About

 

Why is mail-based harm reduction important?

  • Mail-based harm reduction offers a private and accessible approach to care delivery in the era of online medication access. Currently, individuals who use drugs are constrained from accessing harm reduction services and supplies largely by four factors - economics, technical literacy, distance, and stigma.

  • Mail-based harm reduction creates opportunities to better understand marginalized populations who use drugs (rural, BIPOC, etc.). Further, this data collection is necessary on a national scale in order to influence federal policies. 

  • Mail-based harm reduction has notable benefits as a public health measure with respect to providing compassionate care, reducing transmission of blood-borne diseases such as HIV/HCV/TB, reducing overdose rates, etc- all for people who inject drugs that are not currently served by pre-existing traditional models.

What

  • Health departments need a way to reach high-risk populations who use drugs through novel mechanisms because of systemic and institutional barriers that exist for these individuals. This leads to the reusing of syringes for weeks due to scarcity.  


How does NEXT function? 

  • Problem: Lack of access/knowledge related to harm reduction 

    • We consolidated harm reduction resources (supplies and education) for people who use drugs and their families at a national scale 

  • Problem: Lack of data for policymakers and public health practitioners

    • We generate data on isolated/marginalized and low or no access populations that can then be used to target interventions

  • Problem: Lack of capacity of health organizations to incorporate mail-based harm reduction (health dept would pay NEXT a small fee to set up the ordering/backend data pathways/distribution system/tech assistance)

    • We provide technical assistance via NEXT’s track record of success in establishing distribution pathways for mail-based harm reduction services as well as access to our backend technology platform

Now

  • <Insert Impact to Date>

  • Current costs and ROI 

  • Goals: 

    • Have a 50 state strategy for mail-based harm reduction. All states should have a mail-based harm reduction strategy embedded in practice or policy for those who can’t access supplies in other ways. Currently operating in 34 states (naloxone), and distro (5 states). 

    • Build narratives around access via research and policy to advance drug policy in the US. 

Ask

We are looking for states that fund harm reduction and SEPs to invest in an expansion of services via mail-based harm reduction. Accordingly, we seek grant/funding partners to build capacity at the local, state, and national level. If you wish to be a champion in these efforts please reach out to us. 

  • What does it mean to onboard NEXT for a state department

  • Below is notes on ideas for things we need to incorporate into the document to make it more well rounded 


Federal law prohibits any person from using the mail to transport drug paraphernalia, 21 U.S.C.863(a). There is an express statutory exemption covering "any person authorized by local State, or Federal law to manufacture, possess, or distribute such items" 21 U.S.C. 863(f)(1). Therefore mail-based syringe access can be carried out in accordance with approval from Departments of Health. 


Asks

Each state department of health develops a letter of support memorandum for mail-based harm reduction services. 

Each state department of health designates funding to support online and mail-based harm reduction service. Funding should be driven to an in-state pre-existing harm reduction program and to NEXT Distro for back-end administration of the online function, operational support, and technical assistance. 


What budget lines would I need to implement mail-based harm reduction

  • Recommended Personnel: 1 FTE- Shipping, supply inventory, supply packing (i.e., kits, supplies that need pre-packaging prior to shipping), 1 FTE- Participant communication and support including but not limited to, health insurance enrollment, testing and treatment services, supportive counseling, referrals, and other case coordination for mail-based participants

  • Supplies: Program supplies including but not limited to safer injection, hazardous waste disposal tools, and educational materials; mailing supplies including shipping boxes and bubble mailers

  • Postage: USPS the most economical option

  • Other: Additional essential costs include computer, thermal printer, office supplies

  • Technology: Administration related to enrollment and ordering, data cleaning, data reporting, encryption systems maintenance; onboarding, training, capacity building, and technical assistance as needed

Funding models

California: NEXT is funded to expand online and mail-based harm reduction in the state and sub-contracts with an in-state pre-existing harm reduction program. As part of this subcontract, two staff have been hired to carry out strategy and mailings. Staff are members of the California program and all mail-based operations are supervised by NEXT. 

Michigan: Funding is directed to both an in-state syringe access provider to fund staff, and to NEXT to fund back-end administration, supervision, and technical assistance. This particular contracting process funds postage and supplies through NEXT but could be administered various ways.