Improving access to naloxone for laypersons is a cornerstone of the US strategy to reduce opioid overdose deaths. This study evaluated change in distance to opioid overdose prevention programs (OOPPs) providing walk-in naloxone across two time points. We also explored individual and neighborhood disparities in distance to OOPPs, associations between 2020 OOPP locations and 2018 overdoses, and associations between OOPPs and neighborhood fatal overdose rates. Using fatal opioid overdose locations in 2018 (n = 1167) and 2020 (n = 2045) in New York City, we mapped OOPP locations and fatal overdose locations to visualize areas of unmet naloxone need. We used logistic regression to assess individual (age, sex, race/ethnicity) and neighborhood correlates of odds of an overdose occurring within walking distance (≤ 0.5 miles or 0.8 km) of an OOPP and negative binomial regression to assess the relationship between census tract-level OOPP counts and overdose rates. Distance to OOPPs significantly improved over time, with average distance decreasing by 1.7 miles (2.7 km) (p < 0.001). OOPPs were more likely to be located in neighborhoods with higher poverty in both years and in closer proximity to Latinos in 2020—suggesting improved access for Latinos and in higher poverty neighborhoods. OOPP locations in 2020 were significantly positively associated with overdose locations in 2018. OOPPs were not well-situated in neighborhoods with elevated overdose rates in 2018 but were better situated in 2020, controlling for other neighborhood variables. Community lay naloxone access through OOPPs improved over time and could have promising effects for improved overdose rates in the future.

改善非专业人士获得纳洛酮的机会是美国减少阿片类药物过量死亡战略的基石。这项研究评估了在两个时间点提供步入式纳洛酮的阿片类药物过量预防计划 (OOPP) 的距离变化。我们还探讨了个人和社区与 OOPP 距离的差异、2020 年 OOPP 地点与 2018 年用药过量之间的关联，以及 OOPP 与社区致命过量用药率之间的关联。 我们利用纽约市2018 年 ( n  = 1167) 和 2020 年 ( n = 2045) 的致命阿片类药物过量地点，绘制了 OOPP 地点和致命过量地点的地图，以可视化未满足纳洛酮需求的区域。我们使用逻辑回归来评估 OOPP 步行距离（≤ 0.5 英里或 0.8 公里）内发生服药过量的个体（年龄、性别、种族/民族）和社区相关性，并使用负二项式回归来评估人口普查区之间的关系- 级别 OOPP 计数和过量率。随着时间的推移，到 OOPP 的距离显着改善，平均距离减少了 1.7 英里（2.7 公里）（p  < 0.001）。这两年，OOPP 更有可能位于贫困程度较高的社区，并且到 2020 年更靠近拉丁裔，这表明拉丁裔和贫困程度较高的社区的准入条件有所改善。 2020 年的 OOPP 位置与 2018 年的用药过量地点显着正相关。在控制其他社区变量的情况下，2018 年用药过量率较高的社区中 OOPP 的位置不佳，但在 2020 年的位置较好。随着时间的推移，社区通过 OOPP 获取纳洛酮的情况不断改善，并且可能对未来改善用药过量率产生良好的效果。