Resources: Harm Reduction

Reports on the implementation, activities, and outcomes of state opioid response (SOR) grantees using data collected in fiscal years 2020, 2021, and 2022. Includes accomplishments for all the states and territories and rural mentions throughout.

Outlines federal drug policy priorities and promotes short and long-term solutions to reduce drug use, overdose, supply, and other related harms in the U.S. Covers information and strategies to prevent youth substance use, expand access to medications for opioid use disorder and other evidence-based treatments, building recovery communities, and strengthening efforts to disrupt drug trafficking. Includes strategies to address substance use issues in rural, tribal, and other underserved communities.

Consists of a network of 10 regional centers, a central coordinating office, a National Hispanic and Latino ATTC, and a National American Indian and Alaska Native ATTC working in addiction treatment and recovery services. Promotes awareness and new and evidence-based practices and services for the treatment of opioid use disorder (OUD) and substance use disorder (SUD). Facilitates the adoption of new technology by addiction treatment and recovery service providers. Offers education, training, resources, and information for the behavioral healthcare workforce in rural areas.

Provides information on mortality disparities from overdose, suicide, and alcoholic liver disease/cirrhosis, also known as diseases of despair, in the Appalachian region among people aged 15-26. Uses 2022 data from the Multiple Cause of Death database to examine mortality trends regionally, by state, as well as by gender, and metropolitan or nonmetropolitan designation.

Identifies and describes the following 7 drug policy priorities for the first year of the Biden-Harris Administration: expanding access to evidence-based treatment; advancing racial equity issues in drug policy; enhancing evidenced-based harm reduction efforts; supporting evidence-based prevention efforts to reduce youth substance use; reducing the supply of illicit substances; advancing recovery-ready workplaces and increasing the addiction workforce; and expanding access to recovery support services. Outlines next steps for the Office of National Drug Control Policy (ONDCP) to coordinate with other federal agencies to address drug policy priorities.

Develops partnerships between the U.S. Department of Health and Human Services (HHS) and community and faith-based organizations. Provides up-to-date information on federal health and human service activities and resources to help local organizations better serve their communities. Focuses on supporting grassroots efforts to address the issues of mental health and youth, opioids and preventing overdose, suicide prevention, and supporting individuals reentering society after incarceration and their families.

Provides information to first responder agencies, communities, and other stakeholders to support practices and approaches for first responders to connect people to substance use treatment and other support services. Offers evidence-based strategies, public health approaches, resources, and program models, including best practices for responding to opioid overdoses. Considers potential challenges, such as those faced in rural areas, and other factors when implementing initiatives to support people who use drugs.

Summarizes key focus areas, needs, and recommendations of underrepresented rural and tribal law enforcement leaders in 9 states that were the result of a series of listening sessions with federal agencies. Includes topics such as substance use and addiction; mental health and medical care; illegal drug trafficking and related crime; school safety; and funding, among others. Describes ongoing federal responses to rural law enforcement concerns and highlights several best practices and new ideas to support local efforts to enhance public safety and reduce crime in rural and tribal areas.

Provides interactive data visualizations on drug overdose mortality rates in the U.S. from 2003 through 2021. Shows national trends broken down by age, sex, and race and provides state and county-level data. Includes urban/rural trends by state for the estimated crude death rates for drug overdose.

Provides information to law enforcement, courts, child welfare agencies, and schools on how they can create cross-sector collaborations to reduce the harmful effects of substance use on children and families. Includes 8 strategies for cross-sector collaboration and provides examples of successful collaboration projects. Considers factors related to addressing substance use in rural communities.

Provides information and guidance to rural communities on establishing deflection and pre-arrest diversion (DPAD) programs. Promotes the use of DPAD to reduce criminal justice system involvement for people who use drugs and those with substance use disorders and help link them to evidence-based treatment services. Describes challenges to implementing DPAD programs in rural areas and offers strategies and resources to address these barriers. Includes example projects from 2 rural communities.

Provides a worksheet to assist rural health departments in developing partnerships with local groups and organizations to address the inter-related issues of suicide, overdose, and adverse childhood experiences (ACEs) in their communities. Discusses risk and protective factors as well as data sources relevant to suicide, overdose, and ACEs. Offers important considerations for current and future partnerships designed to enhance prevention in rural areas.

Provides an overview of a 10-year U.S. Department of Health and Human Services (HHS) initiative, starting in fiscal year 2020, to reduce new HIV infections in the U.S by 90% by 2030. Outlines the Centers for Disease Control and Prevention's (CDC) role in the initiative and strategies for working with national, state, and local partners in efforts to diagnose, treat, and prevent new HIV infections, and respond to potential HIV outbreaks. Includes information on funding for the initiative, priority jurisdictions, including 7 states with substantial rural burden, local plans focused on ending the HIV epidemic, success stories, and resources for partners and grantees.

Provides guidance and resources to help individuals and communities build and strengthen community coalitions with the ultimate goal of decreasing opioid overdose deaths. Includes insights from rural communities and rural considerations.

Fact sheet detailing a 6-step planning process to help schools and institutions of higher education develop or update emergency operation plans (EOPs) to address overdose and other potential threats and issues resulting from fentanyl and opioid misuse. Discusses the 5 mission areas of preparedness for opioid-related emergencies and the effects of the opioid crisis on school-aged children, young adults, and school safety. Includes links to additional resources and information to aid in the development of school EOPs, and programs and activities to prepare for and respond to an opioid overdose.

Collaborates with tribal stakeholders across the U.S. to address issues related to the treatment of chronic pain and the use of heroin and prescription opioids among tribal populations. Works to promote appropriate and effective pain management, reduce opioid overdose deaths, and improve access to culturally appropriate substance use prevention, treatment, and recovery services for American Indian and Alaska Native communities. Workgroup focus areas include prescriber support, treatment and recovery, harm reduction, program effectiveness metrics, technical assistance, and communications.

Serves as a clearinghouse of resources to assist law enforcement agencies across the country in establishing a naloxone program to reduce the harm and number of deaths associated with opioid overdose. Offers information on a range of topics related to operating a naloxone program, including naloxone medication and its role in law enforcement; acquiring and administering naloxone; training law enforcement; liability and risk issues; and collaboration with other agencies and stakeholders. Provides a variety of tools and materials, such as sample documents and templates for data collection forms, training materials, press releases, community outreach materials, and more. Product of the Bureau of Justice Assistance's (BJA) National Training and Technical Assistance Center (NTTAC) funded by a contract through the U.S. Department of Justice (DOJ) Office of Justice Programs (OJP).

Documents the challenges, successes, and lessons learned from the Rural Opioid Overdose Reversal Program (ROOR), a 2015 pilot grant program administered by the Health Resources and Services Administration's (HRSA) Federal Office of Rural Health Policy. Includes resources to support related projects and programs, with links to training, data strategies, and outreach tools.

Provides an overview of a 2017 pilot project to enhance the ability of local health departments (LHDs) to address opioid use and reduce the occurrence of fatal and non-fatal overdose in their communities by working more effectively with state and local partners. Summarizes project activities and goals and gives a brief introduction to the four pilot sites: Bell County, Kentucky; Hillsborough County, New Hampshire; Montgomery County, Ohio; and Boone County, West Virginia.

Provides information on the availability of, and access to, medications for treating alcohol use disorder (AUD) and opioid use disorder (OUD), and for reversing opioid overdoses within state Medicaid plans. Discusses policies and regulations affecting access to these medications and reviews the present coverage and availability of the medications to Medicaid beneficiaries in each state. Includes 5 innovative models for expanding medication access to underserved Medicaid populations, including those residing in rural areas, American Indian/Alaska Native communities, and individuals recently released from incarceration.

Delivers information, resources, technical assistance, and training to K-12 schools and institutions of higher learning to assess school climate, implement evidence-based programs to improve learning conditions, and measure outcomes in 3 core areas: providing a well-rounded education, improving the safety and health of students, and improving the effective use of technology. Offers multiple products, policy guides, toolkits, research, media, online events and training related to issues of substance and opioid misuse for students, families, schools, and communities.

Provides expert technical assistance and resources to help communities, health departments, treatment programs, and other organizations providing or planning to provide harm reduction services.

Interactive map providing data on suspected nonfatal drug overdoses in pre-hospital care settings in the U.S. at the national, state, and county level. Offers data on nonfatal drug overdose incidence and trends, including overdose rates, number/rate of naloxone administration, and average emergency medical services (EMS) response time. Allows users to explore disparities according to demographic characteristics, such as age, race, gender, and frontier, rural, and urban geographies, as well as by the suspected drug involved.

Serves as a Rural Opioid Technical Assistance Regional Center (ROTA-R) providing training and technical assistance to address opioids, stimulants, and other substances impacting rural communities in New Jersey, New York, Puerto Rico, and the U.S. Virgin Islands.

Provides an overview of the U.S. Department of Veterans Affairs (VA) Opioid Overdose Education & Naloxone Distribution (OEND) program. Focuses on reducing opioid overdoses and deaths among veterans through education and training for prevention, recognition, rescue response, and naloxone kit use. Includes OEND videos and materials for providers and patients.

Allows local organizations, providers, state and local health departments, and other stakeholders to add a free, customizable version of the Centers for Disease Control and Prevention (CDC) opioid overdose website to their own websites. Helps communities disseminate online, current CDC opioid information and resources, as well as training on the CDC guidelines for prescribing opioids for chronic pain.

Toolkit sharing field guidance, resources, and presentations to support clinical decisions about starting, continuing, or tapering opioid therapy, and other challenges related to safe opioid prescribing. Includes patient and provider education, clinical tools, and other resources.

Offers comprehensive information and resources on the use of prescription opioids, managing chronic pain, and opioid use disorder (OUD) for patients and providers, specifically for American Indian and Alaska Native (AI/AN) communities and Indian Health Service (IHS) providers. Includes online tools, technical assistance resources, guides, and training for patients and providers on topics such as opioid crisis data, opioid prevention, proper pain management, opioid prescribing/stewardship, culturally appropriate practices, maternal health, harm reduction, naloxone use, drug checking, child health and wellness, medication-assisted treatment (MAT), tele-MAT, trauma-informed care, best practices, supportive services, wellness courts, and training opportunities. Resource is an initiative of the IHS Alcohol and Substance Abuse Branch (ASAB).

Provides a brief overview of the issue of opioid overdoses in rural areas and offers public health policy and strategy options to help communities prevent and reduce rural opioid overdose deaths. Includes case studies describing interventions implemented in 3 states.

Provides guidance to policymakers, communities, and key stakeholders to develop and implement system- and practice-level changes to reduce opioid overdose deaths. Presents results from the National Institutes of Health (NIH) Helping to End Addiction Long-term (HEAL) Initiative's HEALing Communities Study. Outlines priority populations and 19 evidence-based interventions to prevent and reduce opioid related overdose deaths. Offers resources on various topics related opioid overdose and highlights model programs, including those serving rural areas.

Provides guidance and resources to help communities, healthcare providers, and volunteers providing opioid use disorder (OUD) treatment and harm reduction and recovery services address opioid use in their communities. Include rural mentions throughout.

Details the U.S. Department of Health and Human Services strategy to respond to drug overdoses and prevent overdose deaths across the U.S. Shares research, resources, and evidence-informed overdose interventions focused on 4 priority areas: primary prevention, harm reduction, evidence-based treatment, and recovery support. Offers strategies and resources designed to increase coordination among key stakeholders, reduce stigma, and expand access to healthcare and treatment for underserved populations, including rural and tribal communities.

Shares information, resources, and tools organized around 7 strategies to help local and state health departments link people at risk of opioid overdose to care. Includes rural examples and discussion throughout.

Consists of a public health and public safety collaboration between the High Intensity Drug Trafficking Areas (HIDTA) program and the Centers for Disease Control and Prevention (CDC) across the U.S. Seeks to help communities reduce fatal and non-fatal drug overdose rates by improving information sharing across agencies and supporting evidence-based interventions. Equips states with a Drug Intelligence Officer (DIO) and a Public Health Analyst (PHA) who are responsible for helping to increase communication, data flow, and intelligence sharing between public safety and public health sectors within and across states.

Consists of a network of 10 regional resource centers, a central coordinating office, a National Hispanic and Latino PTTC, and a National American Indian and Alaska Native PTTC that work to support effective substance use prevention interventions. Develops and disseminates education, training, resources, and information to raise awareness and promote the implementation of evidence-based prevention practices. Facilitates the adoption of new technology by individuals and organizations working in the field of substance use prevention. PTTC focus areas include community coalitions and collaborators; health equity and inclusion; data-informed decisions; implementation science; cannabis prevention; and workforce development.

Provides training and technical assistance to BJA's Residential Substance Abuse Treatment (RSAT) grantees in their efforts to address substance use disorders (SUDs) and reduce overdose deaths in jails and prisons. Aims to enhance the capacity of state, local, and Indian tribal governments to provide residential SUD treatment during detention and to plan and deliver community-based treatment and aftercare services upon release from incarceration.

Provides literature reviews on rural health priorities identified in the Rural Healthy People 2030 survey. Includes chapters on the issues of addiction, rural substance misuse, mental health and mental disorders, chronic pain, and more. Seeks to inform rural policymakers, providers, advocates, and other stakeholders to promote the health of people living in rural communities.

Provides an overview of the opioid crisis in rural America and includes information and resources on initiatives and funding opportunities to address the crisis. Covers successful rural model program examples, events, and other tools for prevention, harm reduction, and treatment.

Provides a clearinghouse of information, best practices, tools, events, and research to support comprehensive approaches to prevention, treatment, recovery, and policy to address substance use disorder (SUD) in rural communities nationwide.

Directory of behavioral health treatment locator tools, hotlines for suicide prevention, treatment referral services, assistance for veterans in crisis, and more. Includes links to resources and services related to substance use disorder (SUD) prevention, treatment, and recovery; mental illness; medications for opioid use disorder (MOUD); harm reduction; opioid overdose; crisis care; and suicide prevention.

Provides an overview of medications for opioid use disorder (MOUD) and medications for alcohol use disorder (MAUD), as well as information on opioid treatment programs (OTPs). Describes current federal regulations and requirements for practitioners to prescribe MOUD. Includes information and training resources for healthcare providers, researchers, and patients.

Describes how naloxone and nalmefene are used and the side effects of opioid overdose reversal medications (OORMs). Briefly discusses causes of opioid overdose. Highlights how the Substance Abuse and Mental Health Services Administration (SAMHSA) is working with communities, local governments, local law enforcement, and state and federal partners to expand naloxone/nalmefene use.

Presents the Substance Abuse and Mental Health Services Administration's (SAMHSA) 4-year strategic plan detailing the agency's guiding principles, priorities, goals, and objectives to address behavioral health needs in the U.S. Focuses on 5 key areas: preventing substance use and overdose; access to suicide prevention and mental health services; promoting resilience and emotional health for children, youth, and families; integrating behavioral and physical healthcare; and strengthening behavioral health workforce. Emphasizes behavioral health equity for underserved and/or historically marginalized populations, including rural and tribal communities.

Serves as a Rural Opioid Technical Assistance Regional Center (ROTA-R) in the Southeast region of the U.S. Develops training and provides technical assistance to address opioid and stimulant use in rural communities. Supports rural communities in Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee.

Provides information and resources for local health departments and community organizations implementing or expanding overdose prevention and response strategies at the local level. Offers guidance in developing practical measurement strategies to monitor progress, demonstrate accountability, and assess the outcomes and impact of grant-funded overdose initiatives. Includes examples from programs implemented in rural counties.

Details a school-centered pilot project that examined implementing strategies to prevent youth substance use and risky sexual behaviors in high-risk rural communities in Ohio, Kentucky, and Indiana. Highlights efforts to address related issues of HIV, sexually transmitted diseases (STDs), teen pregnancy, and high-risk substance use through education, primary prevention, and early detection screening. Program activities included implementing new health curricula, partnering with health departments and community drug-free coalitions, and developing and distributing informational products and video campaigns.

Serves as a planning resource for schools and stakeholders interested in implementing the Teens Linked to Care (TLC) program, an integrated prevention strategy to address both substance use and risky sexual behavior in youth living in rural communities. Outlines the 4 phases of the TLC program, and shares tools and other resources to help schools support sexual health and substance use education and policies.

Serves as a Rural Opioid Technical Assistance Regional Center (ROTA-R) in New England. Provides support, technical assistance, and naloxone training to address substance use disorder (SUD) and overdose throughout rural areas in Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont.

Provides data describing urban and rural differences in drug overdose death rates in the year 2020, using mortality data from the National Vital Statistics System (NVSS). Shows differences in rural and urban overdose death rates by sex, race and Hispanic origin, and selected types of opioids and stimulants.

Provides access to education materials developed by the VA Pharmacy Benefits Management Services (PBM) Academic Detailing Services (ADS) sharing evidence-based treatments to help providers improve the health of veterans. Offers provider and patient education tools and outreach resources to encourage evidence-based decision making for a variety of medical conditions and diseases, including opioid use disorder (OUD) and substance use disorder (SUD), pain, suicide, dementia, depression, HIV, post-traumatic stress disorder (PTSD), and more.

Offers evidence-based information, recommendations, guides, and tools for U.S. Department of Veterans Affairs (VA) and U.S. Department of Defense (DoD) healthcare providers and patients to assist in the decision making process to improve the treatment and outcomes for patients with substance use disorder (SUD), including opioid use disorder (OUD), methamphetamine use, and co-occurring mental health conditions. Describes best practices to help patients avoid preventable complications, reduce substance use, and improve their overall health and wellness.