Introduction: What Does Harm Reduction Look Like across Different States?
As drug overdose deaths contribute to more than 100,000 deaths per year, states are seeking ways to rapidly deploy resources and support communities to limit rates of overdose. Harm reduction strategies — or interventions intended to prevent overdoses and reduce negative outcomes related to drug use — are backed by research and have been operational in the U.S. for decades. However, access to legally sanctioned and publicly funded harm reduction services has varied in practice. Stigma, limited resources, and variability of state laws continue to pose barriers to lifesaving harm reduction services. While states have an array of legislative, regulatory, fiscal, policy, and programmatic tools to effectively support harm reduction strategies, most harm reduction services are ultimately delivered at the community level. Consequently, the success of many state-level harm reduction initiatives rely on robust state infrastructure that provides data, resources, and technical support aimed at bolstering and empowering local harm reduction providers to effectively engage communities and tailor strategies to meet on local needs.
Defining ‘Harm Reduction’
Developed with guidance from SAMHSA’s harm reduction framework, harm reduction can be understood as both an approach as well as a set of services. Under both definitions, harm reduction works to reduce overdoses and mitigate the harmful consequences of drug use.
Harm Reduction Approach
- Centers the experiences of people who use drugs
- Empowers individuals to live healthier lives through non-judgmental, trauma-informed, culturally responsive, and person-centered care
Harm Reduction Services
- Are often led by community-based harm reduction programs , which can be community-based organizations or health departments
- Can include services such as naloxone distribution, provision of sterile syringes, drug testing supplies, overdose prevention education, safer smoking kits, wound care, and other services that reduce the risk of disease transmission and other adverse effects of drug use
- Offer low-barrier or direct linkages to care for substance use disorders or greater physical, behavioral health, or social services
Understanding how states have used policy levers to meet needs across diverse settings can help support other states in addressing their own unique challenges. To highlight how states are working to support community-level harm reduction approaches, NASHP developed case studies of harm reduction strategies in four geographically and politically diverse states. These case studies were developed through interviews with state officials from Georgia, Utah, Maryland, and Vermont, and demonstrate how state agencies have adapted harm reduction approaches within their unique contexts to support the effective delivery of harm reduction services.
Key State-Level Strategies for Supporting Community-Level Harm Reduction
There is no “one size fits all” approach to harm reduction. Each state and community will have its own unique history, politics, and community health ecosystem — as well as its own mix of partners and harm reduction skeptics. At the state level, responsibility and funding for harm reduction activities may flow through multiple agencies with differing responsibilities for behavioral health, overdose prevention, or prevention of infectious diseases. State public health systems may also be centralized or decentralized (e.g., with fiscal authority at the local level) or have “home rule” provisions that grant additional autonomies to local governments to authorize or prohibit harm reduction activities. These roles and responsibilities have implications for how harm reduction services are supported and delivered.
Although harm reduction efforts may look different in response to differing contexts and needs across states, there are several key strategies that states may consider as they seek to expand their harm reduction services. Regardless of a state’s public health and health care infrastructure, state health leadership can play a critical role through:
Using Data to Target Communities in Need — Collecting and sharing data related to the drug supply and overdose rates can help state agencies and partners more effectively deploy resources and support coordinated efforts to respond to community needs.
Aligning Funding Streams — Harm reduction providers are often funded by braided funding from federal, state, and/or philanthropic sources. Taking inventory of provider needs and funding streams at the state level can support harm reduction programs sustainably and address resource gaps.
Establishing Central Resource Hubs — In many states, state agencies can function as a centralized resource hub, handling purchasing and distribution of harm reduction-related resources such as naloxone, the opioid overdose reversal medication. Through these activities, the state can address purchasing barriers, better understand resource needs, and build relationships and trust with community organizations and harm reduction providers.
Building Coalitions to Support Harm Reduction — Stigma against people who use drugs continues to be a factor to community-level implementation of harm reduction strategies and interventions. Local public health and community organizations with deep roots in the community are often the best messengers for building community-level support. By empowering local players such as advocates, providers, and private entities with data and resources, individuals can help raise awareness about the speci
Supporting Coordination across Harm Reduction Service Providers — Harm reduction providers can vary in their service offerings, creating the potential for individuals to need referrals or connections to additional care. By facilitating connections among providers working in different service, population, or geographic areas, a state can develop a roadmap for service offerings and connect individuals with specific care or resources along the continuum of harm reduction interventions.
Engaging People with Lived and Living Experience in Decision-Making Processes and Maintaining Bidirectional Communication with Impacted Communities — Collaborating with people with lived and living experience can assist in the development of processes and services that more closely meet the needs of individuals affected by the opioid epidemic and larger overdose crisis. By including these perspectives at all levels of the policy implementation process, state officials can continuously incorporate feedback on harm reduction programs. Maintaining ongoing forums for communication and coordination between state and community partners allows for sharing of information and resources, builds trust between partners, and helps ensure that efforts are more responsive to community needs.
Providing Technical Assistance and Resources for Providers — Harm reduction providers can benefit from funding and resource opportunities offered by the state, as both ensure that the providers can sufficiently operate. Many states offer a range of technical assistance or resources based on internal capacity, which could include direct assistance with registering a program for operation or sharing information related to harm reduction and care coordination, among other examples.
Georgia’s Approach to Harm Reduction: Equipping Local Harm Reduction Providers
Sparked by research that revealed high rates of HIV and hepatitis C transmission correlated with high rates of injection drug use in particular areas across the state, the Georgia Harm Reduction Coalition and Emory University worked to establish the first operating syringe service program (SSP) in Georgia. Now, with SSPs legalized in 2019, the coalition and other community-based organizations work closely with state partners to deliver a variety of harm reduction services across the state, supporting bidirectional sharing of data and resources to help target areas of need and tailor offerings. Georgia’s harm reduction approach centers around:
- Collaborating across state agencies to limit duplication of efforts, share data, and distribute resources efficiently
- Contracting with community-based organizations to offer “one-stop shops” for harm reduction resources
- Adapting resource and educational outreach efforts based on real-time opioid-related hospitalization and death rates across counties.
State Laws Relating to Harm Reduction
Georgia legislation requires syringe service programs to be registered and comply with operating requirements enforced by the Georgia Department of Public Health. Georgia operates over 30 SSPs across the state, which offer additional medical services such as wound care, blood pressure and glucose screening, and sexually transmitted bloodborne infection prevention resources. Related to drug-checking equipment, Georgia permits the use of testing equipment for “determining whether a controlled substance contains a synthetic opioid.” SSPs are given permission to possess and distribute this drug-checking equipment, though participants are not given the same immunities.
Legislation
- Related to syringe exchange 24-902(a)
- Good Samaritan Law
- Drug Paraphernalia Act 24-908(a)
State Level Infrastructure for Harm Reduction — Cross- and Inter-Agency Collaboration
Georgia structures its harm reduction framework and services based on the definition for harm reduction from the Substance Abuse and Mental Health Services Administration (SAMHSA), offering naloxone and fentanyl test strip distribution, syringe exchange, and health promotion through various media campaigns, among other examples. Georgia’s Department of Behavioral Health and Developmental Disabilities (DBHDD) houses most of the harm reduction-related work, working to identify areas of focus and need in the harm reduction space through engagement with community advisory councils and local providers, partnerships with universities and consultants that focus on determining gaps in programming, and cross- and inter-agency data sharing. DBHDD’s primary roles in the harm reduction space include providing funding, oversight, technical assistance, and resources such as naloxone and fentanyl test strips to contracted harm reduction providers and community-based organizations across the state.
Additional offices both within DBHDD and across other state agencies fulfill harm reduction-related roles, such as supporting syringe service program operation, opioid-related data collection, and targeted outreach or media campaign efforts. The Department of Public Health (DPH), a separate state agency, reviews syringe service program applications, registers programs to operate, and monitors their operations. DPH also provides quarterly reports on opioid trends in relation to race, age, gender, and county. The Office of Behavioral Health Prevention, which resides within DBHDD, sends out weekly notices of cities experiencing higher than average opioid-involved deaths or hospitalizations. These agencies coordinate with DBHDD regularly to strategize resource allocation for communities in need and ensure harm reduction efforts are not duplicative.
Equipping Community-Based Organizations to Offer a Continuum of Resources
Georgia Harm Reduction Coalition (GHRC), one of Georgia’s local-level contractors, has been operating as a trusted community partner since 1994 by offering a whole-person care approach to substance use treatment. GHRC, alongside other partners such as Georgia Overdose Prevention, assist the state in distribution of naloxone and overdose prevention education efforts. GHRC braids funding from DBHDD, SAMHSA, and the Centers for Disease Control and Prevention (CDC) to support a range of additional services such as medications for opioid use disorder, syringe service programs, and prevention education and training. The organization operates across four offices and seven mobile health units, servicing 130 out of 159 counties in Georgia.
The coalition also offers various social support services, including case management, legal aid, employment training, and food and clothing. Having a wealth of resource options allows the coalition to tailor its approach to match community needs and build a trusted reputation among the populations being served. For example, the coalition identified one county in support of recovery-oriented services, so it initiated a recovery program within its office. Frequent touchpoints between community providers, such as the GHRC, and DBHDD also inform needed service expansion — the state now offers multiple harm reduction vending machines and supports a statewide anti-stigma campaign.
Using Data to Inform Response Efforts
Because coalition offices and other community-based organizations are clustered in more urban areas, there are clear discrepancies in resource access between rural and urban communities. To address this, the state relies heavily on bidirectional data exchange with community partners, with the state providing reports on counties with high opioid-related hospitalizations or overdoses and local partners providing reports on the number of resources distributed or community engagements facilitated. From these values, the state can identify and target specific areas with overdose prevention media campaigns and educational resources, and harm reduction service providers can reach out to local health departments, organizations, law enforcement, or trusted community partners to evaluate what services they can offer and how to best support the population of focus.
State Innovation
Sparked by the need to include diverse perspectives and insight in the state’s strategic plan to address the opioid crisis, Georgia’s Department of Public Health launched a multi-cultural committee and needs assessment project. The committee’s initial charge was to research needs and personal experiences related to the opioid crisis from individuals of diverse cultural backgrounds. From these findings, the research group recommended building out trauma-informed resources, increasing accessibility to resources, expanding educational opportunities related to harm reduction, and addressing stigma as several strategies to assist the state in improving harm reduction service delivery.
Maryland’s Approach to Harm Reduction: Implementing a Statewide Strategy Informed by Community Feedback
Maryland local health departments work closely with the Maryland Department of Health (MDH) for public health service delivery across the state. Within MDH’s Prevention and Health Promotion Administration, Maryland’s Center for Harm Reduction Services (CHRS) oversees a statewide strategy for overdose prevention that supports local health departments and harm reduction service providers in developing community-focused strategies. To meet the unique needs of its urban and rural communities, Maryland’s harm reduction approach emphasizes:
- Operation of a centralized office for resource and funding distribution, technical assistance, and guidance related to harm reduction
- Direct engagement with community-based organizations and inclusion of community feedback in program development
- Regular dialogue and sharing of overdose prevention-related data with the community
State Laws Relating to Harm Reduction
Maryland legislation enables the operation of overdose prevention programs, defined by the state as entities that provide overdose education and dispense naloxone and fentanyl test strips, and syringe service programs, which provide a wider range of services, if they are located within local health departments or community-based organizations that received approval from their local health department. The current harm reduction resource network includes 216 overdose response programs and 23 syringe service programs, operated by both local health departments and community-based organizations. A revision to the drug paraphernalia definition removed equipment used to “test and analyze” controlled substances from the paraphernalia classification, thereby legalizing the distribution of fentanyl test strips and other drug checking equipment.
Legislation
- Related to syringe exchange 24-902(a)
- Good Samaritan Law
- Drug Paraphernalia Act 24-908(a)
State Level Infrastructure for Harm Reduction — A Centralized Resource Hub
Maryland’s harm reduction philosophy emphasizes stigma-free connection to care, person-centered services, and addressing social determinants of health as they relate to substance use. The CHRS is a hub for all services and assistance related to harm reduction, which allows the state to have oversight and align investments to support resource distribution and harm reduction-related needs of different communities. Responsible for managing and distributing SAMHSA State Opioid Response and CDC Overdose Data to Action grants for harm reduction agencies, the center currently funds 24 nonprofits and 22 local health departments to support overdose prevention or syringe service programs.
The CHRS reviews applications for all syringe service programs and overdose prevention programs, ensures operating programs follow guidance and reporting requirements, and manages naloxone and fentanyl test strip distribution across the state. A variety of maps details resource locations across the state, and mail-in options are provided for residents without close access to resources. The center also partners with Maryland’s Harm Reduction Training Institute to support the harm reduction workforce across the state, offering training and educational opportunities and assistance to programs that currently or prospectively provide harm reduction services
Implementing a Statewide Strategy for Harm Reduction Informed by Community Feedback
Harm reduction program offerings are informed by community feedback and local needs. The CHRS assists prospective harm reduction programs by providing funding, technical support, and other tailored resources to help implement services based on specific community wants. Additionally, the center hosts quarterly meetings with an advisory committee, which includes members with lived and living experience, to hear about emerging challenges, areas of needed support, and any requests related to harm reduction service offerings. Regular meetings such as these serve as vital touchpoints that help to foster trust between state and community partners, providing a clear line of communication and ensuring transparency around harm reduction needs and information.
Sharing Data with the Community
Directly engaging with local and state harm reduction partners and dispensing resources from one centralized source positions the CHRS to collect lots of data related to harm reduction needs, best practices, and efforts across the state. The state completed and published several assessments related to harm reduction and commits to routinely sharing data with communities through reports and other publications. The Statewide Ethnographic Assessment of Drug Use and Services, for example, highlights the unique experiences of people who use drugs in each county and identified opportunities for expanding harm reduction services locally. Additional resources such as a toolkit for improving linkages to care for people at risk of overdose and annual reports on data-informed overdose risk mitigation support community members in learning about overdose prevention best practices.
State Innovation
Amidst the rising presence of fentanyl in the drug supply, Maryland piloted a test program in eight syringe service locations that offered rapid drug analysis testing. Participants could donate used paraphernalia for sampling and received notice regarding the contents of their sample in less than 48 hours. This study highlighted the importance of drug checking to both inform safer use and shed light on emerging trends in the state’s drug supply. The state has since maintained the resource of rapid analysis of drugs, offering syringe service program participants the chance to test samples from used paraphernalia. As threats such as fentanyl and xylazine continue to poison the supply, offering the resource of drug checking helps reduce unexpected risk from substance use and inform the state on how to best adapt resource offerings to meet the changing landscape.
Utah’s Approach to Harm Reduction: Empowering Local Responses
Public health services in Utah are delivered by 13 local health departments, which have fiscal authority over public health spending. The Utah Department of Health and Human Services supports these local health departments in advancing overdose prevention and harm reduction efforts uniquely tailored to the needs of each community across the state through:
- Oversight and support of locally administered SSPs
- Advancing public education campaigns and resources, including a fentanyl test strip locator, and providing technical assistance and training to local health departments and harm reduction providers
- Empowering trusted community members and workers to meet the unique local need
State Laws Relating to Harm Reduction
Legislation related to harm reduction in Utah, passed in 2016, legalizes syringe exchange and establishes specific operational and reporting requirements for entities administering these programs. Utah has 13 syringe service providers across the state, three of which are run out of local health departments. Legislation enacted in 2023 removed fentanyl test strips from paraphernalia classification, and recently passed legislation alleviates legal implications for individuals involved in syringe exchange services.
Legislation
- Related to syringe exchange and education Utah Code 26B-7-117
- Good Samaritan Law Utah Code 58-37-8
- Drug Paraphernalia Amendments B. 60
State Level Infrastructure for Harm Reduction — Supporting Local Providers
Harm reduction services supported by the State of Utah include syringe exchange, overdose prevention (e.g., naloxone distribution and education), sexually transmitted infection testing and education, provision of wound care supplies, and access to external health care services, which can include medications for opioid use disorder (MOUD), substance use treatment, and other connections to care. Under the Utah Department of Health and Human Services (DHHS), two main offices oversee and advise harm reduction activities and funding, which largely comes from federal grants. The Office of Substance Use and Mental Health directs some SAMHSA State Opioid Response grant dollars to fund and advise the Office of Health Promotion and Prevention (OHPP), which helps to support, monitor, and contract out awards to syringe service programs and harm reduction providers at the local level. Other overdose prevention resources, such as naloxone, are funded under CDC’s Overdose Data to Action grant.
Additionally, the state works closely with local health departments and community-based organizations for bulk distribution of harm reduction supplies such as naloxone, fentanyl test strips, and xylazine test strips. The state campaign “Stop the Opidemic” offers a fentanyl test strips locator, naloxone training and order options, and clinical resources and distribution materials for providers.
Offering Technical Assistance and Educational Resources to Local Harm Reduction Providers
The state plays a key role in providing technical assistance and resources to localities receiving federal funding for harm reduction activities. DHHS houses a variety of resources for local partners involved with harm reduction initiatives, prominently featuring resources such as the Utah Syringe Exchange Program Handbook, which details guidelines and recommendations for SSPs based on the law, administrative rule, and best practices; and approved presentations such as “Harm Reduction 101” and “Legal Considerations for Harm Reductionists.” By having variety of educational materials available, individuals interested in potentially becoming a harm reduction provider, or people who are just looking to learn more about the subject, have a greater opportunity for finding tailored resources.
DHHS also compiles necessary instructions, forms, and materials for enrolling SSP providers. OHPP also supports the Utah Syringe Exchange Network, which brings together over 30 partners including community, state, and local officials, law enforcement, and medical providers in monthly meetings for best practice and resource sharing related to syringe exchange efforts across the state. The Network offers harm reduction navigator certification, which entails learning the basics of harm reduction, and an abundance of resources organized for Network partners, SSP participants, providers, and community members.
Empowering Trusted Messengers
To effectively reach target audiences, Utah DHHS relies on partnerships built with trusted messengers at the local level. Supporting community ambassadors and local health departments has proven to be an effective way for Utah to reach populations with harm reduction materials. Those who have been successful in operating harm reduction programs at the local level often share their successes with neighboring communities, prompting added engagement with information and resources for setting up harm reduction programs.
State Innovation
Among the various syringe service providers across the state are several unique enrollees who sought out certification as an SSP after identifying the potential to further help the populations they connect with. The Salt Lake Fire Department, which sends out a team of social workers on emergency dispatch calls, frequently responds to overdoses and identified the potential to enhance their response services. As a now-enrolled SSP provider, the Department is able to distribute kits of harm reduction materials, such as naloxone, fentanyl and xylazine test strips, sharps containers, and sterile syringes, while on dispatch calls. Other unique SSP enrollees, such as nonprofits Odyssey House and Soap2Hope, saw the potential to provide their respective populations served with harm reduction resources and capitalized on the opportunity to become an enrolled provider through the state.
Vermont’s Approach to Harm Reduction: Expanding Access Beyond the Treatment System
Public health services in Vermont are delivered through one centralized health department, with 12 district offices embedded in communities across the state working to identify partners and concerns at the local level. To support harm reduction across the state, the Vermont Division of Substance Use Programs synthesizes data related to overdose prevention, fosters working relationships with local providers, and helps identify areas of needed support for harm reduction resources through:
- Overseeing operations of syringe service and drug checking programs
- Evolving resource offerings to respond to emerging threats and resource needs at the local level
- Using overdose fatality data to inform efforts to reach individuals with no connection to the treatment system and build infrastructure in rural communities
State Laws Relating to Harm Reduction
Vermont operates four syringe service programs across the state, all of which either operate as a mobile site or have both mobile and fixed site options. The commissioner of health authorizes syringe service programs if they comply with operating guidelines overseen by the Division of Substance Use Programs. Related to drug checking, Vermont authorizes fentanyl test strip distribution and allows service providers to test and analyze substances for individuals, protecting those individuals from criminal proceedings after receiving their results. Pending legislation may authorize the state to pilot and study overdose prevention centers, which would provide space supervised by trained health care professionals and staff where people who use drugs can consume pre-obtained drugs and medication for substance use disorder.
Legislation
- Related to syringe exchange – 18 V.S.A. § 4478
- Good Samaritan Law – 18 V.S.A. § 4254
- Drug Paraphernalia Law – 18 V.S.A. § 4475
State Level Infrastructure for Harm Reduction — Overseeing Local Operations
Within the Vermont Department of Health and Human Services, the Division of Substance Use Programs oversees and advises overdose prevention funding and activities. The division allocates state funding to each of the four syringe service programs, while also allocating funding from SAMHSA State Opioid Response and CDC Overdose Data to Action grants for broader overdose prevention activities. Across the state, naloxone funding comes from a special taxation on pharmaceutical companies, providing a continuous funding source for providing free access to the resource. To supplement treatment services financed by Medicaid, other substance use-related funding streams, such as SAMHSA Opioid State Targeted Response grants, are used to support coverage of medications for opioid use disorder and other resources.
Along with distribution of funding, the Division of Substance Use Programs oversees licensure of syringe service programs, provides guidance and documentation for drug checking across the state, and offers technical assistance to community-level partners. Because the state has a centralized health department as opposed to local health departments, the state relies on relationship building with each of the 12 district offices embedded in communities across the state. Local providers serving on the Opioid Settlement Advisory Committee are key to informing the division’s funding strategy.
Innovative Strategies to Respond to Emerging Threats and Community Needs
Vermont has found success in establishing trust and a working relationship with communities. Each of the 12 district health offices plays a key role in identifying partners at the local level and hears directly from impacted communities about their challenges and needs. This two-way dialogue informs a tailored resource allocation and technical assistance response. With the emergence of xylazine, for example, the state assisted with adapting SSP resources to include wound care supplies, and the University of Vermont Medical Center was awarded state opioid settlement funding to support telehealth wound care assessments and treatment plan development for local providers.
Recognizing barriers to interventions in rural areas, the state prioritizes expanding facilities and services to areas not currently saturated with resources. The state’s hub and spoke model for medication for opioid use disorder offers an opportunity for connecting rural areas with the state’s larger treatment system. The model entails nine regional “hubs,” which are opioid treatment programs with the ability to dispense MOUD, who connect patients, share information with, and provide technical support to over 75 “spokes,” which are local community providers who offer broader medical care services. This model expands access to treatment and fosters collaboration and coordination among addiction medicine providers.
Reaching Individuals Outside the Treatment System
Vermont relies heavily on data to inform targeted resource expansion efforts. The state’s annual social autopsy reportsanalyze trends in how individuals who died of a drug overdose previously engaged with the state correctional, social services, and health systems to identify intervention points and shape agency efforts to prevent future deaths. As noted by the Vermont Opioid Settlement Advisory Committee, the majority of individuals who died of an overdose had no prior engagement with the treatment system. The state has since funded a variety of innovative services through state settlement funding and other sources to reach these populations that may face barriers to access, with some examples including harm reduction supply leave-behind packs for those who engage with emergency medical services, harm reduction vending machines, and mail order services.
State Innovation
Contingency management (CM), defined as “an intervention that provides tangible reinforcement when target behaviors are completed,” has become a strategy of focus in Vermont for engaging individuals in treatment services. In October 2023, the Vermont Department of Health issued a request for proposals for organizations to implement contingency management in existing substance use treatment service. Organizations were awarded from a total of $840,000 in state opioid settlement funding for their proposals. Additionally, the state offered an opportunity for targeted technical assistance in CM approaches and proposed additional state settlement fund allocations for ongoing CM support for organizations. With the rise in cooccurring stimulant use alongside opioids, CM — recognized as one of the most effective strategies for treating stimulant use disorder — will likely become more prominent in states’ approaches to substance use disorder treatment.
Conclusion
Stigma, limited resources, and variability of state laws continue to pose barriers to implementation of lifesaving harm reduction services. Despite continuing challenges, state leaders continue to find ways to work across agencies and directly with impacted communities to advance evidence-based harm reduction interventions. By working in partnership with impacted communities and the organizations that serve them, state leaders can help advance evidence-based interventions and lower barriers to lifesaving care. Fostering these relationships, along with investing in other state-based strategies to align funding and resources for harm reduction, are among several options state leaders have for developing a tailored approach to harm reduction that best suits the needs of their respective populations.
Glossary
Drug Checking — A harm reduction practice in which people check to see if drugs contain certain substances (National Institute on Drug Abuse (NIDA))
Lived or Living Experience — A broad term used to refer to people who are directly affected by the opioid crisis or strategies that aim to address it. It may encompass a broad range of life paths or views. People with lived or living experience may include individuals who use opioids or other drugs, those who are receiving services for opioid use disorder, those who are in recovery from opioid use disorder, or others directly impacted by opioid or drug use.
Medications for Opioid Use Disorder (OUD) — The standard of care for treatment of opioid use disorder, recommended for all individuals with opioid use disorder. Three medications are approved by the Food and Drug Administration for the treatment of OUD: methadone, buprenorphine, and naltrexone. (New York State Office of Addiction Services and Supports)
Overdose Prevention Services — Includes taking steps to reduce the risk of overdose in the first place, responding to an overdose by administering naloxone or other opioid overdose reversal medications, and referring the person to harm reduction services and supports. (SAMHSA)
Syringe Service Program — Community-based prevention programs that can provide a range of services, including access to and disposal of sterile syringes and injection equipment, vaccination, testing, and linkage to infectious disease care and substance use treatment (NIDA)
Acknowledgments
NASHP would like to thank Lisa Anderson Akine, Mojgan Zare, Malik Burnett, Tricia Bishop, Hannah Adams, Mark Levine, and Nicole Rau for sharing their insights to help inform this piece, as well as Aisha Salman and Noah Duff at the National Academy of Medicine. NASHP would also like to thank the Foundation for Opioid Response Efforts for its continued support in NASHP’s ongoing work to assist state leaders in opioid settlement spending and planning.
