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Mayor de Blasio threw his support behind a plan to open spots in New York City where addicts can inject drugs under watchful eyes.

No city in the United States has opened the so-called supervised injection facilities, which are meant to prevent overdose deaths — but there are more than 100 around the world.

De Blasio backed the controversial idea as the Health Department released a long-awaited report on the concept — finding that the program could prevent 130 overdose deaths each year.

The administration said it decided to embrace the idea despite obstacles — especially federal law, which makes it a crime to run a location that facilitates drug use.

If the plan proceeds, sites would open as a one-year pilot program in up to four locations — Gowanus in Brooklyn, Midtown West and Washington Heights in Manhattan, and Longwood in the Bronx.

There are currently needle exchanges at each proposed site. The injection facilities would be run by the nonprofit Research for a Safer New York, and would not get city money.

“The opioid epidemic has killed more people in our city than car crashes and homicides combined,” de Blasio said.

“After a rigorous review of similar efforts across the world, and after careful consideration of public health and safety expert views, we believe overdose prevention centers will save lives and get more New Yorkers into the treatment they need to beat this deadly addiction.”

In 2017, 1,441 people died of drug overdoses in New York City — driven by an epidemic of opioids like heroin and fentanyl. Fatalities have surged 166% since 2010.

In order to proceed, the city says it will need approval from the state Department of Health, an agreement by district attorneys to protect clients and operators from prosecution, and the support of the Council members representing the sites.

Deputy mayor Herminia Palacio wrote to state health commissioner Howard Zucker Thursday asking him to license a pilot research study to create the facilities, which the city is calling Overdose Prevention Centers.

If those parties sign off, the city will take another six months to a year to form a community advisory board before opening the injection sites.

Advocates have been pushing de Blasio to embrace the injection sites — including at a protest Wednesday where 11 people were arrested.

"More people are dying of overdose in New York City than ever before and there's no sign of stopping anytime in the near future," said Alyssa Aguilera, Co-Executive Director of the group VOCAL-NY. "The reality is that people use drugs, and forcing individuals to inject in public bathrooms and parks is unsafe and inhumane.”

While no injection facilities currently exist in the United States, three cities — Seattle, San Francisco, and Philadelphia — are moving toward opening them.

In addition to federal laws against drug possession, a law known as the “crack house statute” makes it a crime to run a location that facilitates drug use. Violators could be fined or jailed, and property used in such an operation could be seized.

But it would be up to the feds to decide whether to vigorously enforce the law, or look the other way as they largely have with states that legalize marijuana.

Ed Mullins, president of the Sergeants Benevolent Association, blasted the injection facilities plan.

“It’s total insanity,” he said. “Drugs are illegal. So we are now telling people it’s OK to break the law.”

The city has been studying the issue since the City Council put up $100,000 for the effort in 2016. “These sites will save lives and connect addicts with treatment options and trained professionals that could lead them to recovery,” said Council Speaker Corey Johnson.

A spokesman for the state health department said they’d review the city’s request.

Brooklyn district attorney Eric Gonzalez said officials can’t “sit by and let people die when there are proven interventions that can save lives,” and the Manhattan district attorney’s office also said they support the idea. Bronx DA Darcel Clark said she was “open minded” and would study the issue. With Shayna Jacobs