Overdose prevention centers in the United States: A multi-level evaluation.

Author: Magdalena Cerdá, Bennett Allen, Alexandra Collins, William Goedel, Aaron Fox, Brent Gibson, Brianna Norton, Alexandra Harocopos, Brandon Marshall, Brandon Marshall

Theme: Epidemiology & Public Health Research Year: 2023

More than one million people have died from accidental drug overdose in the United States in the past 20 years. In response to this crisis, New York City implemented two publicly recognized safe consumption sites (SCS) in the nation in November 2021. Rhode Island became the first US state to authorize SCS through state legislation and will open a site in late 2022. We are conducting a rigorous, multi-site, multi-component evaluation of SCS in New York City and Rhode Island. At the individual level, we assess whether a cohort of 500 persons utilizing SCS experience lower rates of overdose, other health problems (e.g., hepatitis C, skin infections), and emergency department use, and a higher rate of substance use treatment initiation, compared to a cohort of 500 persons who use drugs but do not utilize SCS. At the community level, we examine whether neighborhoods surrounding the SCS experience a greater change in overdose, measures of drug-related public disorder, and acute economic conditions following the opening of SCS, compared to neighborhoods unexposed to SCS. Third, we delve into the role that the operational context, including neighborhood location, program models, and operating procedures, plays in shaping the effectiveness of SCS using qualitative and ethnographic approaches. In this presentation, we: (1) present the study design and harm reduction and equity-focused framework which will be used to evaluate the impact of SCS in New York City and Rhode Island; (2) discuss challenges and lessons learned from working with community partners and government agencies to design and implement an SCS evaluation, and (3) share findings from the first phase of the evaluation on the impact of SCS on neighborhood levels of public disorder.

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