Expanded Naloxone Distribution by Opioid Overdose Prevention Programs to High-Need Populations and Neighborhoods in New York City

From 2014 to 2017, the drug overdose death rate per 100,000 in New York City (NYC) increased by 81%, with 57% of overdoses in 2017 involving the opioid fentanyl. In response, overdose education and naloxone dispensing (OEND) efforts were expanded in NYC, informed by neighborhood-level and population-level opioid overdose fatality rates. We describe the demographic and geographical distribution of naloxone by NYC opioid overdose prevention programs (OOPPs; the primary distributor of naloxone to laypersons in NYC) as OEND was expanded in NYC. We developed and examined a measure of high-need naloxone distribution defined by OEND in a high-priority neighborhood, to a high-need population, or from a high-priority OOPP (i.e., syringe services programs, criminal legal-related programs, programs for unhoused people, substance use disorder treatment programs, etc.). We reported recipient-level naloxone dispensing data by OOPP type from April 2018 to March 2019 using descriptive statistics and age-adjusted population rates. We conducted univariable logistic regression analyses to identify predictors of naloxone receipt by race/ethnicity. Of the 69,333 naloxone recipients, 97.3% met our definition for high-need naloxone dispensing, with 55.8% residing in one of 13 high-priority neighborhoods. Naloxone receipt by race/ethnicity varied by OOPP type. Program goals to expand naloxone distribution to high-need populations were met. We observed racial/ethnic differences in receipt of naloxone by program type, which supports using a variety of OOPP program types to reach racially diverse populations.