In late November, National Harm Reduction Coalition (NHRC) joined policy advocates from across the country in submitting joint comments in response to the U.S. Food and Drug Administration (FDA) proposed rule which would create a new category of medication – between prescription and non-prescription – called “nonprescription drug product with an additional condition for nonprescription … NHRC Advocates for Change to Naloxone’s Drug Status
Join Barrot Lambdin & Lynn Wenger, RTI International; Paul LaKosky, Dave Purchase Project; Emy Martinez, IDEA Exchange; Sara Bowen-Lasisi, Phoenix Center, & Braunz Courtney, HEPPAC for a conversation about how they have implemented high saturation models of naloxone distribution in their communities. This panel will discuss recently released data from MMWR, opportunities to improve the … Office Hours: Strategies for Scaling Up Naloxone Distribution

Understanding Naloxone Is someone overdosing? Click Here Naloxone (also known as Narcan®) is a medication called an “opioid antagonist” used to counter the effects of opioid overdose, for example morphine and heroin overdose. Specifically, naloxone is used in opioid overdoses to counteract life-threatening depression of the central nervous system and respiratory system, allowing an overdose
... Understanding Naloxone
Module 3: Take-Home Naloxone Program Development Today, there are more than 300 programs doing community-based naloxone distribution. Most of these programs are run out of syringe access or other harm reduction programs, but take-home naloxone programs are expanding to physician’s offices, drug treatment programs and hospital emergency rooms. Harm reduction programs were a
... Module 3: Take-Home Naloxone Program Development
Module 2: Overdose Prevention Strategies Without Naloxone There are important ways you can integrate overdose prevention into your current work at little to no cost. Although all of these suggestions may not be relevant to your unique program structure, they are a great starting point to begin brainstorming ways overdose prevention can fit into your
... Module 2: Overdose Prevention Strategies Without Naloxone

Introduction Fatal overdose is the leading cause of death for people in the U.S. under 50 years old. More than 800,000 people died from fatal overdoses in the U.S. from 1999-2018. The rate of overdose deaths today has increased more than five-fold since 1999. We are experiencing an overdose crisis and overdose deaths are preventable.
... Guide to Developing and Managing Overdose Prevention and Take Home Naloxone Projects

Speakers Alex Stack Director of Programs & Strategic Initiatives, CHC Aimee Moulin Co-Director, ED Bridge Steve Tremain Physician Improvement Advisor, Cynosure Health Josh Luftig PA-C, Regional Director, CA Bridge Curtis Geier Emergency Department, SFGH Webinar abstract/description The Surgeon General’s guidance on naloxone distribution advocates an “all hands on deck” approach to reduce the overdose
... Distributing Low Barrier Naloxone in Emergency Departments

Speakers Kimberly Sue MD, PhD, (now former) medical director at National Harm Reduction Coalition Webinar abstract/description: Learn from National Harm Reduction Coalition’s former Medical Director, Dr. Kimberly Sue, how to prevent opioid overdose in the community in this free, archived webinar for Icahn School of Medicine at Mount Sinai’s weekly webinar HepCure series.
... Naloxone: Preventing Opioid Overdose in the Community

Having naloxone on hand can help you reverse an otherwise fatal overdose from opioids. For overdose education and naloxone distribution (OEND) programs and others looking to assemble kits for distribution, check out these detailed instructions courtesy of The DOPE Project at National Harm Reduction Coalition (NHRC). There are different ways to assemble naloxone kits.
... How to Assemble Naloxone Kits
*This Training is for Wyoming and Intermountain West folks* Training Overview: Overdose is now the leading cause of death for people under 55 in the United States, with death rates steadily increasing year after year in most of the country. In this hour long session, we’ll explore the systems and circumstances that put people who … Wyoming- Overdose Prevention & Response
This 2 -hour webinar is a part of our Foundational Fridays Series taking place every last Friday of the month from 12pm– 2 pm EST from July 2025 – June 2026. This webinar provides foundational knowledge on overdose prevention, with a particular focus on opioid overdose. Through a harm reduction lens, we will explore practical strategies … Foundational Fridays – Overdose 101
Harm Reduction Issues Harm Reduction Vending Machines Vending machines can provide additional opportunities for SSPs and other harm reduction organizations to connect people who use drugs to life-saving harm reduction equipment, including naloxone, fentanyl test strips, and hygiene items. NHRC, in collaboration with our partners at RTI International and the North American Syringe Exchange Network
... Harm Reduction Vending Machines
New York Regional Initiatives New York City Check out our new FREE training modules for New York residents! Now also in Spanish! New York Training Institute We offer comprehensive and practical education and capacity building for community-based organizations, health departments, and coalitions, small teams and individuals in New York. JuneJuly 2026August MOTUWETHFRSASU 2930Horas de Oficina
... New York City Initiatives
As NYC overdoses spike, harm reduction needed more than ever “While they drag their feet, people are dying” As overdoses continue to soar in New York City, NYC Health is asking the community to carry naloxone (commonly known by brand name Narcan) to reverse overdoses. Overdoses are preventable, and access to naloxone — among … NHRC urges action amid NYC overdose soar
Life-saving statewide coalition shifts the narrative on International Overdose Awareness Day CASEP celebrates the ‘sheroes’/’theyroes’/heroes saving lives across CA SACRAMENTO, CA, August 30, 2023 — Over 60 harm reduction programs that make up the California Syringe Exchange Programs (CASEP) Coalition are taking collective action August 31 on International Overdose Awareness Day to focus on … CASEP PRESS RELEASE: LIFE-SAVING COALITION SHIFTS NARRATIVE ON IOAD
CALIFORNIA MAKES HISTORY WITH HARM REDUCTION INVESTMENT Funding supports CASEP’s life-saving work With the largest investment in harm reduction in California’s history, National Harm Reduction Coalition (NHRC) is profoundly ecstatic about the state budget’s inclusion of $61 million over four years for life-saving programs and services stemming from California’s Opioid Settlement Funds. NHRC, the … PRESS RELEASE: California makes history with harm reduction investment
Drug Policy Alliance and National Harm Reduction Coalition issue joint statement condemning San Francisco’s forced treatment scheme and arrests of people who use drugs San Francisco’s effort to arrest drug users will not save lives and is counterproductive to efforts to reduce harms of drug use and improve public safety SAN FRANCISCO, CA, June … JOINT STATEMENT: DPA and NHRC condemn SF’s forced treatment and arrests
‘If this funding is not extended…our people will die,’ NHRC director says Advocate network rallies for life-saving programs amidst budget talks SACRAMENTO, CA, MAY 15, 2023 — Lives are on the line as legislators decide the California state budget, and advocates are fighting to renew funding that has saved thousands of lives in … PRESS RELEASE: ‘If this funding is not extended…our people will die,’ NHRC director says
Written by: Laura Guzman Dear friends, I am honored to continue my service with the National Harm Reduction Coalition (NHRC) as acting executive director! I have transitioned to this role after serving for three years as NHRC’s senior capacity building and community mobilization director, leading our fabulous San Francisco and California team and work. … A Message from Our Acting Executive Director, Laura Guzman
The DOPE SRO Project launched in San Francisco, California during the height of the COVID pandemic. DOPE, an acronym for Drug Overdose Prevention & Education, was created in December 2001 for the purpose of providing overdose education to participants in shelters, jails, treatment programs, and syringe access programs. The DOPE Project is the oldest of … A Peer-Led Initiative Leads Overdose Prevention & Response Within Supportive Housing
THANK YOU TO ALL WHO MADE #HARMRED22 SO SPECIAL! Credit: Colectivo Moriviví National Harm Reduction Coalition creates spaces for dialogue and action that help heal the harms caused by racialized drug policies. We Work for the Harm Reduction Movement. National Harm Reduction Coalition builds evidence-basedstrategies with and for people who use drugs. We’re fueled by
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Content Warning: This is a zine about death, overdose, grief, and drugs. The Harm Reduction community observes International Overdose Awareness Day on August 31 each year. The DOPE Project worked with artist Gaia Wxyz to create a single-page zine as an act of care for a community that experiences too much preventable loss. You … Grieving Overdose Zine: Your Grief Matters and So Do You
I ❤️ people who use drugs. 🗣️ This 15″ x 15″ tote bag can fit all the naloxone you can carry. You can learn how to respond to an overdose from opioids here. For more than 25 years, National Harm Reduction Coalition has worked with communities to create, sustain, and expand evidence-based harm reduction programs … I ❤️ People Who Use Drugs Tote Bag
No one is disposable. 🗣️ *Slaps fanny pack* this here can fit so much naloxone in it. For more than 25 years, National Harm Reduction Coalition has worked with communities to create, sustain, and expand evidence-based harm reduction programs and policies. Learn more about our work.
No one is disposable. 🗣️ This 15″ x 15″ tote bag can fit all the naloxone you can carry. You can learn how to respond to an overdose from opioids here. For more than 25 years, National Harm Reduction Coalition has worked with communities to create, sustain, and expand evidence-based harm reduction programs and policies. … No One is Disposable Tote Bag
The harm reduction community faced deep loss and pain together in 2020. At the same time, the ways we continued to care and show up for each other have shown our strength and resilience. This has been a transformative year of growth and overcoming for NHRC. Thank you for your support and solidarity, which has … A Year of Resilience: The Work of 2020 with National Harm Reduction Coalition
Over the past year, I’ve had the opportunity to collaborate with the United we Rise Coalition on a mission to embody collective liberation — both for the well-being of people living with HIV and for the improvement of the physical and mental health of all our communities. As that work continues to expand and generate … Collective Liberation and Uniting to End HIV
Covid-19, Stigma, & it’s Impact on Marginalized Communities – Part 2 This 2 -hour virtual panel discussion is the SECOND of a TWO PART series examining the impact of stigma and COVID-19 on marginalized communities. The first part of the series featured leaders of the largest harm reduction policy organizations in New York and the … Covid-19, Stigma, & it’s Impact on Marginalized Communities – Part 2
On Thursday, December 10 at 3:00 p.m. ET, join Faith in Harm Reduction for Liberatory Love: A Human Rights Day Ritual Experience with People Who Use Drugs. Drawing on liturgies from our new resource Spirit of Harm Reduction: A Toolkit for Communities of Faith Facing Overdose, members of the Faith in Harm Reduction leadership collective … Liberatory Love: A Human Rights Day Ritual Experience with People Who Use Drugs
“Choose your leaders with wisdom and forethought. To be led by a coward is to be controlled by all that the coward fears. To be led by a fool is to be led by the opportunists who control the fool. To be led by a thief is to offer up your most precious treasures to … This election was never going to save us
This 2 -hour virtual panel discussion is the FIRST of a TWO PART series examining the impact of stigma and COVID-19 on marginalized communities. The first part of the series will feature leaders of the largest harm reduction policy organizations in New York and the nation as well as representatives from New York City Department … Stigma, COVID-19 and the Impact on Marginalized Communities — Part 1
This two-part course will provide health and human service providers with a comprehensive overview of harm reduction support for with individuals who have experienced reversal of an opioid overdose. These courses will review the factors that place a person at risk for overdose and strategies for reducing the risk of future overdose. They will focus on information … Harm Reduction Support Following an Opioid Overdose Reversal — Part 2
This two-part course will provide health and human service providers with a comprehensive overview of harm reduction support for individuals who have experienced a reversal of an opioid overdose. These courses will review the factors that place a person at risk for overdose and strategies for reducing the risk of future overdose. They will focus on … Harm Reduction Support Following an Opioid Overdose Reversal — Part 1

We’re National Harm Reduction Coalition and we’re building power and equity with people who use drugs. We’re committing to building a movement that centers racial justice and the leadership of people most impacted, so we’re being explicit about our national commitment. It's 2020 and we're doing a refresh for a future that is bold, unapologetic,
... Meet the New National Harm Reduction Coalition

Harm Reduction Issues Overdose Prevention 190 people die from an overdose every day. That equals 70,000 preventable deaths every year. Harm reduction offers evidence-based strategies that reduce the risk of dying from an overdose. We aim to support people who use drugs, and the people who love people who use drugs, with information to mitigate
... Overview

Overdose & Other Medical Emergencies This chapter covers: What is an overdose? How do overdoses happen? How can you tell if someone has overdosed? Naloxone What to do if someone overdoses What you should not do if someone overdoses Accidental needlestick injuries Whether or not an individual survives an overdose depends mostly on what those
... Overdose & Other Medical Emergencies

Overdose FAQs Is someone overdosing? Click Here This is a list of questions and responses that overdose education and naloxone distribution trainers have gathered. Naloxone is that stuff that you stick through the heart, like in that movie Pulp Fiction, right? No, while naloxone does have an injectable form, it is never injected
... Overdose FAQs

Responding to Opioid Overdose **IF SOMEONE IS EXPERIENCING A MEDICAL EMERGENCY, CALL 911 IMMEDIATELY** Is someone overdosing? The most important thing is to act right away! It is rare for someone to die immediately from an overdose – it is usually a slowish process that takes anywhere from a few minutes to a
... Responding to Opioid Overdose

Overdose Risks & Prevention Is someone overdosing? Click Here This section explains some of the primary risk factors associated with opioid/depressant overdose, and offers prevention tips. It covers: Mixing Drugs Tolerance Quality Using Alone Age & Physical Health Mode of Administration Previous Non-Fatal Overdose Mixing Drugs Drugs taken together can interact in ways that increase
... Overdose Risks & Prevention

Is someone overdosing? Click Here This guide covers all the information you need to know about how to respond in the event of an overdose. If you read this from end-to-end, you’ll have a thorough understanding of: - How an overdose affects the body - What naloxone is and how it works - Overdose risk
... Opioid Overdose Basics

Fentanyl Test Strip Pilot: San Francisco 2017-2018 In August 2017, in response to an increase in fentanyl in the drug supply in San Francisco, the DOPE Project partnered with the Syringe Access Collaborative (SAC) to pilot a fentanyl test strip monitoring survey. The SAC includes the San Francisco AIDS Foundation’s Syringe Access Services,
... Fentanyl Test Strip Pilot
Stimulants and other drugs containing fentanyl As San Francisco’s experience with fentanyl has evolved over the last three years, we have seen changes in how it is sold and made available to PWUD in the drug supply. When fentanyl first arrived in San Francisco in 2015, it was sold as a white powder that PWUD
... Stimulants and Other Drugs Containing Fentanyl
San Francisco’s Response to Fentanyl and Fentanyl-Involved Overdose The SFDPH-funded Drug Overdose Prevention and Education (DOPE) Project has been managing the multi- sectoral, coordinated response to the gradually increasing presence of fentanyl in San Francisco since 2015. The DOPE Project distributes materials through all collaborative partner programs and has developed targeted messaging around fentanyl. Collaborative
... San Francisco’s Response to Fentanyl and Fentanyl-Involved Overdose
Background: Overdose and fentanyl in San Francisco California has one of the lowest rates of overdose deaths in the nation, with the number of opioid-related overdose deaths hovering around 2,000 over the last few years. However, the California Department of Public Health (CDPH) reports 234 fentanyl-related deaths in 2016 and 373 in 2017, marking a
... Background: Overdose & Fentanyl in San Francisco
What you need to know The following was adapted from the White House Fentanyl Safety Recommendations for First Responders in 2016. Fentanyl can be present in a variety of different forms (e.g. powders, tablets, capsules, solutions, and rocks) and can be present in multiple different types of drugs (black tar heroin, methamphetamine, rock or
... What You Need to Know

This report was authored by Eliza Wheeler and produced by The DOPE Project with information about overdose and fentanyl for San Francisco first responders. The information in this report is relevant for other first responders, harm reduction programs and providers, and public health programs and professionals across the country. This report was authored in 2016
... Fentanyl Safety: A Guide for San Francisco’s First Responders
The presentations Frankfurt, Germany: Drug Consumption Rooms Werner Schneider, former Drug Policy Coordinator for the City of Frankfurt in Germany, spoke about the success of their “Four Pillars” framework, which he helped pioneer. This Four Pillars approach sought to address public drug use and associated harms and to establish safer drug use as a
... The Presentations
Benefits Credit: MSIC What are the key benefits of overdose prevention centers? Over 30 years of research has indicated that OPCs offer a variety of benefits. These benefits include but are not limited to: Overdose: Reduce fatal overdose by responding to overdoses onsite that may otherwise have occurred in another condition that may or may
... Benefits
Module 3: Running Your Program “You have to respect them. That’s basically what we do. We always speak to them, greet them and they don’t bother us. They know what we’re out there doing, we educate them and let them know what we’re doing and we have no problems.” - anonymous peer, speaking about law
... Module 3: Running Your Program
Module 2: Getting Peers Started “It’s helpful to be exposed to staff in the field so you get to see a lot of styles in action. This goes beyond classroom training. It’s also important to have a mentor in the beginning. This can be a staff person or another peer (as long as the peer
... Module 2: Getting Peers Started
Appendix E: Overdose Protocols The following are suggestions for inclusion in OD Protocols, followed by sample protocols developed by SAPs: 1) Call 911 Calling 911 is important to ensure the safety of both the person who is ODing and, in the long run, the program. The person responsible for calling 911 should do so
... Appendix E: Overdose Protocols
Appendix A: Additional Resources By Topic Links can be accessed at harmreduction.org GENERAL RESOURCES San Francisco Syringe Access and Disposal Program Policy and Guidelines (2011) San Francisco Department of Public Health (SFDPH) Recommended Best Practices for Syringe Exchange Programs in the United States Consensus Statement (2009) Recommendations from a New York City
... Appendix A: Additional Resources By Topic
Module 2: Operational Issues This modules covers: Staying Focused Policies and Procedures Supplies Disposal Overdose Prevention Data Collection, Monitoring, and Evaluation Whether the SAP operates on its own or is coupled with additional program services, it is essential to keep the syringe access component “low threshold” to ensure that participation is maximized. Low threshold means
... Module 2: Operational Issues
Acknowledgements Originally published: Fall 2012 Last edited: May 2020 Written by: Eliza Wheeler, Katie Burk, Hilary McQuie, and Sharon Stancliff Edited by: Emily Winkelstein Images and photographs courtesy of: Maya Doe-Simkins, Mary Wheeler, Joanna Berton Martinez, N.O.M.A.D. (Not One More Anonymous Death), Nabarun Dasgupta and Roxanne Saucier. Many thanks to following individuals
... Acknowledgements
Module 6: Frequently Asked Questions This section adapted from the work of Maya Doe-Simkins, Alex Walley and colleagues for their “Notes from the Field (temporary title)” Overdose Prevention Manual. This is a list of questions and responses that overdose education and naloxone distribution trainers have gathered. Naloxone is that stuff that you stick
... Module 6: Frequently Asked Questions
Module 5: Overdose Prevention and Response Risks and prevention strategies The following section highlights common overdose risks and provides prevention tips. We understood every prevention message might not be applicable or pragmatic in every situation; we hope these tips can provide direction and messages can be shared and adapted as needed. Risk factor:
... Module 5: Overdose Prevention and Response
Module 4: Program Implementation and Management Funding Existing programs have found creative ways of funding overdose prevention efforts for many years. In some cases, state, county or city public health departments have found ways to designate money towards overdose prevention activities. As mentioned in The DOPE Project case study, the City and County
... Module 4: Program Implementation and Management
Module 1: Understanding the Basics What is overdose? Overdose (OD) happens when a toxic amount of a drug, or combination of drugs overwhelms the body. People can overdose on lots of things, including alcohol, Tylenol®, opioids or a mixture of drugs. Mixing heroin, prescription opioids (like Oxycontin®, fentanyl, morphine, Vicodin®, Percocet®, etc.) and
... Module 1: Understanding the Basics

What is HepConnect? HepConnect was a five-year, multi-million-dollar initiative aimed at addressing the increase in hepatitis C (HCV) infections funded by Gilead Sciences. In partnership with local organizations, the HepConnect Initiative developed and implemented evidence-based solutions to meet the needs of people most affected by the opioid crisis. National Harm Reduction Coalition leads the
... HepConnect: From Project Launch to Grant Awards
The Landscape The United States is experiencing rising rates of hepatitis C virus (HCV) infections; in greater Appalachia, the increase in injection drug use has led to a more than three-fold rise in HCV infection rates. CDC: 2016 Hepatitis Surveillance Report Harm reduction services in this region vary widely by state and even county —
... The Landscape
Start a harm reduction program There are hundreds of harm reduction programs across the country, but many communities still have limited or no access to these services. If you love people who use drugs, consider learning more about how to start a syringe service program (SSP) or naloxone distribution program in your community. Step
... Start A Harm Reduction Program
New York City Initiatives New York City Check out our new FREE training modules for NYC folks! Now also in Spanish! New York Training Institute We offer comprehensive and practical education and capacity building for community-based organizations, health departments, and coalitions, small teams and individuals in New York. JuneJuly 2026August MOTUWETHFRSASU 2930Horas de Oficina de
... New York City Initiatives
The DOPE Project Expanding Overdose Prevention and Naloxone Access in San Francisco In partnership with the San Francisco Department of Public Health The Drug Overdose Prevention and Education (DOPE) Project is the largest single-city naloxone distribution program in the country. We’ve trained more than 13,000 people in San Francisco on how to administer naloxone to
... The DOPE Project
Harm Reduction Trainings National Harm Reduction Coalition facilitates trainings around the country. We open our virtual doors to individuals and teams seeking training on important evidence-based harm reduction strategies. Credit: Precision Join a training Our public training sessions are open to all who wish to attend. Whether you’re part of a community-based or
... Training Center
Together we can end the overdose crisis Credit: Luceo Decades of experience and evidence prove that getting naloxone into the hands of people who use drugs is the most effective way to prevent overdose. Tens of thousands of providers and programs across the country are working to support the resilience of people who use
... Overdose Prevention
News & Media Info Send all media requests to communications@harmreduction.org What Is National Harm Reduction Coalition? National Harm Reduction Coalition is a national advocacy and capacity-building organization that promotes the wellbeing and dignity of people and communities affected by drug use. Our efforts advance harm reduction policies, practices, and programs that address the adverse
... Media
California Regional Initiatives Harm Reduction Resources for People Who Use Drugs in California Oakland is our home. It’s where the first harm reduction working group came together over twenty five years ago, and where our West Coast office is still located today. We remain passionately dedicated to people who use drugs and their communities in
... California Regional Initiatives
Find Harm Reduction Resources Near You Harm reduction aims to connect people who use drugs to resources and community to thrive. Whether you use drugs, or love someone who does, this page is an access point to resources that support safer drug use. Need sterile syringes? Find a local syringe access program using the
... Harm Reduction Resources Near You
Harm Reduction Issues Overdose Prevention Is someone overdosing right now? Overdose deaths are preventable. We have the tools we need to stop people from dying from drugs. Nearly 110,000 people have died due to drug overdose in the last year. That's about one death every 5 minutes. Harm reduction offers evidence-based
... Overdose Prevention
Harm Reduction Issues Fentanyl Fentanyl is a synthetic opioid that can be about 50 times as potent as heroin. People use fentanyl because it is cheap to manufacture and a small amount goes a long way. Many individuals consume fentanyl without knowledge while others use it intentionally because of its potency. Overdose deaths involving
... Fentanyl
Harm ReductionWork in Action Credit: Nigel Brunsdon The best way to understand the effectiveness of harm reduction strategies and solutions is to look at the results of active harm reduction programs. National Harm Reduction Coalition puts strategies and ideas into action in the real world to create measurable and dramatic change. See how we’re transforming
... Work In Action

Fentanyl overview This fact sheet was produced by The DOPE Project. Fentanyl is a synthetic opioid that is 50 times more potent than heroin. Fentanyl is a more condensed, more potent opioid, which means that consuming the same amount of heroin and fentanyl may have different impacts on the body based on an
... Fentanyl Use and Overdose Prevention Tips
Harm Reduction Issues Fentanyl Fentanyl is a synthetic opioid that is 50 times more potent than heroin. Overdose deaths related to illicit fentanyl have quadrupled in recent years. This makes evidence-based harm reduction strategies more vital than ever. Search the Resource Library Explore our resource library for practical resources to promote the health and dignity
... Fentanyl
Harm Reduction Issues Overdose Prevention Is someone overdosing right now? Overdose deaths are preventable. We have the tools we need to stop people from dying from drugs. 190 people die from an overdose every day. That equals 70,000 avoidable deaths every year. Harm Reduction offers evidence-based strategies that reduce the risk of dying from an
... Overdose Prevention

We’re fueled by a commitment to bring these solutions to scale. Here’s what that looks like: Build the harm reduction movement Infuse harm reduction with racial justice End the overdose epidemic Expand syringe access to all 50 states Learn what Harm Reduction means Be a Catalyst for Love, Justice, Community and Connection. Together, we can
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