OBJECTIVE

The goal of this toolkit item is to provide incentives to overdose survivors for engagement in harm reduction services following the initial outreach visit. POST teams have found that many overdose survivors encountered during outreach are not active participants in local harm reduction programs. While the POST encounter is an opportunity to offer on-the-spot risk reduction assessment, advice, and supplies, there are also potential barriers to full engagement during the visit (e.g., presence of public safety, family, or others). The initial POST encounter may not offer adequate space or comfort to talk about risk reduction and navigation to services. These barriers may be amplified for people who use cocaine or methamphetamine and Native, Black, Latino, Hispanic or youth survivors. Incentivizing overdose survivors to access harm reduction services following an outreach visit is a promising approach to improve engagement.

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OBJECTIVE

Support After a Death by Overdose (SADOD), a statewide overdose grief organization, facilitated a grief group with frontline POST program workers. During this discussion, a hypothetical outreach scenario was presented where the outreach team unexpectedly encountered grieving family members. The objectives of the discussion were to learn how to: 1) appropriately respond to someone who is experiencing acute grief, 2) provide appropriate resources to grieving family members, and 3) manage grief from secondary trauma experienced by outreach workers engaged in this work. A template for hosting a grief scenario is included in the toolkit, as well as information on how to attend weekly grief groups for outreach workers hosted by SADOD.

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OBJECTIVE

As a supplement to the Grief Support Resources document, the toolkit also includes an implementation guide outlining the steps that POST programs can take to make a direct “warm referral” to the Sun will Rise organization. This service, which is exclusive to POST programs, guarantees that a member of Sun Will Rise will contact the person referred within 24-48 hours after the referral is made.

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OBJECTIVE

These trainings/videos provide an overview of cultural responsiveness, current insights around overdose in communities of color and youth populations in Massachusetts, and how culture impacts post-overdose outreach strategies. These trainings have been developed in conjunction with our Toolkit Development Group members and our advisory board members.

OBJECTIVE

This infographic is intended for outreach staff and public safety partners to facilitate discussions about how outreach will be conducted. Pre-visit discussions can help teams customize their approach for each outreach visit, ensure the correct outreach staff are present (to account for things such as language barriers), and promote a safe and positive encounter.

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OBJECTIVE

This infographic is intended to promote open discussion between public health and public safety partners about how post-overdose outreach services will be conducted. The aim of this toolkit item is to support the development of formal and informal policies and procedures to guide outreach services. It covers topics such as team member roles, warrant checking, separating outreach from law enforcement activities, and minimizing harm and unintended consequences for overdose survivors.

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OBJECTIVE

This is an implementation guide outlining the steps that POST programs can take to make a direct “warm referral” to the Learn to Cope organization. This service, which is exclusive to POST programs, guarantees that a member of Learn to Cope will contact the family or social network person referred within 24-48 hours after the referral is made.

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OBJECTIVE

There are many aspects of harm reduction unique to people who use or inject cocaine or methamphetamine that are not always covered by Harm Reduction 101 classes. This training includes information on needle sizing, injection technique, safer smoking supplies, and injecting cocaine or methamphetamine. This training was initially presented at the POST Convening in March 2023, and has been recorded on Zoom to be viewed at any time here. 

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OBJECTIVE

Post-overdose outreach is mostly reactive; a person overdoses which triggers a team to respond to offer services. This toolkit item offers a proactive approach outreach workers can use to identify high-risk areas within their communities for cocaine or methamphetamine-related overdose. With the proliferation of fentanyl into the cocaine and counterfeit pill supply, people who may not normally engage with naloxone distribution programs are at risk of an accidental opioid overdose. Having conversations with community partners about where naloxone can be made available is a method of engaging people in high-risk areas. One possible method is to use NaloxBoxes in areas known to have overdoses.

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Community Accessible Naloxone Resources

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NaloxBox-Specific Resources

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OBJECTIVE

A Tabletop Exercise (TTX) is a tool used by emergency managers to assist communities in preparing for a variety of disasters, pandemics, or other catastrophic situations. Stakeholders from all segments of the community are gathered to plan a response to an identified threat. In this exercise, we use the example of fentanyl-contaminated cocaine spreading through a community. By centering harm reductionists as the experts on overdose, this TTX will help communities plan a response that centers the perspective of people who use drugs. Communities will work through a multi-module, multimedia experience and work together to produce actionable solutions. An after-action report (AAR) will be developed at the end of the exercise and provided back to the community.

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OBJECTIVE

Using generic, plain brown paper bags is a recommended approach to discreetly distribute harm reduction materials to overdose survivors. This method increases privacy for the overdose survivor. Family members or friends may become suspicious, so use with caution and be prepared for questions. You should reiterate that these are generic bags that the team gives to everyone. This toolkit item identifies possible harm reduction items that can be included in the bag, but we recommend that the contents of the bag reflect the specific needs of each survivor. 

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OBJECTIVE

Overdose survivors may be uncomfortable having conversations about substance use, harm reduction, or overdose in front of their family or law enforcement officers. An effective outreach strategy employed by many POST programs is to create space by heading to another room, offering to follow up in a different location, or asking the survivor to talk outside of the residence. This infographic was developed to illustrate different approaches to promoting private discussions. It can be distributed to outreach partners as an educational tool.

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OBJECTIVE

This document identifies settings and sectors that post-overdose outreach programs can engage with in their communities to build partnerships. The toolkit item shows where cocaine or methamphetamine use and overdoses frequently occur or where community stakeholders may be present. These may be some of the most effective places for outreach. It is recommended that post-overdose outreach organizations build relationships and engage with community members, specifically in these locations, to learn more about the community, build community trust, encourage referrals for support, and provide education on overdose prevention and response to the people who work or volunteer in these settings. Post-overdose outreach programs should center themselves as the experts in their community on substance use and overdose. The areas/locations with the highest number of overdoses varies between communities. Post-overdose outreach programs should consider other, community-specific locations and sectors to build partnerships. An implementation worksheet is also included which can be used to brainstorm with partners about intended future outreach efforts.

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