Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Feb 15;21(1):40.
doi: 10.1186/s12954-024-00955-6.

"Make yourself un-NIMBY-able": stakeholder perspectives on strategies to mobilize public and political support for overdose prevention centers in the United States of America

Joseph G Rosen  1 , Erin Thompson  2 , Jessica Tardif  2 , Alexandra B Collins  3 , Brandon D L Marshall  3 , Ju Nyeong Park  2   3   4
Affiliations

"Make yourself un-NIMBY-able": stakeholder perspectives on strategies to mobilize public and political support for overdose prevention centers in the United States of America

Joseph G Rosen et al. Harm Reduct J. .

Abstract

Background: Overdose prevention centers (OPCs), also known as supervised injection facilities and safe consumption sites, are evidenced-based interventions for preventing overdose deaths and drug-related morbidities. The pathways to legalizing OPCs in the USA have confronted multiple social, political, and legal obstacles. We conducted a multi-site, qualitative study to explore heterogeneities in these pathways in four jurisdictions, as well as to understand stakeholder perspectives on valuable strategies for galvanizing political and public support for OPCs.

Methods: From July 2022 to February 2023, we conducted 17 semi-structured, in-depth interviews with OPC policymakers, service providers, advocates, and researchers from California, New York City, Philadelphia, and Rhode Island, where efforts have been undertaken to authorize OPCs. Using inductive thematic analysis, we identified and compared contextually relevant, salient approaches for increasing support for OPCs.

Results: Participants described several strategies clustering around five distinct domains: (1) embedding OPC advocacy into broader overdose prevention coalitions to shape policy dialogs; (2) building rapport with a plurality of powerbrokers (e.g., lawmakers, health departments, law enforcement) who could amplify the impact of OPC advocacy; (3) emphasizing specific benefits of OPCs to different audiences in different contexts; (4) leveraging relationships with frontline workers (e.g., emergency medicine and substance use treatment providers) to challenge OPC opposition, including 'NIMBY-ism,' and misinformation; and (5) prioritizing transparency in OPC decision-making to foster public trust.

Conclusion: While tailored to the specific socio-political context of each locality, multiple OPC advocacy strategies have been deployed to cultivate support for OPCs in the USA. Advocacy strategies that are multi-pronged, leverage partnerships with stakeholders at multiple levels, and tailor communications to different audiences and settings could yield the greatest impact in increasing support for, and diffusing opposition to, future OPC implementation.

Keywords: Harm reduction; Injection drug use; Opioids; People who use drugs; Qualitative research; Supervised consumption sites.

PubMed Disclaimer

Conflict of interest statement

JNP serves as a technical consultant on a grant funded by the U.S. Food and Drug Administration (U01FD00745501). The remaining authors have no competing interests to declare.

Figures

Fig. 1
Fig. 1
Purposively selected study sites, by overdose prevention center authorization and implementation status
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Spencer MR, Miniño AM, Warner M. Drug Overdose Deaths in the United States, 2001–2021. Atlanta, GA: Centers for Disease Control and Prevention; 2022 Dec. (National Center for Health Statistics Data Briefs).
    1. Mattson CL, Tanz LJ, Quinn K, Kariisa M, Patel P, Davis NL. Trends and geographic patterns in drug and synthetic opioid overdose deaths: United States, 2013–2019. MMWR Morb Mortal Wkly Rep. 2021;70(6):202–207. doi: 10.15585/mmwr.mm7006a4. - DOI - PMC - PubMed
    1. Gladden RM, O’Donnell J, Mattson CL, Seth P. Changes in opioid-involved overdose deaths by opioid type and presence of benzodiazepines, cocaine, and methamphetamine: 25 states, July-December 2017 to January-June 2018. MMWR Morb Mortal Wkly Rep. 2019;68(34):737–744. doi: 10.15585/mmwr.mm6834a2. - DOI - PMC - PubMed
    1. Park JN, Rashidi E, Foti K, Zoorob M, Sherman S, Alexander GC. Fentanyl and fentanyl analogs in the illicit stimulant supply: results from U.S. drug seizure data, 2011–2016. Drug Alcohol Depend. 2021;218:108416. doi: 10.1016/j.drugalcdep.2020.108416. - DOI - PMC - PubMed
    1. Zibbell JE, Aldridge AP, Cauchon D, DeFiore-Hyrmer J, Conway KP. Association of law enforcement seizures of heroin, fentanyl, and Carfentanil with opioid overdose deaths in Ohio, 2014–2017. JAMA Netw Open. 2019;2(11):e1914666. doi: 10.1001/jamanetworkopen.2019.14666. - DOI - PMC - PubMed

Publication types