Implementation of Project DHARMA and Future Directions

Problem: Overdose deaths and rising rates of infectious disease in the state of Maine warrant a strong public health response, overdose prevention education, and interventions. Initiatives for community drug checking are an innovative approach to understanding the composition of the current drug supply. Drug-checking initiatives can inform people who use drugs (PWUD) what adulterants might be present in their drug supply. In partnership with 3 community organizations in Maine, Project DHARMA supports PWUD and community partners with infectious disease screening, community drug checking, and infection and overdose prevention. Approach: Project DHARMA supports the delivery of evidence-based infection and overdose prevention strategies across the state by funding outreach specialists embedded in community organizations. The outreach specialists work with PWUD to provide education, supplies, and linkage to care for infectious disease prevention and treatment, wound care, and substance use treatment. Outcomes: Over 3 years (2022-2025), outreach specialists distributed 61295 fentanyl test strips, tested 1644 people for HIV, trained 10193 people on how to use naloxone, and provided overdose education to 9417 people. We sent 82 samples for Fourier transform infrared spectroscopy testing for our community drug-supply initiatives. We partnered with universities for technical assistance to inform our drug-checking protocols and provide training to students in the health professions, and 312 students and providers in infection and overdose prevention. Next Steps: The Project DHARMA team will continue to track testing and screening rates for infectious diseases, collecting data to inform initiatives, and examining drug-checking trends throughout Maine. With funding from Maine’s opioid settlement funds, we will continue this work with community partners and outreach specialists. With additional funding, we are exploring the feasibility and acceptability of drug-checking programs. This work will inform how to best deliver drug-checking results to PWUD.