NYC's Overdose Prevention Centers: Data from the First Year of Supervised Consumption Services

Unintentional drug overdose deaths are a critical public health concern nationally and locally; New York City (NYC) reported 3,026 overdose fatalities in 2022, the highest number of overdose deaths citywide since reporting began in 2000. The burden of overdose deaths is highly unequal: older New Yorkers, Black and Latino/a New Yorkers, people experiencing homelessness, and residents of high-poverty neighborhoods continue to experience the highest rates of fatal overdose citywide. The rise in overdose deaths is driven by the proliferation of fentanyl, which was present in 81% of overdose deaths in NYC in 2022. Overdose prevention centers (OPCs), also known as supervised consumption spaces, have demonstrated international success in reducing overdose deaths and associated harms. OPCs provide hygienic spaces where people can use previously acquired substances under the supervision of trained staff. These OPCs, which opened in NYC on November 30, 2021, are recognized as the first OPCs with supervised use of illicit substances to be formally supported by a governmental entity in the United States. The OPCs are operated by the nonprofit organization OnPoint NYC; the City of New York provides monetary support for many services at the OPCs except direct supervised consumption, as well technical assistance and programmatic oversight by the NYC Department of Health & Mental Hygiene. This report summarizes the first year of operations of these two centers in NYC. From November 30, 2021, to November 30, 2022, 2,841 individuals visited the two OPCs 48,533 times and staff intervened during 636 visits (1.3%) to prevent overdose-related injury and death. During this period, emergency medical services (EMS) were called only 23 times, and no overdose deaths occurred in the OPCs. Results suggest that the OPCs diverted up to 39,000 instances of public drug use and played a critical role in connecting participants to care, with 75% of participants accessing other harm-reduction, social, and medical services through OnPoint NYC. Despite these early successes, these and other OPCs face challenges sustaining operations in uncertain legal and law enforcement, legislative, and funding environments. Additional research exploring the needs of participants, patterns of OPC service utilization, and the long-term impacts of OPC use on health outcomes is needed to expand the body of evidence supporting OPCs in the United States.