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Maryland Center for Harm Reduction Services

ACCESS Harm Reduction 

ACCESS is a centralized platform for harm reduction resources made available by the Maryland Department of Health for local health departments and community-based organizations. Resources are provided through ACCESS with the goal of improving service engagement of people who use drugs and reducing drug-related harms in Maryland. ACCESS is ​Advancing Cross-Cutting Engagement and Service Strategies for People Who Use Drugs. 

Here you can learn about application opportunities, for both in-kind support and grants, that are available to local health departments and community-based organizations. You will also find application guidance, relevant deadlines, background materials, and links to the application forms for resources that are available at a given time.

​What is Harm Reduction?

“Harm reduction is a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use…it incorporates a spectrum of strategies from safer use, to managed use to abstinence to meet drug users ‘where they’re at,’ addressing conditions of use along with the use itself.”   - Harm Reduction Coalition, Principles of Harm Reduction

Resource available through ACCESS will support a broad range of activities that apply a harm reduction framework, with priority of the following:

  1. Provide services to people who are actively using drugs, without the expectation that they stop using drugs; and,

  2. Engage people who use drugs in a non-judgmental, non-stigmatizing manner.

Training and education resources on harm reduction topics in Maryland is available through the Maryland Harm Reduction Training Institute​.You can access a list of training and education opportunities under section D "Training and Technical Assistance".

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1. COVID-19 and naloxone access for Opioid Treatment Programs 

Free naloxone is available for patients impacted by COVID-19 policy change. An order form for OTPs is now live.

Maryland Opioid Treatment Programs can work to prevent COVID-19 among patients, staff, and communities by supporting social distancing with increased number of take-home medication doses. However, this must be balanced with mitigation of overdose risk associated with increased availability of methadone or worsened pulmonary function among patients from infection. 

Maryland Department of Health Center for Harm Reduction Services in partnership with the Behavioral Health Administration is making the overdose reversal drug naloxone (Narcan) available to OTPs to encourage overdose risk education and reduce risk of death. Patients can be educated on overdose and given a naloxone kit to take home for use in an overdose emergency.

Due to limited supply, OTPs are asked to make the first request for kits based on assessment of their number of high risk patients. The criteria for prioritizing patients to receive naloxone kits in this first phase of availability:​

Patients with persistently unstable Opioid Use Disorder
Patients over the age of 60 and those with high risk medical conditions, including COPD, asthma, any other pulmonary condition, blood disorders such as sickle cell, chronic kidney disease, chronic liver disease, pregnancy, stroke, CHF, CAD, diabetes, HIV, or other immunosuppressed state. (This group of individuals is at higher risk for severe COVID-19 infection and could experience compromised pulmonary function and higher risk of respiratory depression even with stable OUD and stable methadone doses.​)

Order naloxone kits for your OTP using this form. 

Find more information and FAQs for OTPs at the Behavioral Health Administration's webpage​. 


2. Overdose Response Program

The Center for Harm Reduction Services administers the Overdose Response Program, which provides the means for training bystanders to administer naloxone in the event of an opioid overdose. MDH authorizes local entities as Overdose Response Programs, allowing them to provide overdose education and dispense naloxone through partnerships with prescribers. 

Entities Seeking Authorization as Overdose Response Programs

Entities interested in providing overdose education and those interested in dispensing naloxone may apply for authorization as an Overdose Response Program with MDH. Entities may apply for authorization to provide training. In order to dispense naloxone as an authorized Overdose Response Program, entities must enter into an agreement with a licensed health care provider with prescribing authority. This prescriber may issue a standing order prescription for all individuals trained by the authorized entity, and may delegate dispensing to employees/volunteers of the entity. The prescriber will also work with entities to establish dispensing protocols. 

Entities authorized by MDH as Overdose Response Programs may be eligible to receive free naloxone from MDH to dispense to trainees. After becoming authorized, see below "Naloxone for Authorized Overdose Response Programs" or contact mdh.naloxone@maryland.gov for more information. 

Entities applying for ORP authorization can access the webform here​. ​The following documents are required to be uploaded to the webform for entities that plan to dispense naloxone to trainees. They are not required for entities planning to provide training only. 
  
Naloxone Use Report
 
The Maryland Department of Health continues to track naloxone administrations. The form will collect basic information about whether or not naloxone was used, how many doses were used, whether or not 911 was called, and whether or not it is known if the person went into an ambulance or started breathing again. You no longer have to email the report, you can now access the report through our web-based form, which can be accessed from anywhere. Please complete the form as fully as possible when you learn of naloxone use in the community. To access the web-based form, please click this link 

​Naloxone for Authorized Overdose Response Programs

We offer intramuscular injectable naloxone and Narcan nasal spray at no cost to the Overdose Response Program through ACCESS. To apply for this opportunity, you must be a local health department or non-profit organization with an active ORP status. If your organization qualifies for this opportunity you can order/request naloxone at any time through our centralized purchasing model. You may  place an order using the Naloxone Ordering Form, click here ​. For more information on how to place an order or further assistance, please email mdh.access@maryland.gov. ​

For entities interested in applying for naloxone that are not authorized as Overdose Response Programs, email mdh.naloxone@maryland.gov​ or see above information about applying for authorization as an Overdose Response Program. 
 

3. Syringe Services Programs

​Entities Seeking Approval to Operate a Syringe Services Program

The Center for Harm Reduction administers the Maryland Syringe Services Program, reviewing new applications, managing progarm reporting, issuing program guidance, and providing TA and support to approved programs. 

Programs seeking approval to operate SSPs must apply using the webform linked below. Please read the application guidance document thoroughly before submitting an application. For more information about the program, application and requirements, please email mdh.syringeservices@maryland.gov​

Syringe Services Program Application, click here

Syringe Services Program Application Guidance, click here​


Approved Syringe Services Programs 

There are currently 12 active Syringe Services Programs throughout the state of Maryland. All programs provide the following services; distribution and collection of hypodermic needles/syringes, substance related use disorder counseling, treatment and recovery services,  HIV/HCV testing and STD's reproductive health education and services, wound care, and overdose education and naloxone distribution. For location and hours of operations, click here. 

Standing Advisory Committee (SAC) Public Meetings

The Maryland Department of Health, Center for Harm Reduction Services hold quarterly meetings with the Standing Advisory Committee on Opioid-Associated Disease Prevention and Outreach. These meetings are open to the public.
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4. Harm Reduction Grants (APPLICATIONS OPEN)

The Maryland Department of Health Center for Harm Reduction Services is pleased to announce a new Request For Applications (RFA) for Social Organizations. Grants will be awarded for October 1, 2020 - June 30, 2022; grants will support projects that demonstrate a comprehensive approach to drug user health and support the Center's strategic goal to reduce substance-related morbidity and mortality by optimizing services for people who use drugs.​ See the below documents for more information. Please read all attachments thoroughly. 

A separate application process is available for Local Health Departments (Plan and Budget Request process). Local Health Departments may contact mdh.access@maryland.gov for more information. ​


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5. Training and Technical Assistance

Maryland Harm Reduction Training Institute

The Maryland Department of Health, Center for Harm Reduction Services partners with the Maryland Harm Reduction Training Institute (MaHRTI) to provide individuals with training, technical assistance, and educational resources related to harm reduction. For more information visit http://www.bhsbaltimore.org/mahrti or contact mahrti@bhsbaltimore.org. 

 
Regrounding Our Response

The Regroun​ding Our Response initiative launched in the Summer of 2019 with a series of intensive training events and regional summits that brought together community members, public health professionals, service providers, law enforcement and faith communities. Each event focused on a public health concept crucial to reducing stigma and evidence-based approaches to the opioid overdose crisis. The Center for Harm Reduction Services now supports a multi-disciplinary network of Master Presenters across the state who completed training in one of five core concepts: Stages of Change, Adverse Childhood Experiences, Social Determinants of Health, MAT Overdose Prevention, and a Drug User Health Framework. The training network is committed to raising awareness about public health approaches to the overdose crisis by presenting on these core concepts in Maryland throughout 2020. Please contact MDH.RORPresentations@maryland.gov​ to learn more and schedule a presentation in your community. 

​ACCESS Statewide Conference 
The ACCESS Statewide Conference, originally scheduled for August 2020, has been postponed until 2021. Please stay tuned for more information about this event. ​​
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6. Additional Resources

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