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New York – At an unassuming storefront on a busy Brooklyn street, people sign up to use a bathroom outfitted to try to curb an overdose crisis.

Waiting his turn, a man named Robert is frank about why he’s there, instead of one of the stairwells, parks, rooftops or porches where he has used heroin in the past.

“It keeps us safe. It keeps us from getting arrested. You feel secure here,” says Robert, who discussed his drug use on condition that his last name not be used because he fears arrest and damage to family relationships. “You know they’re not going to let nothing happen to you.”

As communities debate trying to stem overdose deaths by allowing safe havens for people to take heroin and other narcotics, places like this needle exchange program are quietly providing a model of sorts: bathrooms monitored by intercom, so someone can intervene to stop an overdose.

Officially, they aren’t the more full-fledged and controversial facilities – often called safe injection sites – that cities including New York, Philadelphia, San Francisco and Seattle are seeking to open and that already operate overseas. At the same time, some counties and cities have pre-emptively banned injection sites, and federal officials have said they’re illegal.

While the discussion plays out, Robert and about a dozen other people turned up on a recent afternoon to use the bathroom off the green-and-orange drop-in room at VOCAL-NY, where work includes needle exchange, support groups and advocacy campaigns.

A sign on the bathroom allows 10 minutes “to take care of business.” But every three minutes, a staffer checks in by intercom. If there’s no response, the staffer will release the door lock and come in, ready to administer anti-overdose medication. In eight years, a few people have overdosed but all have been rescued, VOCAL says.

If not official, the restroom isn’t exactly underground, either. State Health Department policies suggest that needle exchange programs bathrooms have such safeguards.

“This bathroom is literally a response to hundreds of overdose deaths in bathrooms and streets across the city,” said Jeremy Saunders, VOCAL’s co-executive director.

Opioid drugs have spawned the deadliest epidemic of drug overdoses in U.S. history. It has killed over 47,000 people nationwide in the 12 months that ended in November.

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