Boston Medical Center (BMC) Grayken Center for Addiction Training and Technical Assistance (TTA)

A Resource for Healthcare and Social Services Professionals


Harm Reduction

Overdose Prevention in the Presence of Xylazine
Boston Medical Center's Grayken Center for Addiction TTA and the University of Pittsburgh have created informational handouts for patients on overdose prevention in the presence of Xylazine. There are MA specific and National pocket-size versions in English with Spanish coming soon!

English Pocket Guide (MA)
English Pocket Guide (National)

Xylazine Wound Care Handout for Patients
Boston Medical Center's Grayken Center for Addiction TTA and the University of Pittsburgh have created xylazine wound informational handouts for patients. There are pocket-size versions in English and Spanish and a larger version for visual display.

English (pocket-size)
Large size (English)
Spanish (pocket-size)

Harm Reduction at SAMHSA
The Substance Abuse and Mental Health Services Administration (SAMHSA) is the agency within the U.S. Department of Health and Human Services that leads public health efforts to advance the behavioral health of the nation. This includes a comprehensive strategy, in which harm reduction is part of the continuum of care.
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How to Use Fentanyl Test Strips
This brochure illustrates step-by-step how to use fentanyl test strips. If you would like physical copies of this brochure as a resource for patients, please send an email with your mailing information, contact information, and number of brochures requested to
Download file

National Harm Reduction Coalition
The National Harm Reduction Coalition’s mission is to promote the health and dignity of individuals and communities affected by drug use. As a nationwide advocacy and capacity building organization, they build evidence-based strategies with and for people who use drugs.
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National Harm Reduction Technical Assistance Center (NHRTAC)
NHRTAC provides free help to anyone in the country providing (or planning to provide) harm reduction services to their community.
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The Real Deal on Fentanyl
The Real Deal on Fentanyl is a harm reduction website with information about fentanyl, its dangers, and how to reduce harm and the risk of a fatal overdose.
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Overdose Prevention and Response

Canary is an overdose prevention mobile phone application that monitors for a user’s inactivity after activation. In the event that a user stops moving and fails to respond to prompts by Canary, the app issues an alert to others. PLEASE NOTE: This app is available only on the App Store for iPhone.
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Getting Naloxone from a Pharmacy (MA)
Information for community members about how to get naloxone to help prevent overdose deaths.
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HHS Opioid Overdose Reversal with Naloxone for First Responders
Steps to respond to a suspected opioid overdose while reducing risk of COVID-19 exposure.
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How to Respond to an Opioid Overdose | HHS
Access opioid overdose response resources from the U.S. Department of Health and Human Services website.
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Lifesaving Naloxone | CDC
Visit the Centers for Disease Control and Prevention (CDC) website to learn about naloxone, how it works, how to use it, where to find it, and more.
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Naloxone | SAMHSA
Learn about naloxone, its side effects, the signs of an opioid overdose, and SAMHSA’s efforts to expand the use of naloxone.
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Never Use Alone
Never Use Alone (NUA) is a 24/7 overdose response hotline that provides free, confidential overdose response support whenever you use drugs. An operator will stay on the phone with the person using substances and will call for help if they become unresponsive. No judgment. Just love! Be safe, and never use alone.
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Novel Naloxone Distribution Strategies
This document outlines potential strategies to increase patient access to nasal naloxone by serving as a guide for administrators, healthcare providers, and non-medical providers attempting to create reimbursable streams for naloxone.
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SAMHSA Opioid Overdose Prevention Toolkit
This toolkit for communities and local governments from the Substance Abuse and Mental Health Services Administration (SAMHSA) includes material to develop policies and practices to help prevent opioid-related overdoses and deaths.
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Safer Injection Practices

Getting off Right: A Safety Manual for Injection Drug Users
The Harm Reduction Coalition's safety manual for injection drug use.
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Syringe Service Program Laws
This is a cross-sectional dataset that presents state-level statutes and regulations that impact syringe service programs (SSPs) in effect as of August 1, 2019. The map identifies the method of authorization for SSPs, requirements for the establishment of SSPs, the types of services provided directly and by referral, drug paraphernalia possession laws, and whether an SSP is operating in the jurisdiction.
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Syringe Service Programs Locations | NASEN
NASEN directory of syringe service programs (SSPs) in the United States. Be aware that this directory includes only those SSPs who have authorized NASEN to publish their information solely for NASEN directory purposes. It is not, nor is it intended to be, a comprehensive listing of all SSPs in the United States.
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Safer Sex/ChemSex & STI Screening

ChemSex 101: Everything you wanted to know (but didn’t know to ask)
This toolkit is designed to give harm reduction organizations and syringe services programs an overview of chemsex, including the communities impacted and the range of use; a description of the different substances being used, including their effects, what to expect when using, and how to stay safe; a summary of education to provide participants, the importance of peers, harm reduction strategies, and the role technology plays in chemsex. Includes appendices that have a menu of kits that harm reduction programs can put together for participants, a glossary of common terms used in chemsex, and a guide to chemsex party planning.
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ChemSex First Aid Guide
This booklet covers some general First Aid practices for some specific chemsex-related emergencies. It includes some information on how to make judgment calls, and when not to; when to call an ambulance, as well as some tips to help avoid some of the most common emergencies that can happen in chemsex environments. This document was written and prepared by David Stuart and Ignacio Labayen De Inza. Sept 2018.
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Male Sexwork Handbook: A Basic Guide to Working Safe, Sane, and Smart in the Sex Industry
This handbook, created by HOOK in partnership with the Harm Reduction Coalition, helps those that work with male sexworkers in social services and professionally by stating the concerns and negotiations that face male sexworkers. This information is intended to allow them to better communicate, comprehend, and be sensitive to male sexworker situations and decisions. For those who work in the industry, this handbook serves to communicate the kind of street-sense knowledge that helps you work with both eyes open in hopes that your sessions and experiences enable you to meet your immediate and long-term goals, whether that be a life in the sex industry or recovery from some strokes of bad luck.
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Safer Sex Guide
This guide, created by CATIE (Canadian AIDS Treatment Information Exchange), gives tips on how to prevent sexually transmitted infections (STIs) and explains how to make sex safer.
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Safer Smoking Practices

Safer Crack Smoking
This resource, created by CATIE (Canadian AIDS Treatment Information Exchange), provides information about how to smoke crack and helps to identify when a person is overamping and needs to rest, and when a person needs emergency medical services.
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Safer Crystal Meth Smoking
This resource, created by CATIE (Canadian AIDS Treatment Information Exchange), provides information about how to about how to smoke crystal meth and helps to identify when a person is overamping and needs to rest, and when a person needs emergency medical services.
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Safer Sniffing Practices

Safer Snorting Kit
This one-page flyer, created by the Harm Reduction Action Center, lists and explains the items needed to sniff safely.
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Safer Snorting | QTHC
The Queer & Trans Health Collective (QTHC) is a grassroots health organization run by and for queer and trans community members.
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Grayken Center for Addiction TTA is a program of Boston Medical Center (BMC), a 514-bed academic medical center located in Boston's historic South End and the largest safety-net hospital in New England.

Funding for Grayken Center for Addiction TTA is provided by:

Massachusetts Department of Public Health Bureau of Substance Abuse Services (BSAS)
GE Foundation
Opioid Response Network

The content on this site and the content presented by Grayken Center for Addiction TTA is intended solely to inform and educate healthcare and social service professionals, and shall not be used for medical advice and is not a substitute for the advice or treatment of a qualified medical professional. The hospital, the program, and the contributors are not acting as health care providers or professional consultants on behalf of any specific patient and disclaim establishing a provider-patient relationship with any specific patient.

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