Participant experiences with overdose prevention centers in New York City: a qualitative exploration

Abstract Background Although New York City (NYC) experienced a nearly 30% decrease in drug overdose mortality in 2024, fentanyl-driven overdose deaths remain high. For decades, European nations, Australia, and Canada have adopted overdose prevention centers (OPCs), facilities where people can be monitored by trained staff following consumption of previously obtained substances, to mitigate the risk of overdose. In 2021, NYC opened the first two publicly recognized OPCs in the United States. This qualitative study explores the experiences of participants using these facilities. Methods We conducted 40 semi-structured, in-depth interviews with participants utilizing OPC services in NYC. We used a thematic analytic approach to understand participants’ motivations for and experiences using OPC services. Results We identified three themes from participants’ experiences using NYC’s OPC services: 1) OPCs are a safe haven that mitigate numerous drug-related harms participants face including overdose and street-based violence; 2) compassionate, non-judgmental care is a critical component of OPC service utilization; and 3) participants often adopt safer drug use practices because of the harm reduction education and supportive services offered at the sites. Conclusions Similar to research conducted with OPCs in other jurisdictions, participants in this study reported that engaging with OPC services enabled them to mitigate many of the risks they experienced using drugs in other settings by providing a safe, hygienic space where trained staff could respond quickly in the event of an adverse effect. A central component of participants’ experiences with the sites was the compassionate care they received, which supported the utilization of risk reduction strategies and, for some participants, greater self-efficacy around their substance use.