This story was originally published at Prism.

At 8 a.m. on a Monday morning, most of the soft recliners in the waiting area of the three-story East Harlem overdose prevention center (OPC) are already occupied by those who have come to consume their first dose of the day. Whether it’s for fentanyl, heroin, or another drug, people of all ages trickle into the consumption room at OnPoint NYC, where mirrored cubicles line opposite sides of the room and a staff station sits in the middle with trays of needles, elastics, and wipes organized in rows.

A man, who looks to be in his late 30s, unwraps today’s first fix of what most likely is the opioid fentanyl, which staff say is the most common drug used here. He simultaneously chats with the staff who welcome each visitor with familiarity. The calm ambiance is occasionally punctuated with noise as the metal doors swing, allowing another person to enter.

OnPoint NYC, which opened in 2021 as the country’s first overdose prevention site, aims to be a judgment- and persecution-free space for drug users to safely consume. The idea of preventing people from dying of an overdose is a controversial one. Last year, former U.S. attorney for the southern district of New York Damian Williams told The New York Times that OnPoint’s methods were illegal and hinted at a shutdown, while New York Gov. Kathy Hochul is also opposed, having repeatedly said the centers violate federal and state laws, putting their future operations in the balance.

But amid the national opioid epidemic, drastic measures are needed. More than 100,000 people die each year from drug overdoses in the U.S., according to the National Center for Health Statistics. In November, President-elect Donald Trump announced plans to impose further tariffs on Chinese imports in an attempt to curb what he believes are fentanyl deliveries into the U.S. It follows calls in 2022 from President Joe Biden to increase funding in the budget to address the overdose epidemic, while in 2023 New York Times editors declared that the U.S. had lost the war on drugs.

“Every 90 minutes … four New Yorkers die [of an overdose],” said Sam Rivera, the executive director of OnPoint NYC.

Advocates for OPCs say having a sanitary and safe place to consume drugs diminishes the element of haste or need for discretion that might exist in a public place. This reduces the risk of an overdose, but should one occur, medically trained staff dressed in jeans and leather are ready to respond.

Tilting a chair back, a staffer explains the importance of getting the blood circulating and offering rescue breaths before administering naloxone, which can reverse the effects of opioids. Since 2021, OnPoint NYC has reversed 1,600 overdoses, cleaned up community parks, and opened a sister center in Washington Heights.

Despite the progress, the center, and the few others like it in the U.S.,........

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