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To Whom It May Concern:

We are concerned medical professionals who care for people who struggle with opioid addiction.

Opioid addiction is a chronic medical condition marked by a physical and psychological dependence on opioids (often prescription drugs or heroin). As the disease progresses, patients often require increasing amounts of opioids to prevent debilitating withdrawal symptoms. As a result, many of our patients resort to intravenous injection of drugs, which is a more efficient and cost-effective way for them to treat their withdrawal.

Unfortunately, it is also far more dangerous.

Intravenous injection of drugs puts our patients at increased risk of fatal overdose. It also increases patients’ risk of bloodstream infections and infection with HIV and Hepatitis C.

And due to stigma around injection drug use, many of our patients must resort to public injecting in abandoned buildings, public parks and bathrooms.  Public injection increases the risk of injection drug use even further as these spaces are often 1) unsupervised, putting patients at increased risk of overdose death, and 2) unsanitary, putting patients at increased risk of infection.

While our goal is to link patients who inject drugs to long-term comprehensive treatment for addiction, many are not ready for a variety of reasons. It is these patients who are at the highest risk of harm from their drug use. And it is these patients who are failed by our current healthcare system.

Supervised injection facilities (SIFs) are part of a comprehensive public health approach to reducing the harms of drug use. A SIF is a controlled healthcare setting where people struggling with addiction are able to self-inject pre-obtained drugs in a hygienic environment under the supervision of trained medical staff. SIFs bring a vulnerable and high-risk population out of the shadows — where overdose and injury are more common — and provide a safe, clean space for those who inject drugs but who are not yet ready to engage in drug treatment.

Decades of research on SIFs is strong and compelling. They have been shown to reduce public injecting, overdose deaths and infection with HIV and Hepatitis C. They also increase access to drug treatment for a population that is less likely to seek treatment on their own due to mistrust of the healthcare system.

Moreover, SIFs have been proven to be cost-saving by reducing the need for emergency medical services and by reducing incidence of expensive chronic conditions such as HIV and Hepatitis C.

And despite skepticism by those unfamiliar with the data, SIFs do not increase drug use in the surrounding community. SIFs do not increase initiation of injection drug use. And SIFs do not increase drug related crime.

There are 99 SIFs operating in 66 cities in 10 countries around the world. Yet despite evidence of their success, there is not a single SIF in the United States. We are long overdue. And New York City, which has experienced a steady increase in overdose deaths in the past several years, is in particular need of such a public health intervention.

SIFs cannot prevent all risky drug use or related harms. But evidence demonstrates that they can be remarkably effective and cost-saving, while improving the lives of people who inject drugs and the safety and health of our communities.

NYC Health Professionals Who Have Signed On

1. Matthew Akiyama MD, MSC
2. Ilias Almakaev MD
3. Matthew Anderson MD, MSC
4. Gina Arias RN
5. Marcus Bachhuber MD
6. Diya Banerjee MD
7. Rachael Bedard MD
8. Elisabeth Berger MD
9. Nadejda Bespalova MD
10. Cedric Bien MD
11. Oni Blackstock MD
12. Mindy Brittner MD
13. Ashley Ceniceros MD
14. Rachel Chalmer MD
15. Krystal Cleven MD
16. Robert Cohen MD
17. Michael Cooper MD
18. Chinazo Cunningham MD, MS
19. Elenita D’Aloia RN
20. David Dayan-Rosenman MD
21. Nicholas Deak FNP
22. Oscar Dimant Medical Student
23. Ernest Drucker PHD
24. Maria Duenas MD
25. michael duncan rpa-c
26. Benjamin Eckhardt MD
27. Brian Edlin MD
28. Kevin Fiori MD, MPH
29. Manuel Fishman MD
30. Julia Fleming MD
31. Mary Foote MD, MPH
32. Beverly Forsyth MD
33. Aaron Fox MD, MS
34. Ariel Franks MD
35. Maria Gervits MD
36. Jonathan Giftos MD
37. Marshall Glesby MD, PhD
38. Andrew Goldstein MD
39. Mary Gover MD
40. Philip Gyura NP
41. Philip Gyura NP
42. Ashley Gyura NP
43. Norma Hannigan DNP, MPH, FNP-BC
44. Iman Hassan MD
45. Jo Henderson-Frost MD Candidate
46. Louisa Holaday MD
47. Julie Holland MD
48. Shwetha Iyer MD
49. Jonathab Jacobs MD
50. Andrea Jakubowski MD
51. William Jordan MD, MPH
52. J. Keith Joseph MD
53. Mat Kladney MD
54. Chance Krempasky WHNP
55. Marissa Lapedis MD
56. Karyn London PA
57. valsa madhava MD
58. Lucy Manchester MD
59. Marc Manseau MD, MPH
60. Mayce Mansour MD
61. Leslie Marino MD, MPH
62. Toni Martello MD
63. Mariya Masyukova MD
64. William Matthews PA
65. Samuel Merrick MD
66. Robert Morrow MD
67. Noriyuki Murakami MD
68. Shadi Nahvi MD, MS
69. Daniel Neghassi MD
70. Brianna Norton DO
71. Sarah C Nosal MD
72. Jeffrey Nusbaum MD
73. Mary Ellen Nusbaum MS,SM(AAM),MT(ASCP)
74. Alexander Pappas MD
75. Viraj Patel MD
76. David Perlman MD
77. Russell Perry MD
78. Justine Phifer MD
79. Shruthi Rajashekara MD
80. Caroline Rath PA
81. Evan Rausch MD
82. Luis Rivera Community Health Workers
83. Rebecca Roach MD
84. Gabriela Rodriguez Caprio MD
85. Jonathan Ross MD
86. Zoe Sansted MD Candidate
87. Sheira Schlair MD, MS
88. Erin Schroeder NP
89. Richard Silvera MD, MPH, CPH
90. Gabriel Silversmith MD
91. Sharon Stancliff MD
92. Joanna Starrels MD
93. Jennifer Suski NP
94. Ellen Tattelman MD
95. James UHRIG MD
96. Linda Wang MD
97. Caryn Weiss NP
98. John Welch LCSW
99. Timothy Wilkin MD
100. Philip Zachariah MD
101. Grecia Zamora RN 17
102. Rachel Zhuk MD
103. Jessica Ziemba PA


"I stand with the SIF NYC coalition in calling on New York City and New York State government to take all necessary steps to authorize and establish supervised injection facilities..."


We are a growing coalition of public health and criminal justice reform groups and NYC residents that believes that supervised injection facilities are an important solution to problems related to drug use in our city.