The permanent supportive housing overdose prevention project

Overdose is a large concern in permanent supportive housing (PSH), yet has been sparsely addressed in research or practice. We previously developed a technical assistance intervention to empower PSH buildings to implement evidence-based overdose prevention practices. We now describe delivery of and participation in this novel intervention.

Intervention delivery occurred over four six-month periods from November 2023-January 2026. The six-month intervention included a written implementation Toolkit, individually-tailored practice facilitation sessions, and monthly learning collaboratives. Tenant implementation champions participated alongside staff champions and other key building leaders. Trained practice facilitators recorded the attendance and content of all intervention sessions in REDCap logs. Analysis used quantitative descriptive methods.

Twenty buildings received the intervention; they were located in New York City and upstate New York and served over 1200 PSH tenants. One building discontinued the intervention due to lack of staff time. The remaining 19 buildings participated in 95% of planned practice facilitation sessions. Additionally, 17 buildings attended over half of the monthly learning collaboratives. Most practice facilitation sessions and learning collaboratives (94%; 211 of 225 sessions) included the full content as planned in the intervention guide.

We implemented a novel, place-based intervention to address the leading cause of death among PSH tenants, a population that faces outsized overdose risks. The intervention was feasible to deliver, designed to be sustainable and scalable, and may be a model for other communities seeking to reduce overdose risk in PSH and similar housing settings.