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Maryland Center for Harm Reduction Services

The Maryland Department of Health's Center for Harm Reduction Services was established in 2019 to centralize harm reduction activities across the Department. The Center is housed with the Infectious Disease Prevention and Health Services Bureau in the Prevention and Health Promotion Administration. The Center oversees the Overdose Response Program, Syringe Services Program, naloxone distribution, harm reduction grants, and various workforce development, training, and technical assistance activities. 

The Center for Harm Reduction Services envisions a Maryland where: 

  1. Health care and social service systems meet the needs of people who use drugs in a comprehensive, community-based manner;

  2. People who use drugs have equitable access to high-quality care; and

  3. Services provided to people who use drugs are free from stigma and discrimination.

The Center's strategic goal is to reduce substance-related morbidity and mortality by optimizing services for people who use drugs. 
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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 web form here​. ​The following documents are required to be uploaded to the web form​ 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 and Fentanyl Test Strips for Authorized Overdose Response Programs

We offer intramuscular injectable naloxone, Narcan nasal spray and fentanyl test strips at no cost to the Overdose Response Program through ACCESS. To apply for naloxone, you must be a local health department or non-profit organization with an active ORP status. To apply for fentanyl test strips only, you must be a non-profit or government entity. If your organization qualifies for this opportunity you can request naloxone and/or fentanyl test strips at any time through the ACCESS Resources Request Form​. 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 program reporting, issuing program guidance, and providing TA and support to approved programs. 

Programs seeking approval to operate SSPs must apply using the web form 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. ACCESS Harm Reduction Grants (RFA for nonprofits now closed)

ACCESS is the Center's centralized platform for harm reduction resources 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 stands for "​Advancing Cross-Cutting Engagement and Service Strategies for People Who Use Drugs."

The ACCESS Harm Reduction Request For Applications (RFA) for Social Organizations is now closed. Applications are now under evaluation. 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.

A separate application process is available for Local Health Departments (Plan and Budget Request process), which closes August 31, 2020. 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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