Naloxone and syringe service programs (SSPs) are critical,evidence-based interventions proven to reduce overdose deaths and transmission of HIV and HCV among people who use drugs (PWUD). People experiencing homelessness (PEH) experience high rates of overdose mortality and other adverse consequences of substance use, yet have difficulty accessing SSPs due to systemic barriers. Even if services are available locally at fixed sites, individuals with limited mobility or who are at risk for loss of personal possessions may have difficulty reaching them.

Description:

In December 2019, a group of medical and graduate students initiated mobile delivery of naloxone in a San Diego County zip code with high overdose death rates, prioritizing PEH. Naloxone and harm reduction supplies were obtained through SSP registration with the California Department of Public Health (CDPH). The student organization is run by volunteers and funded through CDPH support, small foundation funding, and individual donations. Weekly outreach is conducted by teams of 6-10 trained volunteers who build trust and rapport, distribute naloxone, safer injection supplies, safer smoking supplies, electrolyte drinks, wound care supplies, emergency blankets, menstrual products, among other essential supplies, and refer to substance use disorder treatment and medical care when desired. Data is collected in accordance with CDPH guidelines at each encounter.

Lessons Learned:

In 2024, the student organization distributed 4,787 doses of naloxone, 34,740 sterile syringes, and 7,602 pipes over 3,309 individual participant encounters, with participants reporting 645 overdose responses, 584 (90.5%) of which were successful. High demand for supplies and frequent overdose reversal reports underscore the importance of outreach directly to communities most impacted by overdose.

Recommendations:

This demonstrates that student-run outreach rooted in harm reduction principles can be effective in reversing overdoses and saving lives suggests that other grassroots community organizations replicate this model elsewhere.