ArticleThe International journal on drug policy2022
City streetscapes and neighborhood characteristics of fatal opioid overdoses among people experiencing homelessness who use drugs in New York City, 2017-2019.
Article in The International journal on drug policy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 17 citations in OpenAlex.
- "We Have to Evict Certain People Sometimes": A Descriptive Mixed-Methods Study of Service Providers' Perceptions of the Impacts of High-Risk Issues in Supportive Housing and Housing First.Community mental health journal · 2026Article
- An Examination of How People Who Use Drugs Conceptualize the Benefits and Drawbacks of Using Overdose Prevention Centers.Contemporary drug problems · 2025Article
- Understanding overdose risk and response in permanent supportive housing: results of focus groups with tenants, staff, and leaders.Addiction science & clinical practice · 2025Article
- Exploring modifiable neighborhood risk factors for fatal opioid overdose: a case-control study in two US cities.American journal of epidemiology · 2025Article
- The effect of lifting eviction moratoria on fatal drug overdoses in the context of the COVID-19 pandemic in the United States.American journal of epidemiology · 2025Article
- Non-fatal Overdose and Associated Factors Among People Who Use Opioids: Findings From a Cross-sectional Study.Journal of community health · 2025Article
- A community-academic partnership to develop an implementation support package for overdose prevention in permanent supportive housing.Journal of substance use and addiction treatment · 2025Article
- Using alone at home: What's missing in housing-based responses to the overdose crisis?Harm reduction journal · 2024Review
- Development of a systematic social observation tool for monitoring use of harm reduction supplies.The International journal on drug policy · 2023Article
- Voices of the unhoused from Santa Fe, New Mexico: A mixed methods study of health status, substance use, and community harm reduction program perspectives.Journal of prevention & intervention in the communityArticle
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundWhile housing is a critical social determinant of nonprescription opioid overdose, little is known about how place impacts fatal overdose for people experiencing homelessness (PEH) who use drugs beyond the public versus private domains. This study investigated patterns of neighborhood environment features at locations of fatal overdoses among PEH.
methodsWe remotely visited locations of opioid-involved fatal overdoses provided by the New York City Office of the Chief Medical Examiner, 2017-2019 (n=3276), with Google Street View and used systematic social observation to assess characteristics of the street block related to drug exposures. We cross-referenced home address with city shelters and supportive housing to identify PEH (n=503). We used the differences of K functions from the spatial point patterns and kernel ratio function maps to identify geographic clusters. We then used logistic regression to identify significant individual-, block-, and neighborhood-level covariates (neighborhood deprivation, segregation, population density).
resultsOver half (55.9%, n=281) of fatal overdoses among PEH occurred in supportive housing or shelters, and 15.5% (n=78) occurred in public spaces (e.g., parks). Spatial analyses identified areas of significant concentrated fatal overdoses among PEH in Manhattan, the South Bronx, and Brooklyn. We identified several significant indicators of physical and social order and disorder associated with increased odds of experiencing homelessness at time of fatal overdose, including construction/renovation, graffiti, traffic calming features, and loitering.
conclusionHarm reduction services should be co-located in facilities that serve PEH and targeted to street blocks with indicators of physical and social disorder. While supportive housing is a crucial step in preventing fatal opioid overdoses among PEH, identifying neighborhoods for intervention services delivery and harm reduction outreach for PEH is necessary.
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