Peer distribution of naloxone and education on its use enhances partnerships between medical researchers, law enforcement, public health leadership, and activist groups in order to achieve the shared goal of reducing fatal overdoses.
Research on goals of naloxone saturation has galvanized interest in designing strategies with people with past or current experience with drug use that effectively target distribution efforts to ensure kits are in the hands of those most likely to observe an overdose and who can share needed messages of hope and health to those in need. This can be accomplished by integrating people who use or have used drugs along a continuum of recovery, with or without professional certifications, into public health approaches. This policy approach potentially provides new avenues for participation, solidarity, and citizenship.
Currently, over 1,000 registered OEND programs exist in New York State (NYS) offering training and provision of naloxone directly and at no cost to persons they have trained. Through the HEALing Communities Study, peer-led organizations in the state have expanded services to champion low threshold, 24/7 engagement of people in need of support and access to harm reduction and pathways to recovery based on a client-centered and mutual aid approach.
Overdose education and naloxone distribution (OEND) programs include education about overdose risk factors and how to recognize, respond to an overdose and administer naloxone, as well as providing naloxone or full rescue kits. Integrating peers or people with lived experience into public health approaches has the potential to provide new avenues for participation, solidarity, and citizenship.
“Peer distribution of naloxone is most effective at getting the lifesaving resource to those most likely to witness or experience an overdose through trusted relationships and direct knowledge of their community,” shared Dr. Timothy Hunt, Research Scientist at Columbia University School of Social Work. “Getting naloxone to those most likely to see or experience an overdose is critical. Those with direct experience who are trusted in communities are most effective for overdose messaging and naloxone distribution, needed to stem the epidemic… getting naloxone to the right place at the right time.”
Successful peer-led OEND programs across New York include:
Monroe County IMPACT Model & NY Recovery Alliance
In 2020, the Monroe County Department of Public Health, with the support of the County Executive, established the county’s first Addiction Services Division, known community-wide as the Monroe County Improving Addiction Coordination Team (IMPACT). Monroe County IMPACT comprises 22 Outreach and Public Health professionals who provide numerous services, including: Narcan distribution; training and education; support and connection to treatment and resources for individuals who have experienced an overdose or who use substances; street-level, data-driven outreach to the community; naloxone box maintenance and supply; 24/7 hotline support and community engagement.
In addition to the IMPACT model, the Monroe County Department of Public Health and the HEALing Communities Monroe County Coalition partnered with the New York Recovery Alliance (NYRA) to distribute naloxone to unhoused individuals and do community outreach in parks. Each week — rain, snow, or shine, and without shame or
judgment — a dedicated team of outreach volunteers both onsite, and in the community, assist anyone facing substance use disorder, mental illness, and/or homelessness. In addition to providing health and recovery resources, basic needs, and nourishment, NYRA deploys a cleanup team to safely dispose of used needles in “hot zones,” (public spaces such as parks, parking lots, and playgrounds) and make wellness checks on unhoused neighbors who have sought refuge in vacant lots or abandoned properties. NYRA also has a specialized team that provides certified Narcan training and community education.
Samadhi Recovery Center, Ulster County
Samadhi is a recovery center founded in 2018 to end the suffering associated with addiction and help individuals overcome obstacles to recovery through compassionate, person-centered care and treatment. Their community-based Outreach Center provides individuals and families services such as peer-led addiction and recovery support groups for both the individual and the family. They offer life skills training, overdose education and naloxone distribution, collaboration with community resources, trauma-informed care (EMDR and Somatic Experiencing), fitness, health, mindfulness-based and wellness activities, and community service opportunities.
Additionally, to address housing insecurity the Samadhi Refuge Program’s central mission is to provide safe, secure, emergency housing and supports to adults struggling with Substance Use Disorder (SUD) who lack suitable housing. While providing emergency housing, they work to find each person safe alternative housing or permanent housing elsewhere, as well as provide each resident with appropriate supports in their recovery.
Nick’s Ride 4 Friends, Cayuga County
Founded in 2016 in honor of Nick Campagnola, who lost his fight with addiction at just 20 years of age, Nick’s Ride 4 Friends is a local, grassroots, 501(c)(3) not-for-profit organization whose mission is Empowering individuals towards recovery, through sharing lived experience and promoting community connections. Nick’s Ride 4 Friends relies upon a peer support model that is client-centered, trauma-informed, and non-judgmental. The organization promotes the importance of developing authentic relationships in combination with embedding harm reduction strategies into all areas of prevention, treatment, and recovery services to engage with people who use drugs. Additionally, the organization advocates for social justice and health equity by promoting education, raising awareness, and celebrating recovery.
Nick’s Ride 4 Friends offers free, peer-based, non-clinical recovery support services. Certified peers leverage their unique personal experiences to engage, connect, and establish trusting rapport with people who use drugs and those already in recovery, supporting all on their personal wellness journeys. Peer services include: one-on-one peer support, transportation services, same-day linkages to treatment, including linkages to medications for opioid use disorder (MOUD), assistance navigating community resources and treatment services, advocacy for individuals who are court-involved or currently incarcerated, empowerment and recovery coaching.
These examples of peer-led organizations are part of the HEALing Communities Study (HCS), a multi-site research study, that tested the impact of an integrated set of evidence-based practices across healthcare, behavioral health, justice, and other community-based settings. HEALing Communities is funded by the National Institutes of Health (NIH) Helping to End Addiction Long-term (HEAL) Initiative®.
HEAL Connections
Research results need to benefit people living with pain, addiction, and other co-occurring conditions but too often get stuck in journal articles and conference presentations. The HEAL Connections Center through funding from the NIH HEAL Initiative® under OTAs 1OT20D034479 and 1OT2OD034481, aims to translate HEAL research into action. Learn more here.