This Site Saves Lives? A Study of the Effectiveness of New York City’s Overdose Prevention Centers

Abstract

In November of 2021, former New York City Mayor Bill de Blasio announced the opening of the city’s - and country’s - first two overdose prevention centers (OPCs). In Europe, Australia, and Canada, OPCs have operated for decades to minimize the harms of drug use. Many scholars have studied the OPCs in these countries and shown that OPCs contribute to reductions in overdose death rates and infectious disease rates. Thus far, only two studies of New York City’s OPCs have been published; the studies found that the OPCs were not associated with significant changes in measures of crime and disorder but were associated with decreases in low-level drug enforcement.

While scholars have researched the impact of OPCs, these studies have not examined any of the OPCs’ goals that they initially sought to achieve. It is important to consider OPCs’ goals when analyzing their effects, because these goals likely influence how OPCs operate and impact their communities. Moreover, a strong understanding of an OPC’s goals can help scholars assess OPCs’ effectiveness as a public health policy.

This thesis sought to define effectiveness for New York City’s OPCs and use that definition to then assess the OPCs’ effectiveness. I explored how effectiveness of these OPCs is defined by speaking with people intimately involved in New York City’s OPCs, analyzing local press about the OPCs, and reviewing scholarship on OPCs from across the world. Using this information, I established that New York City’s OPCs’ effectiveness should be defined by their ability to save lives, promote clients’ physical and mental health, and mitigate adverse impacts for their surrounding communities.

I chose to examine eight metrics that could help assess the OPCs’ effectiveness in achieving the goals I identified. These metrics included: overdose death, drug-related arrest, HIV, AIDS, Hepatitis B/C, and drug-related EMS call rates as well as syringe litter data. I evaluated effectiveness by comparing how these metrics evolved in the experimental neighborhoods - neighborhoods with OPCs - as compared to the control neighborhoods - neighborhoods without OPCs but with similar demographics as the experimental neighborhoods.

Neighborhoods were defined according to their hospital code, because overdose death statistics were provided according to these groupings. However, using these groupings posed a limitation for my analysis because it restricted my ability to select control neighborhoods that exactly matched the experimental neighborhoods’ demographics. My analysis was also inherently limited by the restricted availability of data. For most metrics, the most recent statistics were from 2022, so I could only examine one year of data recorded after the OPCs opened. While this data allowed me to assess early indicators of the OPCs’ effectiveness, trends may change over time, which would likely change some of my conclusions about effectiveness.

My research indicated that the OPCs have been partially effective, and that they show potential for achieving greater effectiveness in the future. Through my data analysis I found that New York City’s OPCs had the strongest impact on drug-related arrest rates, drug-related EMS call rates, and syringe litter. These results suggested that the OPCs have been somewhat effective in promoting clients’ health and mitigating adverse neighborhood impacts, but not in saving lives. However, in order to better assess their effectiveness, I suggest that city agencies examine more specific data over a longer period of time. I also suggest that local organizations and authorities work together to create a mission statement and set of core goals for New York City’s OPCs that better capture their positive impacts. Lastly, I recommend that more attention is dedicated to advocating for federal legislation that legalizes OPCs’ operations in order to promote their long term success in the United States.