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NYC Shelter Health

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Harm Reduction

The NYC Department of Homeless Services (DHS) Overdose Response & Harm Reduction Program builds capacity of NYC shelter staff to carry out evidence-based harm reduction interventions to reduce overdose in shelter. 

Our Approach
Philosophy

The Harm Reduction in NYC Shelters initiative prioritizes the dignity and well-being of shelter residents, meeting individuals where they are with compassion and respect. By embracing harm reduction principles, the initiative promotes a nonjudgmental, trauma-informed, and person-centered approach. This respect for residents’ autonomy and lived experiences fosters a sense of empowerment and inclusion. 

Staff trainings support staff to understanding the many reasons people use drugs and alcohol and how to reduce risk by promoting a full range of interventions including safer use, managed use, behavioral health therapy and medical, mental health or substance use treatment. This approach to working with shelter residents who use drugs and alcohol has facilitated greater connection to harm reduction and treatment services.

Methods

The NYC Department of Homeless Services (DHS) Harm Reduction in Shelters initiative works with shelters, that have experienced the highest number of overdose and substance use incidents, to provide capacity building support for staff and direct services to clients.

Capacity building services offered to shelter providers are rooted in open communication, constructive feedback, and education. Recent substance use related incidents, including suspected overdoses, are approached with care as vital learning opportunities with both shelter residents and staff members. Residents are provided risk reduction and safety planning counseling to foster safer practices, while staff members are engaged in discussion about how to create a safer environment within the shelter.

By bridging gaps between staff, residents, and external service providers, the initiative creates a network of support that directly addresses one of the most pressing challenges facing shelter residents. These efforts have saved lives, reduced stigma, and enhanced the overall quality of care within DHS shelters.

Our Impact

In 2017, DHS became a NYS Certified Opioid Overdose Prevention Program; however, continued to see an increase in overdose deaths. In 2023, the DHS Health Services Office launched the enhanced DHS Overdose Response & Harm Reduction Program. From FY2022-2025, overdose deaths in shelter declined from 253 to 99 (a 61% decline). Learn more

Harm Reduction Toolkit
NYC shelter staff are encouraged to use these resources to help clients reduce the harm of alcohol and drug use.

Training

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Find dates for all upcoming sessions in the DHS Health Training Program Calendar.

  • Harm Reduction Training: Required training for shelter and safe haven staff on substance use risk reduction for people experiencing homelessness. Register

  • Overdose Responder Training: Training on overdose response and how and when to administer naloxone in NYC shelters. Register

  • Overdose Response and Naloxone Distribution Train-the-Trainer: Required training for shelter staff who are Overdose Prevention Champion Trainers. Register

  • Harm Reduction E-Learning: Self-paced online training on how to use a harm reduction approach in shelters. On Absorb for DHS and HRA staff.

  • Harm Reduction Skills Share: Virtual space for sharing harm reduction skills such as risk reduction counseling and safety planning.

  • CEI Drug User Health Training Portal: Clinical trainings and resources on drug user health from the Clinical Education Initiative

Client Education Resources
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Overdose Prevention
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Client Referral Resources: Service Providers
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  • H+H Safety Net Clinics: Referral list of H+H safety net clinics for New Yorkers experiencing homelessness

  • H+H ExpressCare: Medical and behavioral health urgent care and medications. Online or by phone. 24/7, no out-of-pocket cost for DHS clients.

  • H+H PORTpractices Clinics: Specialized health care clinic for people who have been in jail or prison at Bellevue and Kings County Hospitals. Helpline for people who have been in jail or prison providing support accessing medical care, social services, benefits and housing.
    Helpline and referrals: (646) 614-1000 or CHSPORTLINE@nychhc.org

  • Mount Sinai REACH Program: Comprehensive primary care for people who use alcohol or drugs or have hepatitis C, including office-based buprenorphine treatment, risk reduction counseling, support groups.

Client Referral Resources: Service Directories
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Awareness Resources
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Harm reduction resources from other organizations

Fact Sheets

Burprenorphine

 

Cocaine

 

Fentanyl

 

Harm Reduction

 

Hepatitis C

 

K2

 

Naloxone

 

Xylazine

Resource Libraries