>>> GOOD EVENING AND WELCOME TO "METROFOCUS."

I'M RAFAEL PI ROMAN.

BY NEARLY EVERY MEASURE, THE OVERDOSE CRISIS CONTINUES TO WORK.

IN NEW YORK STATE 16 PEOPLE DIE EVERY DAY OF AN OVERDOSE.

THAT'S ONE PERSON EVERY THREE HOURS.

JUST FIVE YEARS AGO IT WAS ONE PERSON EVERY EIGHT HOURS.

NOW FOR THE FIRST TIME EVER, THE FEDERAL GOVERNMENT HAS BEGUN TO FUND AND PROMOTE HARM REDUCTION AS PART OF THE ONGOING EFFORTS TO COMBAT WHAT HAS BECOME A RELENTLESS AND TRAGIC SITUATION.

FOR THOSE WHO HAVE DEDICATED THEMSELVES TO PUSHING BACK AGAINST THIS BRUTAL EPIDEMIC, THIS CHANGE HAS RELEASED MILLIONS OF DOLLARS AND OPENED UP AN ENTIRELY NEW SET OF RESPONSE TACTICS, FROM THE WIDESPREAD DISTRIBUTION OF THE OVERDOSE DRUG MA LOCKS OWN TO THE EXPANSION OF NEEDLE EXCHANGE PROGRAMS.

OVER THE NEXT YEAR WE'LL BE BRINGING YOU A SERIES OF STORIES ON HOW NEW YORK IS CHANGING THE WAY IT DOES THINGS IN AND AROUND THE CITY TO SAVE LIVES.

CHRISTOPHER BOOKER HAS OUR STORY TODAY.

>> THE NUMBER ONE MESSAGE WE ALWAYS GIVE IS NEVER USE ALONE.

THAT'S THE NUMBER ONE HARM REDUCTION STRATEGY.

IF THEY HEAR NOTHING ELSE, NEVER USE ALONE.

WHEN YOU USE ALONE THERE'S NO ONE THERE TO RESPOND IN CASE YOU OVERDOSE.

>> FOR A NEW YORK STATE EMPLOYEE TO BE SPEAKING THIS FREELY AND OPENLY ABOUT HOW INDIVIDUALS SHOULD APPROACH THEIR DRUG USE IS A TESTAMENT TO A CHANGING TIDE.

FOR MARY BREWSTER, NEW YORK'S NEWLY APPOINTED ASSOCIATE COMMISSIONER FOR HARM REDUCTION, SUCH A FRANK AND HONEST CONVERSATION IS LONG OVERDUE.

>> WE KNOW PEOPLE WILL ALWAYS USE DRUGS.

IF WE KNOW PEOPLE ARE ALWAYS GOING TO USE DRUGS, HOW DO WE GET THEM TO USE DRUGS AS SAFELY AS POSSIBLE AND RECOGNIZING THAT EVERY SINGLE LIFE HAS VALUE AND WE SHOULD DO EVERYTHING WE CAN TO SAVE THAT LIFE.

>> Reporter: AS PART OF HER POSITION, THE VERY FIRST-OF-ITS-KIND IN NEW YORK, BREWSTER WILL SPEND MUCH OF THE NEXT YEAR VISITING REHABILITATION CENTERS ACROSS THE STATE, HELPING FACILITIES LIKE THIS ONE WITH THEIR NALOXONE DISTRIBUTION, FENTANYL TESTING AND NEEDLE EXCHANGE EFFORTS.

TODAY SHE'S MEETING WITH TWIN COUNTY RECOVERY SERVICES IN HUDSON, NEW YORK.

>> MAKING SURE ALL THE MOMS HAVE NALOXONE AND KNOW HOW TO USE IT AND HAVE THESE CONVERSATIONS WITH THEIR KIDS THEY KNOW ARE USING OPIOIDS.

IF YOU'RE GOING TO USE, LET ME KNOW SO I CAN BE READY WITH NALOXONE IN CASE.

>> Reporter: HARM REDUCTION PLAYED A CRUCIAL ROLE IN THE DRAMATIC REDUCTION IN HIV INFECTIONS AMONG INTRAVENOUS DRUG USERS.

ACTIVISTS LAUNCHED CLEAN NEEDLE CAMPAIGNS.

IN SAN FRANCISCO, THE AIDS FOUNDATION CREATED A MASCOT, BLEACH MAN.

>> CLEANING IS EASY.

>> Reporter: WHILE HARM REDUCTION HAS BEEN USED FOR DECADES, THE TERM HAS NEVER BEEN USED AS PART OF ANY FEDERAL RESPONSE.

BUT FOR THE FIRST TIME THE BIDEN ADMINISTRATION INCLUDED THE TERM HARM REDUCTION IN LAST YEAR'S FEDERAL BUDGET.

THE INCLUSION COMES AS RESEARCH CONTINUES TO POINT TO THE EFFICACY OF THE APPROACH.

NEARLY 30 YEARS OF RESEARCH SHOW THAT USERS OF SYRINGE SERVICE PROGRAMS OR SSPs ARE FIVE TIMES MORE LIKELY TO ENTER DRUG TREATMENT AND ABOUT THREE TIMES MORE LIKELY THAN THOSE WHO DON'T USE SSPs.

>> HOW IMPORTANT WAS IT TO HAVE THE BIDEN ADMINISTRATION USE THE TERM "HARM REDUCTION?"

>> IT WAS HUGE.

IT WAS HUGE.

FOR THE FEDERAL GOVERNMENT TO, ONE, SAY THE WORD AND THEN TO FUND IT.

>> Reporter: AS PART OF THE $42.5 BILLION BUDGET FOR THE NATIONAL DRUG CONTROL AGENCIES, THE BUDGET EARMARKED MILLIONS OF DOLLARS TO IMPROVE ACCESS TO NALL LAX OWN AND DISTRIBUTE FENTANYL TEST STRIPS ACROSS THE UNITED STATES.

>> THOSE STILL STRUGGLING, I WANT YOU TO KNOW I SEE YOU.

>> WE NEED TO DO EVERYTHING WE CAN TO REALLY HELP KEEP PEOPLE ALIVE.

>> Reporter: DR. CUNNINGHAM WAS APPOINTED COMMISSIONER OF NEW YORK'S ADDICTION SERVICES AND SUPPORTS OASIS BY GOVERNOR HOCHUL IN JANUARY.

>> WHERE WOULD YOU SAY THINGS ARE IN WHAT YOU HOPE TO ACHIEVE?

>> WE'RE IN THE WORST OVERDOSE EPIDEMIC ON RECORD.

IN NEW YORK STATE 16 PEOPLE DIE EVERY DAY OF OVERDOSE.

THIS IS INVOLVING MOTHERS, FATHERS, CHILDREN, AUNTS, UNCLES, NEIGHBORS, CO-WORKERS.

THERE'S NO PLACE THIS DOESN'T TOUCH.

I THINK THERE'S NO FAMILY OR INDIVIDUAL THAT THIS DOESN'T TOUCH.

>> Reporter: WHILE CUNNINGHAM HAS BEEN WORKING IN ADDICTION SERVICES FOR DECADES, SHE SAYS THE OFFICIAL ADOPTION OF HARM REDUCTION STRATEGIES IS SUBSTANTIAL.

>> THERE'S A TON OF EVIDENCE, DECADES OF EVIDENCE ACROSS THE WORLD THAT SHOWS THAT HARM REDUCTION EFFORTS ARE REALLY EFFECTIVE.

THIS IS ALSO USING A DATA-DRIVEN APPROACH AND EVIDENCE-BASED STRATEGIES, ABSOLUTELY WHAT WE NEED TO BE DOING.

THIS IS A MEDICAL CONDITION.

WE NEED SCIENCE TO HELP GUIDE OUR WORK.

THIS IS NOT ABOUT, YOU KNOW, MORALITY AND WEAKNESS OR STRENGTH.

IT'S ABOUT A MEDICAL CONDITION.

SO WE NEED TO APPROACH IT IN THAT WAY.

>> WHAT'S A GREATER CHALLENGE, WORKING WITH THE COMMUNITY OF USERS OR WORKING WITH THE COMMUNITY OF NON-USERS AS IT RELATES TO UNDERSTANDING AND ACCEPTING HARM REDUCTION AS A POLICY?

>> WE ALL GREW UP HEARING THE SAME MESSAGES IN THIS COUNTRY.

SO DOCTORS, LAYPEOPLE AND PEOPLE WHO USE DRUGS.

THOSE MESSAGES WERE JUST SAY NO, AND THIS IS YOUR BRAIN ON DRUGS WHICH, FRANKLY, ARE HARMFUL.

SO I THINK ACROSS THE BOARD IT'S A LITTLE BIT OF UNLEARNING WHAT THOSE EARLIER MESSAGES CONVEYED.

>> I GOT THIS TATTOO BEFORE I GOT THE JOB, BUT I LITERALLY HAVE A TATTOO THAT SAYS ANY POSITIVE CHANGE, IT'S MY HARM REDUCTION TATTOO.

>> WHEN YOU LOOK AT THE CURRENT LANDSCAPE, HOW DO THINGS LOOK TO YOU?

>> IN FIVE YEARS IN NEW YORK CITY WE'VE GOT FROM ONE PERSON DYING EVERY EIGHT HOURS TO EVERY THREE HOURS.

IT WAS REALLY IMPORTANT FOR THE BIDEN ADMINISTRATION TO RECOGNIZE HARM REDUCTION IS LEGITIMATE AND TO ACTUALLY PUT MONEY INTO OUR FIELD.

YOU CAN'T HELP BUT BE OPTIMISTIC ABOUT THAT AND HOPEFUL.

I HAVE TO BE HOPEFUL.

IF I'M NOT HOPEFUL, WHAT'S IT ALL FOR?

WE HAVE TO THINK WE CAN MAKE CHANGE.

>> ON DECEMBER 16th, THE NATIONAL INSTITUTES OF HEALTH ANNOUNCED IT WOULD BE LAUNCHING A HARM REDUCTION RESEARCH NETWORK.

THE $36 MILLION NETWORK WILL FUND NINE RESEARCH PROJECTS AND CREATE ONE COORDINATING CENTER.

THE NETWORK WILL BE THE FIRST-OF-ITS-KIND IN THE UNITED STATES.

FOR "METROFOCUS," I'M CHRISTOPHER BOOKER.

>> WHILE THE TIDE MAY BE CHANGING IN THE WAY NEW YORK IS RESPONDING TO THE OVERDOSE CRISIS, FOR THOSE WHO SPENT DECADES ON THE FRONT LINES, THERE IS A LONG WAY BETWEEN POLICY AND THE STREET.

CHRISTOPHER BOOKER HAS MORE ON THAT STORY AS PART OF OUR ON GOING SERIES.

>> Reporter: TODAY IN FAR ROCKAWAY QUEENS, JOHN McCAIN ANY SIMMONS STARTED WITH HANDOUT Z AT McDONALD'S.

HER FRIEND WAITED OUTSIDE WHILE SHE DISTRIBUTED NALOXONE AND FENTANYL TEST STRIPS.

WE WERE ASKED NOT TO FILM INSIDE.

>> THESE ARE FENTANYL TEST STRIPS.

ARE YOU FAMILIAR WITH THOSE?

>> Reporter: SIMMONS IS AN ASSOCIATE RESEARCH SCIENTIST AT NEW YORK UNIVERSITY HAS A SPECIAL ARRANGEMENT WITH THE MANAGER WHO ALLOWS HER TO CONNECT WITH THE NEIGHBORING COMMUNITY WHO GATHER IN AND AROUND THE RESTAURANT FOR PRIVACY.

McDONALD'S IS THE FIRST STOP.

NEXT IS A NEARBY PARK.

>> IF SOMEONE IS OVERDOSING, IF YOU SEE SOMEONE IN THE PARK THAT'S OVERDOSING -- >> HOW MUCH HAVE YOU BEEN DOING THAT WORK?

>> PRETTY MUCH THREE DECADES IF YOU INCLUDE HIV PREVENTION.

I STARTED WORKING IN OPIOID PREVENTION ABOUT 2013 I THINK.

>> Reporter: TAKING WHAT YOU KNEW FROM YOUR HIV/AIDS WORK INTO THIS WORLD, HOW DIFFERENT IS THAT?

>> WELL, I THINK I STARTED WORKING IN OPIOID OVERDOSE PREVENTION BECAUSE I STARTED TO RECOGNIZE THE SENSE THAT OPIOID OVERDOSE DEATHS WERE SURGING, VERY SIMILAR TO THE AIDS EPIDEMIC.

WE REALIZED A LOT OF PEOPLE WERE GOING TO DIE.

>> I DON'T TAKE DRUGS.

>> IT DOESN'T MATTER.

YOU STILL MAY BE IN A SITUATION WHERE YOU'RE SEEING SOMEONE -- >> YEAH.

WE SEE EVERYBODY.

>> HARM REDUCTION IS ABOUT TREATING PEOPLE LIKE HUMAN BEINGS, JUST TREATING SOMEONE DECENTLY LIKE YOU WOULD ANYBODY ELSE IS THE KIND OF INTERVENTION.

OFTEN A SIMPLE ENGAGEMENT, I THINK JUST OFFERING SOMEBODY A TOOL THAT CAN HELP SAVE THEIR LIFE IS REALLY EFFECTIVE.

>> FOR KEYLESS, THIS APPROACH WAS BORN FROM HIS OWN EXPERIENCE.

HE'S BEEN IN RECOVERY SINCE 1991.

>> HARM REDUCTION IS NOT A SIMPLE -- HOW CAN I SAY -- A SIMPLE THING TO EXPLAIN TO INDIVIDUALS.

THEY DON'T UNDERSTAND WHAT IT IS WHEN YOU TALK ABOUT HARM REDUCTION.

HARM REDUCTION IS, YOU WANT ME TO STOP USING.

I DON'T WANT YOU TO DO ANYTHING YOU DON'T WANT TO DO.

I JUST WANT YOU TO USE SAFER.

SAFER IS A WAY OF SAYING YOU'RE REDUCING YOUR HARM.

>> WAS THERE ANYTHING LIKE HARM REDUCTION WHEN YOU WERE USING?

>> NO, NO.

OTHER THAN THE SPIRITUAL ASPECT OF IT IN MY FAMILY TAKING ME INTO A CHURCH AND LET THEM PRAY OVER ME, THAT WAS HARM REDUCTION AS FAR AS THEY WERE CONCERNED.

GET THE DEVIL OUT OF YOU SO TO SPEAK.

>> WHAT WAS YOUR DRUG OF CHOICE?

>> HEROIN WAS MY DRUG OF CHOICE.

ALTHOUGH I WASN'T ASHAMED TO SAY I USED WHATEVER DRUGS CAME MY WAY.

BUT IF WE TALK ABOUT DRUGS OF CHOICE, IT WAS HEROIN.

>> WHEN YOU WERE USING FENTANYL WAS NOT ON THE SCENE, WAS IT?

>> I DON'T BELIEVE IT WAS.

IT WAS ALWAYS STRAIGHT UP HEROIN.

>> WOULD YOU WANT TO CARRY THIS?

>> NO.

>> YEAH.

WHY NOT?

>> I'D CARRY IT.

>> Reporter: AS KEYLESS POINTS OUT, HIS EXPERIENCES THROUGH THE EARLY DAYS OF THE HIV/AIDS CRISIS ILLUSTRATE HOW EVEN WITH THE PRESENCE OF A KNOWN RISK LIKE INFECTION OR A POTENTIALLY DEADLY OVERDOSE, IT CAN BE DIFFICULT TO REACH USERS.

>> THEY STARTED TO GIVE IT A NAME, HIV.

HOW DO YOU GET HIV?

WELL, WE'RE GETTING IT MAINLY THROUGH INJECTION DRUG USE, AND WE REALLY DIDN'T CARE.

WE USED.

TODAY IS THE SAME SITUATION.

THEY DON'T CARE.

THEY USE, KNOWING THAT THERE IS -- FENTANYL MAY BE IN THE MIX OF THE PRODUCT THEY'RE BUYING.

THEY'RE STILL USING.

>> WHERE DOES THAT LEAVE THINGS THEN?

>> WELL, WE THINK WE REALLY HAVE TO IMPROVE THE MESSAGE AND A WAY TO DELIVER THAT INFORMATION WITH ENOUGH INFORMATION AND ENOUGH FORCE TO MAKE THEM REALIZE THE DANGER THAT'S INVOLVED RIGHT NOW.

DANGERS THAT YOU DIDN'T SEE BACK THEN, BUT DANGERS NOW.

>> DOES THE FACT THAT NEW YORK NOW HAS AN OFFICE DEDICATED TO HARM REDUCTION, DOES THAT CHANGE YOUR WORK?

DOES IT HELP YOUR WORK?

>> WE'LL SEE.

I DON'T KNOW.

THIS IS GOING TO BE A PROCESS.

SOMETIMES IT TAKES A REALLY LONG TIME.

IN THE MEANTIME, A LOT OF PEOPLE DIE.

>> Reporter: WHILE SIMMONS SAYS SHE APPLAUSE THE BROADER APPROACH OF HARM REDUCTION, SHE SAYS THEY RISK OF BEING PUSHED ASIDE AS HARM REDUCTION BECOMES PART OF THE POLITICAL DISCOURSE.

FOR "METROFOCUS," I'M CHRISTOPHER BOOKER.

>> IF YOU OR SOMEONE YOU KNOW NEEDS HELP, PLEASE CALL THE NEW YORK HELP LINE ANY TIME AT 877-8-HOPE-NY.

YOU CAN TEXT 467369 OR VISIT THE NEW YORK STATE OFFICE OF ADDICTION SERVICES AND SUPPORTS WEBSITE AT OASAS.NY.GOV.