Theme: Models of Care Year: 2024
Background: In many rural and Indigenous communities in the United States (US), stigma serves as a deadly barrier to naloxone access. Lack of access to naloxone has contributed to over 500,000 deaths associated with opioids in the US. Individuals at risk of overdose do not seek or obtain naloxone in part because of the stigma associated with substance use, and in possessing naloxone.
Description of model of care/intervention/program: Innovative naloxone distribution models were utilized to distribute hundreds of doses of naloxone to individuals at high risk of overdose in rural and Indigenous Minnesota communities. These included safe, nonjudgmental and trusted persons, places and things; each community utilized safe persons, places, and things uniquely based on their own strengths and community dynamics to distribute naloxone. Safe persons were individuals who were trusted to keep individual identity anonymous as naloxone access points, and safe places as known locations where individuals could obtain naloxone without answering any questions. This model was expanded to include safe things – harm reduction vending machines that were placed in low visibility and safe areas where an individual’s identity could remain anonymous as they obtained naloxone and other harm reduction supplies.
Effectiveness: Even though stigma continues to serve as a barrier to effective naloxone distribution, collaborating with trusted persons, finding locations that are viewed as safe, and exploring innovative harm reduction delivery devices including harm reduction vending machines, have allowed hundreds of doses of naloxone to be delivered to individuals at risk of overdose in northeastern Minnesota, saving hundreds of lives.
Conclusion and next steps: Innovative and community-engaged naloxone distribution techniques that build on the strengths of the community, and include partnerships with nonjudgmental naloxone advocates, can be effective in rural and Indigenous communities that struggle with stigma towards substance use.