Toolkits To Help #EndOverdose 

Every day, more than 100 people die from drug overdoses. Since 1999, one million people in the United States have died from drug overdose deaths. At Vital Strategies, we recognize that ending the overdose crisis requires evidence-based, innovative interventions that support the most underserved communities, including people living in poverty, LGBTQ+ people, and Black, Indigenous, and Latinx people. This also includes expanding access to harm reduction services and centering the health and dignity of people who use drugs.  

Vital Strategies has partnered with community-based organizations, state and local governments, people with lived experience, professional associations, and academic institutions to further initiatives that support people who use drugs. In addition to working with partners to design, scale, and strengthen a public health response to drug use, Vital Strategies has supported the creation of several toolkits and resources.  

Here are six toolkits that Vital Strategies has created to help advance public health responses to the overdose crisis in the United States: 

1. Resources for People Who Use Drugs Alone

People who use drugs may choose to use alone for a variety of reasons. A harm reduction approach demands that we respect those reasons, while still seeking ways to help people stay safer however and whenever they choose to use drugs. With support from Vital Strategies, Project SAFE, a Philadelphia-based mutual aid harm reduction collective for women, queer, and trans people who use drugs and do sex work, published the guide Using Drugs Alone. This resource was created directly by and for people who use drugs. “Using Drugs Alone” offers strategies and tips on how to check the daily drug supply, as well as how to make a safety plan before using substances. While the guide doesn’t guarantee safety when using drugs alone, it offers tools and strategies people can use to reduce the risk of overdose.   

To address the health disparities that pregnant and parenting people face, Vital Strategies supported the Camden Coalition to develop “Creating Safe Care: Supporting Pregnant and Parenting People Who Use Drugs.” This interactive toolkit serves as a guide for health care workers to support the implementation of best practices for working with pregnant and parenting people who use drugs. Pregnant people who use drugs need support, not punishment. The guide offers family-focused and evidence-based strategies and practices for health care workers seeking to improve care for their patients. The toolkit includes sample forms, templates, worksheets, and assessments for adaptation and use in different health care settings.  

The Survival Strategies for People Who Use Drugs guide was created in tandem with the Using Drugs Alone guide. This toolkit for harm reduction providers shares survival strategies for using drugs alone; it also offers suggestions for effective harm reduction and public health messaging on this issue. The content of the guide was informed by harm reduction skill-shares and story-shares with people who use drugs.

2. Opioid Settlement Funds: State-Level Guides for Community Advocates

States and localities have begun to receive payments from last year’s $26 billion settlement with Johnson & Johnson and the three largest U.S. drug distributors. Opioid settlement funds offer a significant opportunity for enhanced investment in evidence-based strategies, such as harm reduction intervention and improved access to buprenorphine and methadone medications for opioid use disorder. Vital Strategies and Christine Minhee, founder of OpioidSettlementTracker.com, collaborated to publish a groundbreaking set of guides on the decision-making and settlement funds allocation processes for all 50 states and the District of Columbia.

Intended for communities and grassroots groups, these guides demystify how each state will receive and allocate opioid settlement funds. The goal is to empower community advocates on the ground to understand and engage with the settlement planning and spending process, so that states’ use of funds is better informed by the inclusion of community voices.[Each state fact sheet provides detailed information on how decisions are made on the use of settlement funding at state and local levels; the role of advisory bodies; parameters states may have on approved uses for the funds; measures states have put in place to promote transparency and accountability. 

3. Creating Safe Care: Supporting Pregnant and Parenting People Who Use Drugs

This toolkit is for perinatal and other health care and supportive service providers working with pregnant and parenting people. 

People who use drugs frequently encounter stigma and discrimination when seeking health care. For pregnant and parenting people who use drugs, harmful experiences within the health care system are often amplified. Such experiences make people less likely to seek prenatal and postpartum care due to punitive drug laws and child welfare policies. Overdose is among the top five non-pregnancy causes of maternal mortality and studies show that risk of fatal overdose increases for mothers when their children are removed from their custody. 

4. Harm Reduction is Healthcare: Sustainable Funding for Harm Reduction Programs

In 2021, the Biden Administration allocated $30 million in federal funding for harm reduction services, including syringe services programs and materials, and drug testing supplies. Despite this welcome influx of resources, harm reduction services remain extremely underfunded—especially given the scale of need and compared with other strategies to end the overdose crisis.  

Together with Vital Strategies, the National Harm Reduction Coalition, Anka Consulting, and In the Works co-developed the e-course and workbook “Harm Reduction is Healthcare: Sustainable Funding for Harm Reduction Programs.” The toolkit offers guidance to harm reduction programs  navigating opportunities to secure healthcare financing, assess opportunities, build meaningful partnerships, and establish sustainable funding streams. The free, six-module e-course identifies an array of funding streams and provides actionable steps for harm reduction programs. In the workbook, harm reduction programs will find tools and resources for maximizing healthcare financing opportunities. For example, the workbook includes an organizational readiness assessment that programs can complete, a template to help programs create a value proposition, and more.  

5. Expanding First Response

This toolkit is for community, government, and provider coalitions exploring and mounting crisis response.

When someone is experiencing a mental health crisis or an overdose,  police are often the default first responders. However, a police force  ill-equipped to deal with these problems can worsen the situation. An estimated one in five people shot and killed by police have a mental illness, and those who experience police violence are disproportionately Black. Growing efforts in communities across the United States are focused on divesting from police intervention in such emergencies and moving instead to a public health response.  

Vital Strategies partnered with The Council of State Governments Justice Center to support the creation of “Expanding First Response: A Toolkit for Community Responder Programs.” This toolkit is designed for organizations, coalitions, and local governments seeking to design, implement, and strengthen first responder programs that focus on a health-based response for drug overdose events. Expanding First Response provides a detailed guide on how to train staff, conduct effective call triaging and needs assessments, financially sustain programs, and advance legislation to support community responder initiatives.  

6. Prosecution, Drug Use & Public Health

This toolkit is useful for line and elected prosecutors, as well as other criminal justice stakeholders interested in a less punitive approach to people who use drugs.

Around one in five people are incarcerated for a drug offense and an estimated two-thirds of people in jail or prison have a substance use disorder. Prosecutors can play a key role in ending the mass incarceration of people who use drugs. Vital Strategies partnered with the Institute for Innovation in Prosecution at John Jay College to convene a working group of experts across relevant sectors to inform the development of “A New Approach: A Prosecutor’s Guide to Advancing a Public Health Response to Drug Use.”  

 This guide provides prosecutors with a set of evidence-based strategies and best practices grounded in harm reduction and racial justice, and  encourages prosecutors to take a less punitive approach to drug prosecution, offering actionable alternatives to traditional prosecution practices through post-conviction.  This resource also includes seven videos featuring people with lived experience, experts on public health and drug policy, and prosecutors; they share their perspectives and experiences advancing practices that reduce the harms of punitive drug policy. 

Bonus: Medication-Assisted Treatment for Opioid Use Disorder in Jails and Prisons

This toolkit is for corrections officials and administrators, and correctional healthcare providers.

People who have been incarcerated are up to 100 times more likely than the general public to die from overdose in the weeks following release from incarceration. Despite high rates of opioid dependence among justice-involved individuals, very few jails and prisons offer access to these medications, which can protect against the risk of death.

Expanding access to methadone and buprenorphine across settings, including jails and prisons, is a top priority for Vital Strategies’ overdose prevention work. We look forward to partnering with state and local governments to ensure these lifesaving medications get to the people who need them.

While there is no single solution to the overdose crisis, adopting evidence-based strategies that center the health of people who use drugs can prevent these tragic deaths. We hope that our audiences find these toolkits helpful in their efforts to end overdose, center the health of people who use drugs and prevent these tragic deaths.

Learn more about our Overdose Prevention Program and follow us on Twitter at @VitalStrat.