ArticleThe International journal on drug policy2023
Perspectives and recommendations of opioid overdose survivors experiencing unsheltered homelessness on housing, overdose, and substance use treatment in Boston, MA.
Article in The International journal on drug policy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 25 citations in OpenAlex.
- Examining Increased Ritalin and Adderall Use Among Low-Income People Who Use Drugs: Mixed Methods Study.JMIR formative research · 2026Article
- Responding to the increase in substance use, HIV, HCV, and overdose in New England (RISE-NE): Protocol for a prospective cohort study.PloS one · 2026Article
- Fentanyl test strip use and homelessness among people who use drugs in Rhode Island.The International journal on drug policy · 2026Article
- Building connection: overdose survivors' and professional service providers' perspectives on immediate post-overdose care.The International journal on drug policy · 2025Article
- Developing a comprehensive inventory to define harm reduction housing.Harm reduction journal · 2025Article
- Multilevel Factors Impacting Substance Use Treatment Access, Engagement, and Racial Equity Among Opioid Overdose Survivors in Boston, MA.Journal of general internal medicine · 2024Article
- "I don't think of it as a shelter. I say I'm going home": a qualitative evaluation of a low-threshold shelter for women who use drugs.Harm reduction journal · 2024Article
- Risk factors for multiple skin abscesses among community-recruited people who inject drugs in Los Angeles, CA, and Denver, CO: a cross-sectional study.Therapeutic advances in infectious diseaseArticle
Corrections and comments
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Authors and funding
11 authors at 6 institutions in 1 country.
Funding
Abstract
introductionOpioid overdose causes one in four deaths among people experiencing homelessness in Boston, MA. To reduce overdose risks, the experience and perspectives of people experiencing homelessness should be incorporated into housing, overdose prevention, and substance use treatment efforts.
methodsIn 2021, we conducted qualitative interviews with 59 opioid overdose survivors to inform equitable access to treatment services. In response to policy debate surrounding a public drug scene near a key recruitment site, we conducted a targeted thematic analysis of transcribed interview data from a subset of participants experiencing unsheltered homelessness (n=29) to explore their perspectives and recommendations on housing, overdose prevention, and substance use treatment.
resultsAmong 29 participants who identified as non-Hispanic Black (n=10), Hispanic/Latinx (n=10), or as non-Hispanic White (n=9), the median number of self-reported opioid overdoses in the past three months was 2.0 (SD 3.7). Three themes emerged from this targeted analysis: (1) Participants described inadequate housing resources and unwelcoming shelter environments. (2) Participants near a large public drug scene explained how unsheltered homelessness was chaotic, dangerous, and disruptive to recovery goals. (3) Participants provided recommendations for improving housing and addiction treatment systems and including their perspectives in the development of solutions to the intersecting housing and opioid overdose crises.
conclusionsThe overdose prevention, housing and substance use treatment systems must address the needs of opioid overdose survivors experiencing unsheltered homelessness. Overdose survivors experiencing unsheltered homelessness described a chaotic public drug scene but resorted to residing in nearby encampments because the existing shelter, housing, and addiction treatment systems were unwelcoming, difficult to navigate, or unaffordable. Despite efforts to provide low-threshold housing in Boston, additional low-barrier housing services (i.e., including harm reduction resources and without "sobriety" requirements) could promote the health and safety of people who use drugs and are experiencing homelessness.
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