OASAS’s Opioid Treatment Program Locations’ Concordance with Racist Redlining Maps

To see the presentation by Shawn Hill at the Rockefeller Institute of Government’s Developing Evidence-Based Drug Policy Conference (October 14, 2021) see:

https://docs.google.com/presentation/d/14DyAjBrGWu8a9EoEP25N3B9J8gCtzsJUV2lYPjJ9Jyc/edit?usp=sharing

or watch the recording of the presentation:

Redlining and Opioid Treatment Programs in New York City

The New York State addiction agency – OASAS – has licensed decades of opioid treatment programs (OTPs) throughout New York.

Examining the locations of the 69 OTPs in New York City, shows a non-random spatial pattern that can be compared to neighborhoods that were racially redlined in 1938. When the two geographies (separated by over 80 years) are overlaid, a shocking correspondence is immediately seen. 96% of OASAS licensed OTPs in New York City, are located in residential areas that had been redlined as “Definitely Declining” or “Hazardous”.

[The map, above, shows 1938 redlined New York City with dots indicating the location of 21st century opioid treatment programs]

This classic example of conscious and unconscious structural racism – locating OTPs under the guise of care while actually mirroring an 80 year-old map’s racist community designations – has had tremendously negative consequences for Harlem and East Harlem. The intense density of large methadone mega centers attracts a daily influx of drug dealers who feed and profit on the concentration of methadone patients. The dealers in turn attract (non-patient) users, who commute into Harlem and East Harlem in order to purchase. The inevitable outcome is that dealing increases, using increases, and overdoses increase – all of which are then used by OASAS to justify increasing the capacity of programs in fragile communities.

To see the full presentation of this cycle, see the video below – a presentation at Rockefeller Institute of Government at the Developing Evidence-Based Drug Policy Conference 2021.

https://fordham.hosted.panopto.com/Panopto/Pages/Viewer.aspx?id=b8f0dec0-2592-475d-8e8e-adc600cc2bd6

Opioid Treatment Deserts

While Harlem is oversaturated with 18% of drug treatment capacities, many districts have no such capacities whatsoever

The distribution of Opioid Treatment Programs (OTPs) reflects the historic and ongoing medical redlining of low-income communities of color. This map of New York City shows (in red) Community Districts that have little or no OASAS licensed programs to support their opioid-addicted residents. As a result, their community members must commute to other, oversaturated neighborhoods for treatment.

Community Districts in red have an Opioid Treatment Program capacity of under 100 for their entire community.
Community Districts in red have an Opioid Treatment Program capacity of under 100 for their entire community.

Oversaturation by Community District (Community Board)

Graph illustrating the capacity of OASAS-certified OTPs
OASAS is oversaturating East Harlem

This visualization illustrates how East Harlem is oversaturated by OASAS. Given that 84% of all opioid treatment programs in CB11 commute into East Harlem from other Community Districts, our community is shouldering far more than its fair share.

East Harlem Burdened By More Than Its Fair-Share

East Harlem (in red, below) hosts a disproportionate number of OASAS-licensed Opioid Treatment Programs, that wealthier zip codes have rejected. This graph clearly illustrates that the NYS Office of Addiction Services and Supports applies discriminatory medical redlining, forcing low-income communities of color to bear more than their fair share of programs.

OASAS Licensed Opioid Treatment Program Capacity Totals (by Zip Code)