BeHERE Resource Library

New publication in the journal of Harm Reduction

Human service settings, especially those not specifically focused on supporting people who use drugs (PWUD), offer a unique opportunity to prevent overdose deaths. During the COVID-19 pandemic, building capacity for overdose prevention, harm reduction, and to address barriers to treatment, recovery, and support services required a virtual training format. Post-pandemic, virtual training remains a cost-effective and convenient alternative to in-person training.

Between April 2020 and June 2022, HRiA’s Behavioral Health and Racial Equity (BeHERE) Training Initiative of Health Resources in Action delivered 224 online trainings. Researchers evaluated the effectiveness of these trainings through the analysis of post-training and follow-up surveys and key informant interviews.

The findings showed BeHERE’s trainings were relevant, engaging, and satisfying to trainees; increased their knowledge, skills, and confidence; and influenced workplace performance. In addition, the evaluation also identified aspects of training that make a virtual format effective at improving the capacity of non-SUD settings to address substance use and support PWUD. Findings offer insights for those interested in delivery of virtual training, as well as training to influence the practice of human service providers across different settings to support PWUD.

Read the full article: https://link.springer.com/article/10.1186/s12954-024-00948-5 

Suggested citation: HW Kenefick. A Wing. “BeHERE’s effective virtual training to build capacity to support people who use drugs in non-substance use disorder settings.” Harm Reduction Journal, Vol. 21, article number 38. February 13, 2024.

This training is designed to build skills, best practices, and strategies to better support young people or adults in moments of escalation. It is vital for human service providers across fields to understand how trauma impacts the brain and often lies at the root of escalated incidents with clients or participants in programs. Utilizing a trauma-informed approach to de-escalation diminishes the chances of re-traumatizing people and builds up better coping mechanisms, encourages positive life-decisions, and allows for cohesive information sharing.  

In this engaging and practical training module, we will focus on concrete ways we can better support our participants through escalated feelings.  We will also discuss how to build a program that is trauma-informed in order to reduce the likelihood of escalations happening and to ease the process of de-escalation when they do.  

By the end of this training, participants will be able to:

1. Describe de-escalation techniques  

2. Review strategies for dealing with challenging situations  

3. Practice dealing with challenging situations  

4. Identify strategies for trauma-informed care 

Schedule a Workshop

Recent studies show a dramatic increase in drug overdose deaths among American teenagers as fentanyl contamination becomes more prevalent in drugs used by young people. Young people are very receptive to harm reduction, and do not respond well to “just say no” or abstinence only approaches to substance use prevention. Despite this, youth programming does not tend to embrace harm reduction or discuss harm reduction strategies with young people. In Boston, there are stories of a lack of access to treatment, harm reduction, and recovery. This 3-hour training aims to equip service providers, youth workers, and other serving youth and working in substance use and/or harm reduction with practical skills related to positive youth development, motivational interviewing, and thinking about how they can incorporate more harm reduction messaging and approaches into their work with young people.

Participants will be able to:   

1. Define and link the concepts of adultism, youth development, and harm reduction 

2. Understand the impact of the War on Drugs on youth and current drug policy  

3. Practice 1-2 strategies of motivational interviewing for talking to young people about substance use 

4. Gain skills to rewrite policies to be more inclusive of harm reduction when working with youth 

The fight for reproductive justice shares profound similarities with the movement for harm reduction. These decades-old, grassroots struggles advocate for the protection of individual bodily autonomy from violation, surveillance, and punishment. In this 4-hour training, which can be offered in two parts, participants will explore the linkages between reproductive justice and harm reduction, while building the knowledge and skills to support any and all people who find themselves at the intersection of substance use, pregnancy, parenting, and reproductive health.

Participants will be able to: 

1. Understand the profound connection between reproductive justice, harm reduction, and other struggles for justice and equity. 

2. Understand the particular drug-related stigma that impacts pregnant/parenting people. 

3. Learn strategies to navigate systemic dangers targeting pregnant/parenting people who use drugs. 

4. Learn how to support a client in understand risks and developing a plan for safer or managed use before, during, and after pregnancy. 

5. Gain motivational interviewing skills to communicate with pregnant and parenting people who use substances. 

6. Gain supports for frontlines staff supporting this population considering it can be particularly difficult/emotionally sensitive work. 

This Executive Summary discusses the evaluation of BeHERE trainings delivered between April 2020 and June 2022.

In 2022, HRiA engaged evaluation consultant Hope Worden Kenefick, MSW, PhD and MPH candidate Alexis Wing to conduct the evaluation. This document summarizes the methodology and findings from the evaluation and offers recommendations for further supporting organizations in their work with those who use substances through enhanced and expanded trainings and technical assistance.

Human service providers in a variety of settings often engage with people who use drugs (PWUD) who may be at risk for overdose. Meeting the specific needs of PWUD is vital to keeping our program participants safe from overdose and other adverse health effects. Broadly speaking, there is a lack of comprehensive training on how we can effectively support this population, while being nonjudgmental and non-stigmatizing in our approach. This three-hour training will offer participants an opportunity to explore the reasons why people may use drugs, how we can assess overdose and other risk using the “drug, set, setting” model, and how we can design our physical program spaces to support engagement among our participants and clients who use drugs.

Learning Objectives 

Participants will:   

1. Understand the intersection between harm reduction and recovery and name the similarities and differences between these two approaches  

2. Explore the societal context of drug use through the “drug, set, setting” model and develop an appreciation for the various reasons people use drugs  

3. Learn non-stigmatizing approaches to interacting with prospective program participants who use drugs and designing the physical program space   

4. Develop skills in the asking, listening, and informing strategy of motivational interviewing to hold conversations about drug use and harm reduction with clients/participants   

Schedule a Workshop

This program aims to fill gap between pharmacies and OEND programs through a streamlined system to order naloxone from the state.

March, 30, 2022. The Opioid Overdose Prevention Training Project (now part of HRiA’s BeHERE Initiative), held their 11th successful summit, Housing as Harm Reduction: Exploring Models to Support People Who Use Drugs. Behavioral health service providers from across Massachusetts gathered to hear from expert speakers on the complex intersections that exist for unhoused people who use drugs, including keynote Brendan Little, former founding Policy Director of the Mayor’s Office of Recovery Services. Mr. Little spoke about his own experience as a runaway youth who was homeless and used drugs.

Conventional narratives of the “opioid crisis” or “opioid epidemic” have often erased the profound impacts of alcohol use. While American drug overdose deaths topped 100,000 for the first time in the 2020s, CDC estimates for annual alcohol-related deaths nearly match that figure. Also noteworthy is the intimate connections between opioid use and alcohol use, with one of the leading risk factors for opioid overdose being the mixture of opioids with other depressants, including alcohol. We need a clearer picture of the real impacts of this legal and regulated drug, as well as a better understanding of the social factors that set alcohol use apart from that of other drugs. This three-hour training will explore the definition and impacts of alcohol use, recognizing the spectrum of use from abstinence to addiction. Specifically, we will examine the social determinants of alcohol use and seek to understand and challenge inequities (e.g. racial, gender-based, etc.) in treatment and recovery.

Learning Objectives 

Participants will:   

1. Understand the impact of alcohol use and alcohol use disorder (AUD) on individuals and society 

2. Define AUD and describe the spectrum of alcohol use 

3. Identify at least 3 harm reduction and treatment options for people who use alcohol 

4. Gain perspective on experiences of people with AUD, actively or in recovery 

5. Understand the profound connections between societal alcohol use and the opioid epidemic 

This site offers support for Illinois-based clinicians providing MAR, also known as Medications for Opioid Use Disorder (MOUD).

In the Toolkits, watch quick video guides for clinicians providing MAR and obtain streamlined MAR protocols with links to clinical tools, deeper learning resources, and patient materials.

Explore the Resource Library of guidelines, templates, patient materials, and learning modules.

Find ways to connect with mentors and other MAR clinicians.

The MA Problem Gambling Specialist Certificate is the official gambling treatment certificate of the Massachusetts Department of Public Health.

The MA PGS Certificate recognizes professional experience, training, and understanding of gambling disorder, as informed by the DSM-V, among substance use disorder clinicians. It was created to help these clinicians understand and recognize the importance of screening, assessing, and treating gambling disorders among their clients

Project Build Up (PBU) is designed to increase the availability of problem gambling treatment services in Massachusetts.

This program strengthens the capacity of outpatient substance use and gambling treatment agencies to provide or promote gambling treatment services. PBU focuses on communities of color, who experience disproportionate impact of problem gambling.

PBU is a Grant and Technical Assistance Initiative sponsored by the Massachusetts Department of Public Health’s (MDPH) Office of Problem Gambling Services (OPGS) and administered by Health Resources in Action (HRiA). 

The Massachusetts Technical Assistance Center for Problem Gambling Treatment (M-TAC) provides capacity building and technical assistance (TA) services for treatment and recovery programs and providers across the Commonwealth.

The TA Center offers assistance in supporting:

• Increased problem gambling treatment capacity
• Organizational capacity building to address problem gambling treatment
• Tracking methods, quality assurance standards, and program evaluation measures

Visit the site to find free training opportunities and to learn more about the MA Problem Gambling Services certificate.

Funded by the Massachusetts Department of Public Health, Office of Problem Gambling Services.

MassCOSH strives to ensure that all workers earn their living and return home alive and well. MassCOSH unites workers, unions and community groups with environmental and health activists, to end dangerous work conditions, to organize for safe, secure jobs, and to advocate for healthy communities. Through training, technical assistance and building community/labor alliances, MassCOSH mobilizes its members and develops leaders in the movement to end unsafe work conditions. 

This training for employers will describe how workplace conditions may lead to injury, pain, and opioid use, explore strategies to create a work environment that will help prevent opioid use and addiction, and identify workplace strategies that support treatment and recovery.

This training can be tailored for Employers, Employees, and Trainers.

The MA Problem Gambling Helpline is the official problem gambling helpline of the MA Department of Public Health. We offer referrals to problem gambling treatment services and support resources. MA Problem Gambling Helpline services are free and confidential. Trained Specialists are available to help 24 hours a day, 7 days a week.

VT Helplink is your statewide, public resource for finding substance use treatment and recovery services in Vermont.

Helplink services are free and confidential. Our caring, trained Specialists will help you or your loved one take a step toward recovery.

Funded by the Vermont Department of Health.

The Helpline is the only statewide, public resource for finding substance use treatment, recovery, and harm reduction services in Massachusetts. Helpline services are free and confidential. Our caring, trained Specialists are available 24 hours a day, 7 days a week to help you understand the treatment system and your options.

Funded by the Massachusetts Department of Public Health.

The IL Helpline is the only statewide, public resource for finding substance use treatment and recovery services in Illinois. The IL Helpline serves people using opioids and other substances, with or without insurance. The Helpline’s caring, trained Specialists are available to help 24 hours a day, 7 days a week.

Funded by the Illinois Department of Human Services.

This abstract describes a presentation from the APHA 2020 annual conference where we shared a framework of harm reduction and explore the ways that organizations can implement harm reduction practices within the confines of workplace policies that may conflict with harm reduction principles.

This blog post describes a growing movement that is revolutionizing how we approach substance use disorder (SUD) treatment and view recovery – changing our language, helping to remove stigma, and celebrating the hard work of maintaining sobriety. (HRiA.org 2018)

This article explores how people can continue in their recovery and stay healthy and how loved ones can help during this or any future public health crisis.

Everyone can play a role in preventing overdose. People who actively use opioids, friends and family, first responders, and even community members can help prevent and stop overdose. This page provides facts and guidance about opioids, overdose, and relevant laws that affect residents of Massachusetts.

This page provides facts about naloxone (Narcan) and guidance on how to obtain and use it to reverse overdose.

Overdose Prevention, Response, and Postvention: Promising Policies and Practices for Organizations aims to help organizations and agencies reduce fatal opioid overdoses in a variety of settings.

This includes, but is not limited to: community corrections centers, family and individual shelters, and substance use treatment facilities. While these recommendations are focused on addressing opioid overdose, implementing them may also be helpful in relation to other medical emergencies or traumatic events.

This document provides guidance for the development, implementation, and updating of policies and procedures within an organization. The needs and resources of every organization are different. Please take these recommendations as a menu of suggestions to implement and integrate into existing organizational policies.

Schedule a Training of Trainers

This three-hour, non-clinical training module is designed to educate and build skills around understanding secondary trauma and cumulative stress with a specific focus on improving the wellness and safety of service providers working in direct care with people who use drugs. Training topics include supporting resilience and preventing secondary trauma, compassion fatigue, and burnout.

Learning Objectives 

Participants will:  

1. Distinguish between primary and secondary trauma and identify similarities in their symptoms. 

2. Describe the causes, symptoms, and outcomes of cumulative stress and secondary trauma.  

3. Develop and implement tools for evaluating stress within their lives.  

4. Identify help resources, self-care tools, and collective care strategies for addressing cumulative stress and trauma.   

This three-hour, non-clinical training is intended to provide supervisors with the best practices and tools for nurturing and supporting staff who work in substance use, harm reduction, homeless services, and other social service fields, with a particular emphasis on supervisory support following workplace incidents

Learning Objectives 

Participants will:  

1. Identify the roles and responsibilities of a supervisor  

2. Articulate the four (4) leadership styles of supervision  

3. Define secondary trauma and self-care needs  

4. Understand best practices for supervision to nurture and support staff  

5. Practice an on-the-job emergency debrief  

As drug use evolves in Massachusetts and beyond, we need to be prepared to support clients no matter what substances they use. In this three-hour training, learn the basics of what stimulants are, what they do in the body, and how we can support people who use stimulants.

Learning Objectives

Participants will:

1. Define stimulant drugs and how they impact the body. 

2. Discuss the history of stimulant drugs and current trends. 

3. Gain 1-2 de-escalation best practices. 

4. Describe 2-3 best practices for working with people who use stimulants.  

When we recognize that recovery looks different for every person, we can better advise our clients. This three-hour training will introduce various forms of recovery, from medication to 12-step programs to cognitive based therapies. Participants will also explore stigma around recovery and how to best support our clients.

Learning Objectives  

Participants will:   

1. Define recovery 

2. Name 2-3 different pathways of recovery 

3. Explore the 10 different principles of recovery as defined by SAMHSA 

4. Discuss impacts of intersectionality (race, class, gender, etc.) on people’s ability/capacity to access recovery resources 

5. Challenge personal biases/stigma towards certain recovery pathways 

This three-hour professional development module is intended to educate service providers, community members, coalitions, and other entities on the American War on Drugs and how it has influenced racist drug policy in the 21^st century United States. Like Alcohol Prohibition in the early 1900s, drug prohibition has done little to curb drug use, while exacerbating drug-related public health crises through disinvestment in effective prevention, harm reduction, treatment, and recovery resources. This training will explore the origins of the War on Drugs and racialized drug policies throughout U.S. history and examine how the drug war has fueled mass incarceration, health disparities, social inequities, and the current waves of overdose deaths in the United States. Participants will be introduced to the Iceberg Model for Systems Thinking to connect how events we see in the world events are fueled by underlying social structures. Participants will also brainstorm tactics and strategies to address some of the ramifications of the War on Drugs in their own communities.

Learning Objectives  

Participants will:

1. Define the War on Drugs  

2. Name 2 ramifications of the War on Drugs that we see play out today 

3. Be able to identify the four levels of racism 

4. Name 2 pieces of historical legislation that have perpetuated the War on Drugs and mass incarceration  

5. Identify 3 strategies to address the impacts of the War on Drugs in our communities 

6. Challenge our own deeply held narratives as individuals and a country around drugs and drug use

Drug-related stigma presents barriers to effectively supporting clients who use drugs. Our biases are learned from a culture that stigmatizes drug use and ostracizes those with substance use disorders. This three-hour training will focus on identifying our biases, unpacking social stigma surrounding people who use drugs, and practicing actions we can take to address them.

Learning Objectives:

1. Unpack drug related stigma at the community, individual, and structural level 

2. Gain a framework (ladder of inference) and tools to examine personal biases and unpack them 

3. Learn about the manifestations of drug-related stigma in media, policies, politics, etc. 

4. Develop strategies to challenge workplace/community policies and culture that perpetuate stigma 

5. Build skills to interrupt/challenge drug-related stigma at the interpersonal level 

Contact us for trainings.

Contact us for trainings.

Recovery from opioid use disorder (OUD) is a life-long journey and can look different for everyone. Wherever you are in your recovery, this toolkit offers the support and resources people with OUD need as they navigate things like housing, employment, and treatment. It is for people in and seeking treatment and recovery, loved ones, providers, allies, and advocates to help navigate through these systems. Each section clearly outlines the rights you hold, how to exercise them, and where to get more support and resources. You can jump between sections by clicking the headers on the menu, and each section can be printed or emailed.