Request for Proposals - Due May 19, 2023

Overdose Prevention Center Consultant Services:

Feasibility Assessment, Stakeholder Engagement, & Planning

Harm reduction is a set of policies, programmes, services, and practical strategies aimed at minimizing negative health, social, and legal consequences for individuals and communities associated with stigmatized and/or illicit behaviors, particularly drug use. Harm reduction is an umbrella term that encompasses a broad range of activities, and as such there is no single universal definition or list of strict criteria that determine whether a program is harm reduction-based. However, a few core principles, as articulated by Harm Reduction International and by the National Harm Reduction Coalition are foundational to harm reduction-based approaches to care for people who use drugs:

  • Accept that drug use is part of human behavior and work to minimize harmful effects and promote safer practices, rather than condemn it or stigmatize it;
  • Respect and protect the human rights of people who use drugs;
  • Provide non-stigmatizing, non-judgmental, non-coercive services than “meet people where they are”;
  • Set as goals the maximization of people’s health, safety, and quality of life - rather than drug cessation - and encourage positive change in their lives, however they may define it;
  • Recognize that drug-related harm is deeply connected to poverty, class, racism, social isolation, past trauma, sex and gender discrimination, and other social inequalities, and thus a commitment to social justice and structural change is necessary to address drug-related harm;
  • Affirm people who use drugs as the agents of their own lives and ensure that they have a voice in the policies and programs that affect them;
  • Reduce the harms of prohibitionist and punitive drug laws and policy, which have failed to promote public health and have caused deep harm to individuals and communities.

GHJP understands harm reduction as foundational to the obtainment of health justice for people who use drugs and their communities. As such, we work to support and advocate for harm reduction-based initiatives in New Haven; for the past several years, this has included collaborative projects in support of the Sex Workers and Allies Network (SWAN), a harm reduction organization led by and for current and former street-based sex workers.
 

 

Rejecting Carceral Approaches to Addiction

On December 12, 2022 GHJP co-sponsored an event with Join the SEICHE Center for Health and Justice and Northeastern's Health in Justice Action Lab for a webinar panel that discussed the impact of urine drug screening for people on probation and parole and questioned the utility of the practice. Panelists and experts explored opportunities in both medicine and the law to align criminal legal practice with the science of addiction medicine. This panel featured Fiona Doherty, Yale Law School; Ayana Jordan, NYU Grossman School of Medicine; Morgan Godvin, Health in Justice Action Lab; and Vincent Shiraldi, Columbia Justice Lab.

In addition to this event, GHJP is currently participating in a working group of public health and legal practitioners to explore avenues to change local policy on the use of urine drug screening for probation determinations. 

Supporting the Expansion of Harm Reduction Services and Practices in the State 

Supporting Statewide Harm Reduction Action Group

GHJP has been a key member of the Statewide Harm Reduction Action Group, a group of harm reductionists  across the state by providing support in writing, advocacy, and research. This group was the key audience and organizing partner for the statewide harm reduction workshop hosted by GHJP students in Fall 2022. 

Harm Reduction Workshop

In Fall 2022, GHJP students organized the virtual workshop, “Overcoming Barriers Toward Overdose Prevention Sites in CT” for harm reduction services providers and allies across Connecticut. The workshop consisted of a speaker panel followed by four breakout sessions for participants to discuss the ongoing challenges and opportunities for establishing overdose prevention sites (OPS) in Connecticut. The objectives of the workshop were to familiarize participants with ongoing legal, political, and social barriers to OPS, and to build community between different players invested in different areas of harm reduction service provision in order to further the movement for OPS. The workshop was moderated by GHJP Co-Director, Gregg Gonsalves, and joined by panelists Leo Beletsky, JD, MPH, Northeastern University, Health in Justice Action Lab; Liz Evans, BScN, M.Ed, Liberation Programs, InSite, NYHRE; Mark Jenkins, Executive Director, Connecticut Harm Reduction Alliance; and Brandon Marshall, PhD, Brown University, People, Place & Health Collective.

Harm Reduction Engagement Center

In Spring 2022, GHJP partnered with the Fair Haven Harm Reduction Group, a diverse set of Fair Haven community stakeholders to identify strategies to address the needs of three groups in the Fair Haven community: people who use drugs (PWUD); street-based sex workers; and day laborers in the Fair Haven neighborhood. Through conversations, focus groups, and surveys, the Group identified a strategic response: establish an Engagement Center to serve these populations via a harm reduction model. The Center aims to provide these populations with a space for respite, connection to clinical care, opportunity for service connection, and serve as a “one-stop shop” for judgment-free harm reduction services in the neighborhood. 

On April 30, 2022,  a student team from the Yale Global Health Justice Partnership and the Fair Haven Harm Reduction Group organized a bilingual survey effort to measure Fair Haven residents, employees, and business owners’ perception of public safety, harm reduction, and the impact of public drug use in the community. This effort resulted in responses from over 140 participants. The results from the survey underscored the need for a space in Fair Haven that can successfully build connections with people experiencing homelessness, street-based sex workers, and people who use drugs in order to provide them with respite, tailored services, and support.

You can read more about the drop-in center efforts in this New Haven Independent article. 

Harm Reduction Shelter

The  lack of a harm reduction-friendly homeless shelter, i.e. a shelter where harm reduction supplies (such as syringes, pipes, etc.) and drug consumption are explicitly allowed or implicitly tolerated, represents a significant barrier to finding shelter for unhoused individuals who use drugs in New Haven. GHJP, along with a group of harm reduction advocates and homelessness service providers organized to establish a harm reduction-based winter shelter in New Haven. GHJP students in Fall 2021 and Spring 2022 researched harm reduction policies, shelter models, key legal issues, and public health best practices. Students from both semesters incorporated this research into memoranda that can serve as a resource for existing shelters or used towards the creation of new facilities. 
 

Addressing Misinformation and Stigma in the Media 

In June 2022, a coalition of harm reductionists, people with lived experience, public health researchers and advocates, and addiction medicine providers, identified negative or misleading media coverage on drug use as a significant barrier to the expansion of harm reduction efforts in Connecticut. Since then, a team of GHJP students partnered with members of the coalition to embark on a campaign that aims to dispel common myths surrounding drug use, overdose, and substance use disorder.

In the fall of 2022, GHJP students conducted a survey of PWUD and their loved ones, addiction medicine providers, harm reductionists, and service providers on what they believe to be some of the biggest issues with local media coverage of drug use and addiction. This survey garnered 69 responses from a wide demographic of participants, including providers and PWUD and informed the creation of specific research themes that students used to analyze the Hartford Courant’s coverage of drug use. In conjunction with coalition members, students developed a research methodology that can be applied to assess other publications. Student research assistants will apply this methodology to additional media outlets and develop a public-facing rubric that can be used by anyone who would like to investigate whether their local media is reporting accurately on drug use or further marginalizing people who use drugs (PWUD).

The goal of this project is to not only change inaccurate perceptions of addiction to pave the way for harm reduction innovation and addiction treatment in the state, but also to develop collaborative partnerships between grassroots harm reduction organizations, Yale students, and people with lived experience. By utilizing interdisciplinary partnerships while leveraging GHJP's institutional resources, this project aims to disseminate accurate information to influential actors within local and state government, media, the community at large, health care providers, and more, in order for PWUD to gain the necessary political power to self-determine their lives, access to treatment, and care. Finally, this campaign aims to recognize how the intersection of race, gender, and class influences the accessibility to harm reduction and addiction services for PWUD, while also recognizing how the same dynamics influence where services are located in Connecticut.

Strengthening connections and collaborations between harm reduction practitioners, advocates, and scholars

GHJP provides coordination support to the Connecticut Harm Reduction Working Group, an informal network of harm reduction practitioners, advocates, and scholars started by GHJP Co-Director Gregg Gonsalves and Director of Harm Reduction Research at the Yale Program in Addiction Medicine Ryan McNeil. The aim of the Working Group is to provide a space for harm reductionists to connect to share knowledge and resources, identify key needs and barriers for harm reduction across the state, form new collaborations, and coordinate joint advocacy. The following are initiatives of the Working Group that GHJP helped support.

Open letter to Governor Ned Lamont, Department of Mental Health and Addiction Services, and Department of Public Health on American Rescue Plan Act funding and harm reduction 

March 30, 2021

Read the press release here

Endorsing organizations as of April 14, 2021 include: Sex Workers and Allies Network, Alliance for Living, Ledge Light Health District, Greater Hartford Harm Reduction Coalition Inc, Community Health Care Van/ Yale University, Yale Program in Addiction Medicine, Yale Global Health Justice Partnership, Hustle Hope, Inside/Outside, Kids Affected By Addiction, CT Bail Fund, Quinnipiack Valley Health District.

The open letter urges the Governor’s Office and State agencies to use American Rescue Plan funding to invest in vital harm reduction programs in Connecticut. Despite the need to address the overlapping crises caused by the COVID-19 pandemic and the overdose crisis, harm reduction service providers have faced barriers in accessing necessary resources. Incoming funding from the American Rescue Plan Act provides Connecticut with a chance to address these gaps and invest in innovative, evidence-based, harm reduction-based approaches to drug treatment and overdose prevention. The letter provides several recommendations for the allocation of these funds to expand harm reduction services and divest from carceral and punitive systems that perpetuate harm against people who use drugs.

 

Responding to the health and rights implications of the COVID-19 pandemic for people who use drugs

The following letters, press releases and memos were released to the City of New Haven by the GHJP, SWAN, and other allied groups calling for immediate actions to protect the health and rights of marginalized persons, including people who are homeless, living in poverty, using substances and/or engaged in sex work, during the COVID-19 pandemic.

What You Should Know About the Legal Power of Quarantine and Isolation in Connecticut

Working paper

Authored by Ali Miller; Zain Lakhani; Kayla Thomas; Anna Wherry. 

GHJP Co-Director Ali Miller and GHJP Clinic students Lakhani, Thomas, and Wherry co-authored a memo describing the scope and limitation of the power to mandate quarantine and isolation under Connecticut law, with a particular focus on the implication for the treatment and rights of New Haven's most vulnerable residents.

Activists Press “Harm Reduction” Response To Covid-19

May 8, 2020 in the New Haven Independent

Read the press release here

Endorsing organizations include: Stop Solitary-Connecticut; the Connecticut Harm Reduction Working Group; Sex Workers and Allies Network; Greater Hartford Harm Reduction Coalition; Katal Center for Health, Equity, and Justice; Alliance for Living; Yale Program for Recovery and Community Health; Yale Global Health Justice Partnership; One Standard of Justice

A coalition of local, statewide, and Yale-affiliated advocacy groups held a press conference calling on Governor Ned Lamont and mayors across Connecticut to implement comprehensive COVID-19 plans addressing the crisis in CT jails and prison as well as the needs of people experiencing homelessness, people who use drugs, people with disabilities, and street-involved persons, including sex workers.

 

Letter to Chief Otoniel Reyes, New Haven Police Department

April 8, 2020

Endorsing organizations include: Sex Worker and Allies Network (SWAN); CT Community Health Care Van; Yale Global Health Justice Partnership; Faultline Ensemble; Yale Program for Recovery and Community Health

The letter outlines demands for changes to policing and arrest practices to cease new incarceration as well as the routine criminalization of poverty, homelessness and survival-based behaviors.

 

Letter to Mayor Justin Elicker

March 27, 2020

Endorsing organizations include: Sex Workers and Allies Network; Yale Global Health Justice Partnership; Sex Workers Outreach Project – USA; National Health Care for the Homeless Council; New Haven Women’s Resettlement Working Group; Yale Community Health Care Van/Syringe Services Program; New Haven Legal Assistance Association

The letter details concerns and proposals for the City of New Haven on the development of accountable and publicly transparent plans and policies with regards to COVID-19 response to ensure cross-sectoral coordination and public consultation; the creation of responsive shelter, health service and housing options for people without housing; the opening of low-barrier drop-in centers; and changes to policing and carceral protocols.

 

Letter to Dr. Mehul Dalal, Community Services Administration

March 23, 2020

By the Sex Workers and Allies Network and Yale Global Health Justice Partnership

The letter identifies key considerations for the establishment of accessible bathrooms, low-barrier drop-in centers, and harm reduction-oriented temporary housing sites.

 

Harm reduction guidance for substance users during COVID-19

March 17, 2020

Created in collaboration by the Yale Program in Addiction Medicine, Global Health Justice Partnership, the Sex Workers and Allies Network, and Crackdown. Adapted with thanks from a document produced by 3D Research.

Public health and harm reduction experts offer guidance to substance users on how to stay safe during the pandemic and minimize risk of COVID-19 infection.