• Czarina N Behrends, Andrew J Trinidad, Michelle L Nolan, Jennifer Dolatshahi, Alexandra Kingsepp, Ashly E Jordan, Alice E Welch, Alex Harocopos, Leah C Shaw, Traci C Green, MarshallBrandon D LBDLDepartment of Epidemiology, Brown University School of Public Health, Providence, RI, USA., and Bruce R Schackman.
• Department of Population Health Sciences, Weill Cornell Medical College, New York, NY, USA. czb2002@med.cornell.edu.
• J Urban Health. 2025 Jan 16.

AbstractFrom 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.© 2025. The New York Academy of Medicine.

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