Reshaping a collective response to harm reduction The escalation of the pandemic has forcibly reshaped the AOD and homelessness sector's collective priorities, resources, and capacity for overdose prevention, resulting in a radical re-think of harm reduction and overdose response activities at Youth Projects. The COVID-19 pandemic and subsequent social measures introduced have had a profound effect on the way harm reduction services are delivered across metropolitan and greater Melbourne. Measures introduced to combat community transmission of the virus have restricted (and in some instances, prohibited) typical face-to-face engagement and drug safety education. In early May, Youth Projects formed the Harm Reduction Outreach Initiative as a rapid response, specialist outreach program to help meet the primary health and AOD needs that emerged through the Victorian Government's Rough Sleepers Initiative - an initiative that saw approximately 2,000 people experiencing homelessness moved into temporary accommodation in hotels across Melbourne. Through this initiative, Youth Projects partnered with Harm Reduction Victoria to deploy a multidisciplinary team into hotels across inner Melbourne to engage people being accommodated in hotels and hotel staff to participate in a diverse range of health promotion, social supports and critical harm reduction activities. The initiative led to: Establishing relationships with hotel management to enable the roll out of harm reduction support services. Co-ordinating harm reduction service delivery with hotels and identifying pathways for service user engagement. Providing information, education and support to hotel management and staff - specifically around sharp disposal management, drug education, overdose response education and training and the provision of sharp safe disposal units. Identifying and monitoring the health and social support needs of the people accommodated in hotels. Providing alcohol and other drug (AOD), mental health, and housing supports through brief interventions. Providing harm reduction supplies, education and naloxone training to people staying in hotels. The initiative has spanned across 11 hotels in the CBD, 69 individual site visits and engaged hundreds of individuals in brief interventions across multiple harm reduction domains, including drug education, naloxone education and training, and safer using information. Figure 1: Overview of brief interventions provided through the Harm Reduction Outreach Initiative The multidisciplinary team worked closely with local health, AOD, hospital, and housing specialist services to facilitate over 180 referrals and provide a holistic and long-term range of supports, including referrals into case management, COVID-19 testing, opioid replacement therapy and pathways into the Royal Melbourne Hospital’s Buvidal injection program (see Figure 2 for a full summary). Figure 2: Overview referrals and linkages provided through the Harm Reduction Outreach Initiative The nature of referrals as part of this initiative included a far more direct and impactful engagement with people accommodated in hotels. The team safely accompanied people to and from appointments, sat in on consultations if extra support was required and weekly check-ins with the Night Nurses Outreach team to ensure a holistic support. If a person required case management, the team would physically bring specialist staff to the hotels and facilitate introductions. Where other services were not able to get people to even leave their rooms, let alone engage with ongoing medical treatment over many weeks, the Harm Reduction Outreach Initiative team are able to act as a conduit between people accessing services and the provision of essential care. Youth Projects recognises that an effective, preventive approach to overdose requires action beyond the 'at-risk' individual. This initiative also seeks to encourage the community to understand and respond to drug overdoses in a way that is beneficial for everyone involved. The Harm Reduction Outreach Initiative will continue to operate throughout inner Melbourne and support people who have experienced, or are at risk of any type of drug overdose, with the goal of preventing future (re)occurences. For information on other harm reduction and drug safety programs, please visit our Drug Safety page.