Door-to-door overdose harm reduction: an Illinois case study.

Area of Science:

• Public Health
• Substance Use Interventions
• Community Outreach

Background:

• Harm reduction for people who use drugs (PWUD) is a priority in US drug policy, encompassing diverse services and settings.
• The Block-by-Block (BXB) pilot intervention focuses on training and distributing naloxone and test strips in high-overdose risk areas.
• Traditional harm reduction services may not reach all PWUD due to stigma or lack of awareness.

Purpose of the Study:

• To evaluate the feasibility, acceptability, and process implementation of the innovative Block-by-Block (BXB) harm reduction intervention.
• To assess the effectiveness of a community-based approach to delivering overdose prevention supplies and training.
• To explore a flexible model for harm reduction services adaptable to changing community needs.

Main Methods:

• The BXB intervention operated in five pilot sites across four Illinois counties starting in 2022.
• Services were delivered in private settings (homes) or non-traditional locations (businesses, libraries) through local partnerships.
• Training on naloxone and fentanyl, xylazine, and benzodiazepine test strips was provided, with take-home supplies and resources.

Main Results:

• The intervention demonstrated feasibility, with over 55% of approached doors being answered.
• Acceptability was high, with 75% of individuals at answered doors receiving training and/or supplies.
• The BXB program showed flexibility, adapting to community conditions, drug supply changes, and evolving high-risk areas.

Conclusions:

• The Block-by-Block intervention is a feasible and acceptable model for delivering harm reduction services directly to PWUD.
• The program's flexibility allows for rapid adaptation to dynamic community and public health challenges.
• This intervention is readily implementable in communities with adequate support and data resources.