Rural Communities Opioid Response Program-Overdose Response - The Naloxone Project (TNP) proposes the Coalition for Harm Reduction, Access to Naloxone, and Grassroots Rural Engagement (Colorado CHANGE) project to address the opioid overdose crisis in Colorado's rural communities. From 2020 to 2023, opioids were involved in over 62% of the 7,022 overdose deaths in the state, with rural areas experiencing overdose death rates higher than the state average. Despite naloxone’s life-saving potential, it is often underused due to stigma and access barriers, particularly in rural communities. The Colorado CHANGE project seeks to improve access to naloxone, overdose screenings, and treatment connections for individuals with substance use and opioid use disorders. TNP currently operates across 118 rural provider sites, including emergency departments, labor and delivery units, and outpatient clinics, where over 4,500 naloxone kits were distributed in 2024. Healthcare settings are vital points of intervention, as they serve as the primary point of contact for many at-risk individuals. However, the TNP sites vary widely in distributing naloxone effectively and connecting individuals in need to behavioral health resources, especially in rural areas with limited healthcare access and long travel distances to treatment facilities. To address these disparities, the Colorado CHANGE project will focus on enhancing naloxone distribution and overdose screening efforts at our rural community partner sites. The project will assess needs, gaps, and best practices in naloxone distribution and overdose screenings by focusing on 16 key rural sites: three high-performing and three lower-performing partner sites from emergency departments and outpatient clinics, as well as two high-performing and two lower-performing partner sites from labor and delivery programs. This targeted approach will guide a planning and quality improvement initiative to optimize workflows for overdose risk screenings, naloxone distribution, and connections to community-based recovery resources. A major outcome of this project will be the creation of a Best Practices Guide to Overdose Prevention and Naloxone Distribution for Rural Communities. Informed by insights from the needs assessment and quality improvement efforts, the guide will be a valuable resource for rural healthcare providers looking to enhance their overdose prevention practices. Additionally, the project will strengthen data collection and reporting systems, ensuring that overdose screenings, naloxone distributions, and referrals to behavioral health services are consistently documented and shared to inform future strategies. By increasing naloxone access in rural healthcare settings, where opioid overprescription has been a longstanding issue, and offering targeted training and support for healthcare providers, Colorado CHANGE aims to reduce opioid overdose deaths and enhance connections to life-saving treatments for individuals at risk. This initiative will also contribute to building a state-wide infrastructure for harm reduction and naloxone distribution, especially in rural areas where resources are limited and cross-agency collaboration is critical. The target population for the Colorado CHANGE project includes individuals at risk of opioid overdose, particularly those in rural areas with limited access to naloxone and behavioral health services. The goal is to ensure that more individuals receive naloxone kits, overdose screenings, and connections to recovery services. By reducing stigma, expanding access to care, and strengthening the healthcare system’s response to the opioid crisis, this project will save lives and foster sustainable harm reduction efforts across Colorado. It will equip rural healthcare providers with the tools and resources needed to effectively address opioid overdose risks while building a more accessible, supportive network of care for individuals in rural communities.
