlement Fund Advisory Board are hoping that, by purposefully reframing their recommendation to more explicitly focus on research, they might win over Hochul this time around.

Specifically, the board recommended the state authorize a research-based overdose prevention center, which would work with academic institutions to develop, plan and evaluate the model from the ground up.

Smith, of the Drug Policy Alliance, noted the federal government is already funding similar research work by NYU Langone Health and Brown University’s School of Public Health to evaluate the impact and outcomes of overdose prevention centers in New York City and Providence, R.I.

U.S. Attorney Damian Williams has said the city's two centers are operating unlawfully until New York policymakers take action to authorize them.

“It’s an open secret that it’s her — she’s the barrier,” Smith said in an interview, referring to Hochul. “The state needs to act.”