Community First Responder Program: A scalable interdisciplinary model for overdose education and naloxone distribution

<h2>ABSTRACT</h2><h3>Background</h3> The opioid overdose crisis continues to challenge public health systems, particularly in rural and underserved communities. Although pharmacy-based naloxone access has improved, structural and social barriers persist. The University of Rhode Island (URI) Community First Responder Program (CFRP) offers a scalable interdisciplinary model to expand harm reduction efforts, overdose education, and naloxone distribution beyond traditional health care settings. <h3>Description and implementation</h3> CFRP, housed within the URI College of Pharmacy, is an opioid overdose education and naloxone distribution initiative that integrates pharmacists, pharmacy technicians, social workers, and students into public health outreach. Since 2019, CFRP has distributed more than 154,000 intranasal naloxone kits through community partners and directly to the public. Its hybrid service model includes in-person trainings, virtual education, mail-order naloxone, and mobile outreach. Community partners span 8 sectors, including harm reduction organizations, municipal agencies, treatment centers, educational institutions, and law enforcement agencies. <h3>Practice implications</h3> CFRP has trained more than 17,600 individuals in overdose response, held more than 480 outreach events, and distributed thousands of fentanyl and xylazine test strips in response to evolving drug supply risks. The program emphasizes accessibility through anonymous, no-cost distribution channels and culturally responsive education tailored to high-risk populations. More than 99% of training participants report that they would recommend the program to others. By offering free virtual programming and mail-order naloxone distribution, pharmacy-led organizations can expand accessibility of harm reduction education and materials to mitigate physical, social, and structural barriers. <h3>Conclusion</h3> CFRP exemplifies a community-based pharmacy model that complements traditional pharmacy access points. By prioritizing education, equity, and accessibility, this model addresses barriers such as stigma, transportation, and rural isolation. The CFRP framework is adaptable, evidence informed, and well positioned for replication in other regions aiming to expand harm reduction infrastructure and reduce opioid-related morbidity and mortality.