They Saved her Life. Now, She’s Saving Others.

White tents decorate the street between 141stst Street and St. Nicholas Avenue, as a multicultural health fair takes over upper Manhattan. Clara Cardelle, a representative from the Washington Heights Corner Project, sits at a table with an assortment of colorful condoms, blue-Narcan kits and candy.

“I am in the business of saving lives,” said Ms. Cardelle. The Corner Project specializes in harm reduction — practices that reduce the harm associated with the use of psychoactive drugs in people who are unable or unwilling to stop. The project offers a needle exchange, free access to condoms and training in how to administer Naloxone, a medication used to prevent an opioid overdose from becoming fatal.

Her presence at a health fair, and the Corner Project’s presence, would have been unheard of 10 years ago. But the stigma associated with drug use and the attitude toward harm reduction are slowly changing.

Ms. Cardelle and a co-worker, Lyn Linda Ayala, representing the Washington Heights Corner Project at a multicultural health fair. Alejandra O’Connell-Domenech/NYT Institute

“Syringe exchange programs started underground in the late 1980s and ’90s,” said Dr. Sharon Stancliff, a medical director for the Harm Reduction Coalition of New York. She said syringe exchange programs started to become more mainstream in the mid-1990s. More exchanges started appearing across the nation, especially in New York state, where there are now 23 safe injection sites.

While speaking at an American College of Emergency Physicians Forum in Washington, D.C., Surgeon General Jerome Adams recently called for emergency room doctors to advocate for evidence-based opioid abuse treatments that include harm reduction. Dr. Adams said that the government should make it easier for physicians to prescribe medications like buprenorphine, an opioid used to treat opioid addiction.

Nearly 1,500 people died last year from drug overdoses in New York City. Earlier this month, Mayor Bill de Blasio announced that four safe injection sites, which he calls overdose prevention sites, would be opened within the next year as part of a one-year pilot program.

At the Corner Project, the mission is to create a safe and nonjudgmental environment. The majority of staff members were addicts who occasionally still use. “I can’t say that my drug use has completely stopped,” said Ms. Cardelle. “ But it has gone down.”

Ms. Cardelle attributed her success to a stable job that she is passionate about, a good relationship with her daughter and to the Corner Project. But she recognizes that not every drug user is as lucky as she is.

Clara Cardelle, left, with her daughter, Isabel Cardelle, on their way to a needle exchange in Washington Heights. Alejandra O’Connell-Domenech/NYT Institute

“When people of color were suffering from an opioid epidemic and dying in the streets, nobody cared,” Ms. Cardelle said. “Now that we have all these white people abusing pills and getting high and dying in the suburbs — now we have an ‘opioid crisis.’”

In recent years the narrative around drug use has changed. Pharmaceutical companies and doctors now bear most of the blame. “White people are treated like they have a disease, whereas everybody else is treated like they are a criminal,” said Dr. Stancliff, of the Harm Reduction Coalition.

According to Ms. Cardelle and Dr. Stancliff, the first step to preventing deaths from overdose is to recognize that licit and illicit drug use will occur. People should work to reduce its harmful effects instead of ignoring the serious illness, they say.

An altar to Clara Cardelle's mother, Jackie. Ms. Cardelle turned to heroin after six years of sobriety after the death of her grandmother. While Ms. Cardelle was battling addition, her daughter was cared for in part by Ms. Cardelle's mother. Alejandra O’Connell-Domenech/NYT Institute

The second step is to reduce risk factors that could lead to drug use. Poverty, trauma, unemployment and early access to drugs are some determining factors in whether someone might potentially become an addict, they said.

A third step, which is popular among law enforcement and left-leaning experts, is to demand reduction, or reducing the public’s desire for licit or illicit drugs. The fourth step is interdiction, catching drugs before they enter communities.

Both Dr. Stancliff and Ms. Cardelle agree that the power of compassion is transformative for both drug users and nondrug users.

Dr. Stancliff recommends those opposed to safe injection sites to go out to the streets and into supervised injections sites where people stop in order to get needles, since injection is a part of their everyday life. Doing so changes one’s perspective on addiction and users, according to Dr. Stancliff.

“Yeah, maybe people are struggling with addiction or living with substance use disorder,” Dr. Stancliff said. “But they also have these lives filled with other things.”