Designing Community-Based, Post-Overdose Outreach Programs in Rural Settings: Insights from People with Opioid Overdose Experiences

Background: The ongoing opioid epidemic in the United States, exacerbated by the presence of fentanyl, requires efforts toward the development of evidence-based practices to address this crisis. Community, Opportunity, Network, Navigation, Exploration, and Connection Team (CONNECT), a post-overdose outreach program in rural Massachusetts, provides rapid response to fatal and non-fatal opioid overdoses and connects witnesses and survivors to care and resources. While programs such as CONNECT have the potential to reduce overdose and increase healthcare services, expanding engagement from one of the most vulnerable populations is challenging. Methods: In 2023, we conducted semi-structured interviews with twenty individuals who had witnessed or experienced an opioid overdose in the previous year. This study aimed to explore the perspectives of overdose witnesses and survivors on CONNECT’s program design and strategies for most effectively engaging potential clients, focusing on the use of the mobile health van. Results: Using deductive and inductive qualitative methods, we identified five themes: (1) Overdose Response and Follow-Up; (2) Concerns Involving Law Enforcement; (3) Stigma and Isolation; (4) Mobile Van Use; (5) Trust and Community Engagement. Conclusion: This study can be used to guide the CONNECT program and inform future directions for research design and effectiveness surrounding post-overdose programs in rural regions.