Lessons Learned from a Grassroots Harm Reduction Effort to Prevent Drug Overdose Deaths.

Inequities with access to naloxone and fentanyl test strips (FTS) due to cost and stigma have reinforced the necessity of community-based distribution of lifesaving harm reduction supplies. In Wichita and Sedgwick County, the epicenter of the opioid epidemic in Kansas, Safe Streets Wichita, a grassroots prevention and harm reduction coalition, started Project Wichita Overdose Recovery Kit Expedited Delivery (WORKED), a free volunteer-led intramuscular naloxone and FTS program. To assess the lessons learned from those involved with Project WORKED, interviews with 12 key stakeholders were conducted. These interviews focused on reflection, constructive criticism, and feedback. Individuals interviewed for this study included volunteers, former/current employees, and naloxone and FTS kit recipients, with special considerations for those with lived experiences of substance-related harms. Based on a reflexive thematic analysis, findings highlight the importance of meaningfully engaging community members most affected by substance-related harms, emphasizing a strengths-based perspective of harm reduction, and being cognizant of the barriers that undermine harm reduction supply distribution efforts and harm reduction in general. These findings help serve as the foundation by which interviewees envision a more holistic and comprehensive approach to harm reduction. Findings will be used to inform the fidelity, efficiency, accessibility, and longevity of community-based naloxone and FTS distribution and the implementation of harm reduction strategies in general across the state of Kansas.