Addressing the Opioid Epidemic in the Bronx Through New Forms of Accountability

When studying heat maps produced by the New York City Department of Health and Mental Hygiene Department, and digging into the endless tables of data describing the contours of the deadly opioid epidemic in NYC, the Bronx stands out from every angle.

According to the city’s most recent data, Bronx residents continued to have the highest rate of overdose death in 2024 and died of an overdose at more than twice the rate of Manhattan residents — the borough with the second highest rate (60.1 vs. 26.8 per 100,000). The Bronx has also been ranked 62nd out of 62 counties for health outcomes in New York State for many years, according to nationwide county health rankings.

Getting to Root Causes

As always when it comes to issues of health equity, there is much more behind these numbers than meets the eye. That reality was brought to light through the NYC Department of Health’s Lincoln Detox Center Healing ARC Symposium held in February 2026 at Hostos Community College in the Bronx.* Over 200 people attended this symposium, which was built upon many years of momentum for anti-racism, health equity, and repair, in New York City.

Focused on the root causes of the tragically high rates of opioid overdose death in the Bronx, the Lincoln Detox Center Healing ARC project was launched following the 2021 Board of Health Resolution declaring racism a public health crisis in New York City. The resolution calls for research to clarify and acknowledge examples of the NYC Health Department’s role in divesting and underinvesting in critical community-led programs.¹ As leaders in the department, we needed an honest strategy to guide our path forward — to ensure that the declaration came with direct action. 

We used a model called the Healing ARC to guide this process. The ARC framework was developed by Sandy Darity, PhD, and Kirsten Mullen, who have been studying and advancing reparations work for decades: ‘A’ — for Acknowledgement, ‘R’ — for Redress, and ‘C’ for — Closure. In the NYC Health Department, one of us (Michelle Morse) and Bram Wispelwey, MD, MPH, applied that approach to health care and public health to repair what systems of oppression have ruptured; we call it the Healing ARC. It starts with a simple truth: we cannot heal what we do not acknowledge.

The Lincoln Detox Center

The Lincoln Detox Center was created in 1970. The Young Lords, a Puerto Rican civil rights group, and the Black Panthers banded together to create The People’s Hospital. A group of activists huddled together in the back of a rented U-Haul, arrived at the doors of Lincoln Hospital, and occupied the ninth floor. These groups were from and for the community. At the time, heroin was devastating residents of Harlem and the South Bronx. The city was not dedicating necessary resources to address an unfolding crisis. This lack of investment motivated the activists to take over Lincoln hospital a second time in November of 1970 to establish the Lincoln Detox Center. Negotiations with city officials followed, and the new drug treatment program received city government funding. 

The result was remarkable. Doctors and nurses joined community organizers — hand in hand — to support a detox program that successfully melded medical and community care. Each of them brought their own expertise to the Center. Leaders of the Lincoln Detox Center used acupuncture to aid with heroin withdrawal symptoms, a groundbreaking approach to addiction treatment. Giving patients a place where they felt they belonged was a central part of the service.

Political organizing was happening in parallel with patient care. Under the leadership of the Black Liberation activist Mutulu Shukur, Lincoln Detox Center patients came to understand that their addiction was not a personal failure. It was a byproduct of a larger system that had failed to care for them. But the Lincoln Detox Center was filling that void. The Detox Center offered holistic services including group counseling, job placement support, vocational training, legal services, social service linkages, political education classes, acupuncture training, and even hired clients who successfully completed the program to become peer counselors. In an unfairly policed community, members were adamant about bringing in their neighbors off the street and into the safety and solidarity of the Center. There is perhaps no greater testament to success than the creation of a community that cares so deeply for each other. When the NYC Health Department team interviewed Lincoln Detox Center patients and staff, there was one central tenet that came up again and again: community is cure.

That was the guiding principle of a program that was saving lives. That is, until the city pulled the grant money, and the Lincoln Detox Center was moved out of Lincoln Hospital. Even still, evolving forms of community and city-sponsored care persisted. Although political education was removed, other holistic services continued and low-cost acupuncture training was expanded while comprehensive maternal treatment services were established. A nursery was established and used as a site for parenting skills training, while a midwife was hired to provide prenatal care out of the clinic. However, without government support or funding, the program became less visible, less resourced, and ultimately less equipped to meet the community’s needs.

The Healing Arc

Today, the top five neighborhoods for overdose deaths in New York City are all located in the South Bronx or upper Manhattan — the exact area the Lincoln Detox Center was serving. The NYC Health Department is finally owning up to its role in that. After three years of engagement with the communities who stood up the Lincoln Detox Center, the department is working toward meaningful reparative action.

In New York City and across our country, government has not always lived up to its promise of serving everyone. That’s why this work on truth and reconciliation has been one of our proudest moments. We are working to write a new history — one in which government resources back the tenets of “community as cure.”

New York City has made strides with programs and partnerships like working with OnPoint, which opened the first overdose prevention centers in the United States right here in New York City in 2021. The NYC Health Department has a long way to go in doing right by New Yorkers who use substances, and an imperative to invest in the Bronx in particular. 

Cleo Silvers, the inaugural director of the Lincoln Detox Center, understood what this community was owed. She recognized health as a right, and that resolve guided the Center from the start. She said: “When you say life, liberty, and the pursuit of happiness, life means health. A healthy life.” We are still working to ensure that founding American ideal does not ring hollow.

* This event was co-sponsored by NYU Langone Health’s Center for Opioid Epidemiology & Policy and the Milbank Memorial Fund