Overdose Prevention and Harm Reduction

Overdose Prevention and Harm Reduction: Just like with any behavior that carries risk, the only way to completely prevent an overdose is by not consuming any opioids, but that is not always realistic. However, we can learn specific techniques to reduce the risk of overdose (see here). These techniques are overdose prevention strategies and fall under the broad heading of a harm reduction approach to drug use.

Information provided on this site is not intended to cover everything –there are many places to find helpful information about overdose prevention and harm reduction.

For information on opioid overdose prevention and education:

To learn more specific to harm reduction philosophies and approaches, we suggest visiting the following sites:

One specific harm reduction strategy is the distribution of naloxone (an overdose reversal medication) to aid in the prevention of fatal overdoses. For information on naloxone:

For information about overdose prevention among veterans through the national VA Overdose Education and Naloxone Distribution program, please see the following: OEND Fact Sheet and OEND: Preventing and Responding to an Opioid Overdose Presentation

For Overdose Education and Naloxone Distribution (OEND) literature, visit the following sites:

 

 

Opioid Use Disorder Treatment

Medication Assisted Treatment (MAT) in combination with behavioral therapies to treat opioid use disorders helps reduce rates of illicit use and overdose by reestablishing normal brain functioning, reducing drug cravings, and preventing relapse (Kampman et al., 2015). MAT also lowers the risk of contracting infectious diseases (Tsui et al., 2014; Metzger et al., 1993).  Research supports the perspective that opioid addiction is a chronic medical disorder that can be treated effectively with medications and supportive services such as psychosocial counseling, treatment for co-occurring disorders, motivational counseling, and vocational rehabilitation (SAMHSA, 2005).

For more information on Medication Assisted treatment, visit:
SAMHSA- Medication Assisted Treatment
PCSS-MATT- Medication Assisted Treatment
Missouri Department of Mental Health – Medication Assisted Treatment
Medication-Assisted Treatment Improves Outcomes for Patients with Opioid Use Disorder

The primary medications used to treat OUD are:

*Information provided on this site is not intended to cover everything –there are many places to find helpful information about opioid use disorder treatment. To learn more, we suggest visiting the following sites:

For information on available drug treatment:

Below are links to a small subset of research conducted on opioid use disorder treatment. For a more comprehensive reference list, please see: Overdose Prevention Alliance and CTN Dissemination Library

World Health Organization: Guidelines for the Psychosocially Assisted Pharmacological Treatment of Opioid Dependence

AHQR Technical Brief 28: Medication- Assisted Treatment Models of Care for Opioid Use Disorder in Primary Care Settings

Long term retention in Office Based Opioid Treatment with buprenorphine

Models of Integrated Patient Care through OTPs and DATA 2000 Practices

Integrated Service Delivery Models for Opioid Treatment Programs in an Era of Increasing Opioid Addiction, Health Reform, and Parity

Increasing Access to Medication Assisted Treatment for Opioid Addiction in Drug Courts and Correctional Facilities and Working Effectively with Family Courts and Child Protective Services

For training, webinars, toolkits and additional resources related to addressing opioid misuse, visit: Taking Action to Address Opioid Misuse , Reducing Substance Use Disorders, and Opioid Use, Misuse, and Overdose in Women

 

Research and Data

Providing overdose education and naloxone distribution (OEND) in various settings (i.e., emergency departments, primary care, prisons/jail, treatment facilities, community centers, etc.) has been strongly recommended by the CDC , World Health Organization , and the American Society of Addiction Medicine based on empirical evidence. This page is not intended to cover everything, but is designed to connect you with some of the research literature and data related to opioid overdose mortality and morbidity, prevention and intervention initiatives, policy impact, and more.

For a comprehensive list of research literature related to overdose prevention, visit:

For systematic reviews of Overdose Education and Naloxone Distribution Programs, Legal Research and literature on opioid overdose prevention, visit:

For publications and reports on naloxone and harm reduction, visit:

For publications and resources on drugs and drug policy, visit:

For additional information, visit the SAMHSA publications on opiates/opioids, heroin, prescription drugs, buprenorphine, methadone, and treatment, prevention and recovery

Legislation and Advocacy

Missouri Legislation:

  • Statute Section 190.255.1, HB 2040, enacted August 28th, 2014.
    Relevant topics covered by this bill:
    – Distribution to first responders
    – First Responder administration immunity
  • House Bill No. 1568. Enacted August 28, 2016.
    Relevant topics covered by this bill:
    – Pharmacy availability (without a prescription)
    – Pharmacist criminal and civil immunity
    – Criminal and civil immunity for any person administering naloxone “in good faith”
    – Immunity from disciplinary action from licensing boards
    – Right to store/dispense for free if acting under a standing order from a health care professional
  • St. Louis City – Board Bill 40
    – A 911 Good Samaritan Law passed in the city of St.Louis providing limited immunity to those who call 911 for someone experiencing an overdose.
    * A statewide Good Samaritan law has not yet passed.

  • Missouri does not currently have a statewide Prescription Drug Monitoring Program (PDMP), though a municipality-level PDMP was created by St. Louis County Department of Public Health.
    – Since March, 2016, six jurisdictions ( Louis City, St. Charles County, Ste. Genevieve County, Jackson County, Kansas City, City of Independence) have adopted legislation to join County’s PDMP. Numerous other jurisdictions across Missouri are currently pursuing or considering legislation as well.
    * For more information, visit: http://www.stlouisco.com/HealthandWellness/PDMP

For additional information on laws and policies, visit: Good Samaritan Overdose Prevention Laws, Naloxone Overdose Prevention Laws, and Syringe Possession Laws

For state-specific naloxone related legislation and Good Samaritan laws, visit the Prescription Drug Abuse Policy System (PSAPS) and the Network for Public Health Law

For more information on prescription drug monitoring programs, visit SAMHSA- Prescription Drug Monitoring Programs: An Assessment of the Evidence for Best Practices

For legal assistance and support on overdose prevention and harm reduction, access the Network for Public Health – Drug Overdose Prevention and Harm Reduction

For more information about how to get informed and get involved: