The Works Program

Overdose prevention has become increasingly essential in combating the impacts of opioids on a national, state, and local level. Staff and volunteers of the Works Program advocate for people who use drugs and are at risk of an opioid overdose by providing free access to opioid overdose education and resources, including Narcan and fentanyl test strips.

This public health crisis is a serious and ongoing concern for Works Program staff, participants, and the Boulder County community at large. To learn more about harm reduction and the opioid crisis, please see the resources below:

• Fentanyl (National Harm Reduction Coalition)
• Drug Overdose (Drug Policy Alliance)

Request Overdose Prevention Training for Your Organization

Intro to Harm Reduction and the Works Program with or without Story of Lived Experience

50-minute or 75-minute options available.

50-Minute Option Includes

• An introduction to harm reduction as a concept, especially as it relates to public health
• A thorough review of harm reduction for drug use, including topics such as stigma, drug criminalization in the U.S., and harm reduction theory and principles
• A Works Program overview of services and supplies
• A briefing of Colorado harm reduction laws and how they support the health of people using drugs, and the broader community

75-Minute Option Includes

• All the above, plus a story of lived experience from Becky Milanski, Peer Recovery Coach with Recovery Café Longmont (this story is a powerful way to humanize the reality of substance use disorder)

Effective Engagement with People Who Use Drugs

Prerequisite: Introduction to Harm Reduction & the Works Program with or without Story of Lived Experience

60 minutes

Includes

• A review of why people use drugs and risk factors for substance use disorder
• The neurobiological effects of substance use
• Interactive education on communication and engagement strategies for people who use drugs

Naloxone/Narcan Training with or without Harm Reduction Basics

30 minutes

Includes

• An overview of harm reduction as a public health concept, as well as harm reduction as it relates to substance use
• What are opioids
• What is naloxone
• Recognizing and responding to an overdose
• Risk factors and harm reduction for opioid overdose
• Works Program resources and naloxone access

Naloxone Training of Trainers

90 minutes

All participants who complete the full 90-minute training are provided with a certificate of completion and public health-developed training materials, with the intention of supporting them in becoming naloxone community educators.

Includes

• An introduction to harm reduction as a concept, especially as it relates to public health
• A brief review of harm reduction for drug use, including topics such as stigma and harm reduction theory and principles
• A Works Program overview of services and supplies
• A briefing of Colorado harm reduction laws and how they support the health of people using drugs and the broader community
• What are opioids
• What is naloxone
• Recognizing and responding to an overdose
• Risk factors and harm reduction for opioid overdose
• Naloxone access
• Interactive small group naloxone education practice, led by a Boulder County Public Health Works Program staff member

Overdose Prevention – Parent’s Education with Parent’s Story

60 minutes

Includes

• A Boulder County parent’s story of their child’s overdose, including live footage of the overdose event
• A review of the opioid overdose crisis by numbers, with a focus on Boulder County-specific data
• A look into teens and young adults and risk-taking behavior, with an overview of harm reduction principles and theory
• Strategies for parents of teens and young adults, including tips for communicating and educating about substances and drug use
• A naloxone training with all the information covered in the standard 30-minute BCPH Works Program naloxone training outlined above
• Youth and parent-specific resources, including naloxone access information

Trainings for youth and families

Request Overdose Prevention Training for Your Organization

Education and Case Management Services

Works Program staff provide harm reduction education about safer substance use practices, including:

• Wound care and vein health
• HIV and hepatitis C testing and harm reduction counseling
• Vaccinations for influenza, hepatitis A and B, and Tdap
• Referral to substance use disorder (SUD) support services
• Overdose Prevention and Response
• Naloxone (Narcan)
• Safety manual for people who inject drugs

Connection to Services

The Works Program supports clients by connecting them with various community resources. Case management is an option for Works participants who need additional assistance navigating referral services. For more information on case management, please email kweigman@bouldercounty.gov.

The Works Program connects clients to:

• Food assistance
• Housing assistance
• Clothing assistance
• Inpatient, outpatient, and medication-assisted substance use treatment
• Mental health treatment
• Sober living
• Shelter resources
• Medical support, including sexual health
• Medicaid or other health insurance options
• Works Program referral list

If clients have special needs, staff will work to find solutions.

Criminal Justice Diversion Services

The Works Program is committed to serving people who inject drugs who have been diverted out of the criminal justice system through law enforcement or court officials.

In addition to syringe access, safer injection supplies, education services, and case management, diversion clients receive screening to assess the risk of their use and access to a counselor.

To access criminal justice system diversion services, please email healthinfo@bouldercounty.gov or call 720-864-6515.

Learn What to Expect at an Exchange

The Works Program provides harm reduction supplies to keep people who use drugs safer. The intention is that a person will access enough supplies so that every use is with sterile/new equipment for themselves and their network of peers.

• Sharps containers
• ID card to protect from paraphernalia charges
• Safer sex supplies
• Syringes
• Cookers
• Waters
• Cottons
• Alcohol wipes
• Antibacterial ointment
• Bandages
• Ties
• Glass pipes
• Silicone containers
• Foil
• Pipe mouthpiece covers
• Razor blades
• Straws
• Push sticks/manicure sticks
• Xylitol gum
• Lip balm
• Narcan
• Fentanyl test strips
• Literature and advice about safer injection practices

Boulder

Boulder County AIDS Project (BCAP)
2118 14th Street
Monday – Friday from 2 – 5 p.m.
303-444-6121

Mental Health Partners
3180 Airport Road
7 days a week, 24 hours a day
303-443-8500

Longmont

515 Coffman St., Second Floor
Monday through Friday from 10:30 a.m. – 4:30 p.m.
720-864-6515.
Public access is through the west and east entrances. All Works participants must check in with the front desk in the main lobby prior to in-person services. Staff can still deliver supplies outside for participants if desired.

Lafayette

1755 S. Public Road, Room 116
Thursdays from 2 – 5 p.m.
303-389-1687

Testing Services

Free, confidential, and rapid HIV and hepatitis C testing is available in Boulder, Lafayette, and Longmont. Appointments are recommended, but testing may also be available at time of Works Program service, depending on staff availability.

Call to Make a Testing Appointment

• Boulder: 720-893-1297
• Longmont: 720-864-6515

Finding a needle or syringe in public can be alarming. Boulder County Public Health does outreach, walks our parks, and communicates with the public about their concerns.

Syringe Disposal

Outdoor syringe collection kiosks are available 24 hours daily at Mental Health Partners (at the front entrance) and Boulder County Public Health Longmont (along the northwest side of the building).

People who don’t feel comfortable picking up used needles should not do it.

But, for those who want to take action or are already doing so, here are some basic safety guidelines to follow:

• Treat all used needles as contaminated. Diseases can spread through needle pokes.
• Never pick up a needle with your bare hands. Wear gloves.
• Wear closed-toe shoes to protect your feet.
• Use a tool like tongs, pliers, or tweezers to pick up needles.
• Don’t discard needles in the trash. Instead, use a sharps container or hard plastic container, like a laundry detergent bottle.
• Put the sharps container on a stable surface next to the needle. Avoid walking a far distance carrying a used needle.
• Please do not hold the container in your hand while placing needles inside it.
• Pick up needles with the point facing away from you and place them in the container point down.
• Remove gloves carefully to avoid contact with the contaminated fluid.
• Wash hands well afterward.
• If you find discarded needles in your neighborhood but don’t feel comfortable picking them up, city services are available, but these services can become overwhelmed.

Since 1989, Works Program staff and volunteer peer educators have provided outreach, education, and syringe exchange/access services to reduce HIV and hepatitis C transmission among people who inject drugs and their partners.

The program uses harm-reduction practices founded in public health research to reduce the spread of disease and increase the safe disposal of syringes. Syringe access programs have been proven to reduce syringe litter, reduce overdose deaths, reduce the spread of disease and associated health care costs, and increase entry into substance use disorder treatment.

Addiction is a chronic neurological disorder that should be treated like other chronic illnesses. In fact, people who use substances (and syringe access programs) come from all walks of life at similar rates. Removing stigma and shame can help people living with substance use disorders seek help.

Best Practices, Research, and Data about Syringe Access Programs

The Works Program is a safe, legal, confidential, and nonjudgmental place to get free injection supplies, support, and links to other resources for staying safe and healthy.

View the following video to learn more about harm reduction

The Harm Reduction Program at Boulder County Public Health partners with Recovery Café Longmont and the Boulder County Sheriff’s office to provide:

• Community recovery support through the Recovery Café in Longmont
• Boulder County Sheriff’s office to provide assessment and treatment of opioid use disorder within the Boulder County Jail
• Boulder County AIDS Project to provide harm reduction supplies, education and resources
• Mental Health Partners to provide harm reduction supplies, education and resources

Having started in 1989, Boulder County Public Health’s Works Program is the third oldest syringe access programs in the country

BCPH’s syringe service and harm reduction program prevent overdose deaths, infectious disease (such as HIV and viral hepatitis/HCV) and increases safe syringe disposal. Many syringe service programs exist throughout the United States. These programs have been extensively studied and proven to save lives and support the health of communities.

The BCPH Works Program provides:

• Sterile equipment for people who use drugs (injecting or smoking equipment) to prevent HIV, HCV (Hepatitis C Virus) and other diseases. These services are delivered through our site at the HUB in Longmont, as well as through our partnerships with Boulder County AIDS Project and Mental Health Partners and through street outreach.
• Free naloxone and training on how to use it. The Works Program also provides naloxone to local community organizations for distribution,
• Training to professionals on overdose prevention and how to provide naloxone
• Fentanyl and xylazine testing kits to prevent overdoses
• Wound care and vein care education
• Community and jail HIV/HCV testing
• Syringe walks to pick up discarded syringes
• Street outreach
• Referrals
• Health screening and Medication Assisted Treatment (MAT) services in the jail through our partnership with Boulder County Sheriff’s Office
• Recovery services and linkages through our partnership with Recovery Café Longmont

Laws

Harm reduction programs are supported via various state and local laws. Participants in our programs carry a card to show their participation in our program. You may come across these – participants should keep these cards for future identification in the program and they should not be taken from participants during searches.

Sample Participant Card

The laws protect people in our program from anti-paraphernalia laws (not possession laws, only paraphernalia laws).

The laws also protect people who are with someone who is overdosing and who provide overdose support. People who are present during an overdose and stay at the scene are immune from prosecution from possessing small quantities of illicit substances

If someone says they are in the program but don’t have their card (people’s belongings are often stolen, particularly the unhoused), the Works Program can write a letter confirming their participation in the program based on their participant code. Please reach out if you need this letter. It could save a lot of resources – we usually provide this to defense lawyers, but it could be helpful to have it earlier.

State Statutes

Senate Bill 10-189 (approved May 26, 2010) authorized the creation of sterile syringe exchange programs. This bill and the Colorado Revised Statutes summarized below provide the foundation for and regulate syringe exchange services in Colorado. It is important to be familiar with these laws and to understand how the law pertains to syringe exchange. Below is a summary of the Colorado Revised Statutes (C.R.S.) that pertain to syringe exchange.

• Colorado public health harm reduction legislation

Syringe Exchange Programs C.R.S. 25-1-520

This law allows local jurisdictions to approve the operation of syringe exchange programs. The Works program obtained approval from the Boulder County Board of Health in 2012. Participants, volunteers and staff are exempt from the provisions of paraphernalia laws sections 18-18-425 to 18-18-430 when associated with an approved syringe exchange program created pursuant to this law .

Drug Paraphernalia Law Exemption C.R.S. 18-18-430.5

Syringe exchange program participants are exempt from drug paraphernalia laws 18-18-425 through 18-18-430.

911 Good Samaritan Law C.R.S. 18-1-711

The 911 Good Samaritan Law states that a person is immune from criminal prosecution for an offense if the person reports in good faith an emergency drug or alcohol overdose event to a law enforcement officer, to the 911 system or a medical provider.

This same immunity also applies to persons that remain at the scene of the event until a law enforcement officer or an emergency medical responder arrives, or the person who remains at the facilities of the medical provider until a law enforcement officer, emergency medical responder, or medical provider arrives. The immunity described above also extends to the person who suffered an emergency drug or alcohol overdose event.

Third-Party Naloxone C.R.S. 18-1-712

This law allows for a person other than a health care provider or a health care facility who acts in good faith to administer an opioid antagonist to another person whom the person believes to be suffering an opioid-related drug overdose. The individual who administers naloxone shall be immune from criminal prosecution for such an act.

Naloxone Standing Orders C.R.S. 12-36-117.7

Signed on 04/03/2015, this law concerns the ability to supply emergency drugs to treat individuals who may experience an opioid-related drug overdose event. The bill allows licensed prescribers and licensed dispensers to dispense an opioid antagonist, either pursuant to a direct prescription order or in accordance with standing orders and protocols.

Needle-stick Prevention C.R.S. 18-18-428.

Signed into law on 04/03/2015, creates an exception to arrest and filing charges for the crime of possession of drug paraphernalia if the person prior to being searched by a law enforcement officer informs the officer, that they have a needle, syringe or other sharp object on their person or in their vehicle or home that is subject to a search. The exception to arrest and filing charges also applies to the crime of possession of a controlled substance as it relates to any residual controlled substance that may be found in a used needle, syringe, or other sharp object.

Colorado Revised Statute §25-1-508

County or district boards of public health have the power to (a) provide environmental health services and assess fees to offset the cost of the services; and (b) approve a syringe exchange program by an agency. County and district boards of public health are not required to approve a proposed program.