Abstract：
OBJECTIVE: Overdose prevention centres (OPC) are non-residential spaces where people can use illicit drugs (that they have obtained elsewhere) in the presence of staff who can intervene to prevent and manage any overdoses that occur. Many reviews of OPCs exist but they do not explain how OPCs work.
METHODS: We carried out a realist review, using the RAMESES reporting standards. We systematically searched for and then thematically analysed 391 documents that provide information on the contexts, mechanisms and outcomes of OPCs.
RESULTS: Our retroductive analysis identified a causal pathway that highlights the feeling of safety - and the immediate outcome of not dying - as conditions of possibility for the people who use OPCs to build trust and experience social inclusion. The combination of safety, trust and social inclusion that is triggered by OPCs can - depending on the contexts in which they operate - generate other positive outcomes, which may include less risky drug use practices, reductions in blood borne viruses and injection-related infections and wounds, and access to housing. These outcomes are contingent on relevant contexts, including political and legal environments, which differ for women and people from racialised minorities.
CONCLUSIONS: OPCs can enable people who live with structural violence and vulnerability to develop feelings of safety and trust that help them stay alive and to build longer term trajectories of social inclusion, with potential to improve other aspects of their health and living conditions.
METHODS: We carried out a realist review, using the RAMESES reporting standards. We systematically searched for and then thematically analysed 391 documents that provide information on the contexts, mechanisms and outcomes of OPCs.
RESULTS: Our retroductive analysis identified a causal pathway that highlights the feeling of safety - and the immediate outcome of not dying - as conditions of possibility for the people who use OPCs to build trust and experience social inclusion. The combination of safety, trust and social inclusion that is triggered by OPCs can - depending on the contexts in which they operate - generate other positive outcomes, which may include less risky drug use practices, reductions in blood borne viruses and injection-related infections and wounds, and access to housing. These outcomes are contingent on relevant contexts, including political and legal environments, which differ for women and people from racialised minorities.
CONCLUSIONS: OPCs can enable people who live with structural violence and vulnerability to develop feelings of safety and trust that help them stay alive and to build longer term trajectories of social inclusion, with potential to improve other aspects of their health and living conditions.
摘要：
目的：过量预防中心（OPC）是非居住场所，人们可以在工作人员在场的情况下使用（他们在其他地方获得的）非法药物，他们可以干预以预防和管理发生的任何过量。存在许多关于OPC的评论，但它们没有解释OPC是如何工作的。
方法：我们进行了现实性的回顾，使用RAMESES报告标准。我们系统地搜索并对391个提供上下文信息的文档进行了主题分析，OPC的机制和结果。
结果：我们的逆向分析确定了一个因果途径，强调安全感-以及不死亡的直接结果-作为使用OPCs的人建立信任和体验社会包容的可能性条件。安全的结合，由OPCs引发的信任和社会包容可以-取决于它们运作的环境-产生其他积极的结果，其中可能包括风险较低的药物使用做法，减少血液传播病毒和注射相关感染和伤口，和获得住房。这些结果取决于相关的背景，包括政治和法律环境，这对妇女和来自种族少数群体的人来说是不同的。
结论：OPCs可以使生活在结构性暴力和脆弱性中的人们产生安全感和信任感，帮助他们生存，并建立长期的社会包容轨迹。有可能改善他们健康和生活条件的其他方面。
方法：我们进行了现实性的回顾，使用RAMESES报告标准。我们系统地搜索并对391个提供上下文信息的文档进行了主题分析，OPC的机制和结果。
结果：我们的逆向分析确定了一个因果途径，强调安全感-以及不死亡的直接结果-作为使用OPCs的人建立信任和体验社会包容的可能性条件。安全的结合，由OPCs引发的信任和社会包容可以-取决于它们运作的环境-产生其他积极的结果，其中可能包括风险较低的药物使用做法，减少血液传播病毒和注射相关感染和伤口，和获得住房。这些结果取决于相关的背景，包括政治和法律环境，这对妇女和来自种族少数群体的人来说是不同的。
结论：OPCs可以使生活在结构性暴力和脆弱性中的人们产生安全感和信任感，帮助他们生存，并建立长期的社会包容轨迹。有可能改善他们健康和生活条件的其他方面。
