Overdose Prevention Through Intensive Outreach Naloxone and Safety (OPTIONS)

A statewide overdose prevention and harm reduction initiative in Maine focusing on naloxone distribution and coordination with first responders

Surviving an overdose and warm handoff to treatment are essential first steps in recovery from opioid use disorder (OUD). Begun in 2020, the Overdose Prevention Through Intensive Outreach Naloxone and Safety (OPTIONS) initiative uses mobile response teams in all Maine counties to reverse overdoses and connect those with OUD to treatment and harm reduction services.

Teams are staffed by licensed behavioral health clinicians ("liaisons") who are supported by first responders such as emergency medical services (EMS) workers and law enforcement personnel. Liaisons are prepared to provide counseling, referrals to treatment, and access to harm reduction services such as syringe exchanges and naloxone distribution programs. Priority target populations include groups at high risk for overdose, such as those experiencing homelessness, those recently released from incarceration, and those who have dropped out of treatment.

The OPTIONS website provides informational resources on safe drug use practices to prevent overdose; contact information for each county's treatment, harm reduction, and recovery services; Covid-19 related advisories; and guidance on how families and friends can assist those with OUD in recovery. A press release gives an overview of the program's rationale and objectives, and a recent program evaluation describes how OPTIONS was implemented and assess lessons learned from the first year of program's operation. 

Public health-public safety partnership contributing to an increase in overdose reversals through increased naloxone distribution and increased engagement through warm handoffs. 

Continuum of Care
Treatment
Recovery
Harm Reduction
Type of Evidence
Peer-reviewed
Response Approach
Crisis intervention
Overdose prevention
Post-overdose response
Syringe service program / Needle exchange
Peer-reviewed Article

Evidence of Program Effectiveness

"The OPTIONS liaison program has proven to be an efficacious intervention to address the burgeoning overdose crisis in Maine. Most impressive is the ability of OPTIONS liaisons to not only refer PWUD to community-based treatment programs but also ensure their clients attend their first appointment with providers by utilizing warm handoffs and follow-up contact. OPTIONS is also an integral part of Maine's robust naloxone distribution and emergency response programs that provide harm reduction to individuals at the highest risk for opioid overdose. These efforts have increased the proportion of nonfatal overdoses in the state over the past year, with a 93% rate of reported overdoses being reversed during the first 11 months of 2021. Implementing county-level public health and public safety partnerships can advance fatal overdose prevention efforts using methods to improve health through data sharing, coordination, collaboration, integration, and stigma reduction." (Carter et al., 2022).