Libraries

“A library is like an island in the middle of a vast sea of ignorance, particularly if the library is very tall and the surrounding area has been flooded.” ― Lemony Snicket, Horseradish: Bitter Truths You Can’t Avoid

The opioid crisis and substance use disorders are among health risks to community members and library visitors. As social safety nets and local health resources become or remain difficult to access for people with SUD and in crisis, libraries face an increasing demand to be aware of resources for those suffering and to respond however they are able or can. 

Colorado libraries, by offering vital resources, education, and social connection, play a critical role in mitigating the impact of the opioid crisis, serving as essential community hubs for support and harm reduction.

Contents

Introduction

“In today’s society, libraries stand out as among the last truly public institutions,” Daphna Blatt, Dr. E.K. Maloney, Dr. James O. Pawelski, and Dr. Katherine N. Cotter write in the introduction for the New York Public Library’s Libraries & Well-Being case study. “Providing access to resources without financial, social, or physical barriers, public libraries make a unique contribution to promoting individual and collective flourishing throughout the communities they serve.” 

Research has established the role of libraries as community health hubs that support holistic wellness and health outcomes. The opioid crisis and substance use disorders are among health risks to community members and library visitors. As social safety nets and local health resources become or are difficult to access for people with SUD and in crisis, libraries face an increasing demand to be aware of resources for those suffering and to respond however they are able or can. 

Responses may include providing education opportunities like library programs about substance use and how to respond to emergency medical situations. It may also involve providing material resources for overdose reversal. Some libraries partner with local public health agencies or community health organizations to amplify those learning opportunities and resources. Other libraries provide staff with training on how to identify people in medical distress including overdoses. Regardless of the level of engagement or ability to incorporate harm reduction practices into daily library services or organizational guidance, all libraries support their communities in direct service and with care and compassion. 

Libraries are uniquely positioned to connect community members, residents, neighbors, and visitors to health information resources and to service providers through resource navigation and directory assistance. Libraries provide opportunities for learning, education, and enrichment through robust collections of print and digital materials, non-traditional items (e.g., Library of Things), park passes and field exploration kits, museum and cultural passes, hygiene and personal care kits, and other items. 

As Shamichael Hallman writes in Meet Me in the Library, “Public libraries in the United States function as civic and social infrastructure. They are a hybrid of the two, unique in their ability to facilitate social connections and ignite civic renewal.” To that end, libraries in Colorado blend learning opportunities with social engagement opportunities. They host programs and events that range in theme and interests to meet community needs and aspirations, including children storytimes, volunteer tax preparation, and filing, community conversation programs, community reads with author talks and book signings, harvest festivals, health resource fairs, Memory Cafes, tabletop role-playing games, technology classes, language learning and, conversation groups, and so much more. 

Connecting communities to resources for living full, healthy lives and bringing neighbors together into meaningful, positive relationships is core to the mission and service philosophy of Colorado public libraries. In this way, libraries function in a manner described by the former U.S. Surgeon General Dr. Vivik Murthy among “The Six Pillars to Advance Social Connection” in their role as social infrastructure in the 2023 U.S. Surgeon General’s Advisory, Our Epidemic of Loneliness and Social Isolation. Loneliness and lack of social connection or engagement with others (i.e., social isolation) have been identified as precursors to illness and ailment and high correlations to adverse public and individual health outcomes. The depths of this are discussed in Dr. Murthy’s 2020 book, Together: The Healing Power of Human Connection in a Sometimes Lonely World. Libraries, then, do not just benefit individuals and communities on a social emotional level, but also in their individual and community level health and wellness outcomes. 

Therefore, Colorado libraries, by offering vital resources, education, and social connection, play a critical role in mitigating the impact of the opioid crisis, serving as essential community hubs for support and harm reduction.

Letter from Jose

His letter goes here

Letter from Nicolle

Her letter goes here

Section 1: Overdose Prevention in Libraries

The very existence of libraries affords the best evidence that we may yet have hope for the future of man. —T.S. Eliot

Libraries are increasingly recognizing their role in overdose prevention, providing access to life-saving resources and education. Equipping staff and patrons with knowledge about naloxone is a critical first step in this effort.

Naloxone Resources Available for Libraries

As libraries across Colorado look to navigate the current opioid crisis and prevalence of fentanyl, the Colorado Consortium for Prescription Drug Abuse Prevention (Colorado Consortium), in collaboration with the Colorado State Library, created this library toolkit for accessing, distributing, and administering naloxone, and
educating library stakeholders on how to safeguard community members and staff from the possibility of an opioid overdose.

Libraries and library districts can receive free naloxone through the Colorado Naloxone Bulk Purchase Fund administered by the Colorado Department of Public Health and Environment (CDPHE). If your library administrators have not yet approved participation in accessing naloxone through the Colorado Naloxone Bulk Purchase Fund, please scroll down to the next section of this document to learn how to enroll. For resources shared by the Colorado State Library, visit the Adult Library Services webpage and find the “Overdose Prevention” section. 

*Remember: Naloxone is just one tool in overdose prevention, but it’s a crucial one that saves lives. Having naloxone available and knowing how to use it can make a difference in an emergency.

Core Library Resources

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Click here to see a list of resources

• Colorado Public Libraries Directory and Map
  • A current list of public library locations. For a map of these locations, find and click “Map” on the top right corner of the page. 
• Libraries Advancing Community Learning to Reduce Substance Abuse (LACL) Materials (Coming Soon)
  • In May 2025, the IMLS funded LACL national forum will convene with workshops and information sharing for librarians and library professionals who work with substance and alcohol use disorder in libraries across the US. When more information is available it will be shared in this toolkit. 
• Public Libraries for Community Building (County Health Rankings) – See headings “Implementation Examples,” “Implementation Resources”
  • From County Health Rankings, a bibliography and resource link on writings related to library implementation of harm reduction and overdose prevention strategies. 
• WebJunction: Supporting Health Communities – Public Library Opioid Responses
  • A trusted leader of library professional learning and resource sharing, WebJunction provides training and links to toolkits and resources for libraries dealing with the opioid crisis. Look for the link to “Opioid Crisis Support Kit for Public Libraries” for the companion toolkit.
• Connecting to Health at Libraries (Colorado)
  • Private telehealth hubs on-site at libraries and take-home kits for borrowers available at rural and small libraries through a partnership between Colorado State Library and the Office of eHealth and Innovation through the Colorado Lieutenant Governor’s Office. Library visitors and borrowers use these resources to access telehealth visits with their medical and mental health providers as well as other therapeutic services (e.g., speech therapy, counseling, etc.).  

If you need additional assistance, please contact the External Relations Strategist for your region on the Community Engagement page of the Colorado Consortium for Prescription Drug Abuse Prevention’s website.

Section 2: Naloxone Access

“The only thing that you absolutely have to know is the location of the library.” – Albert Einstein

Colorado Naloxone Bulk Purchase Fund 

Colorado Senate Bill 19-227 created the Naloxone Bulk Purchase Fund. It allows eligible entities, including libraries and library districts, to obtain opioid antagonists, such as nasal naloxone, at no cost. Due to limited funding, the Naloxone Bulk Purchase Fund (bulk fund) has recently instituted a prioritization process to ensure that naloxone is given to the people and agencies most at risk for encountering an opioid overdose. 

Naloxone Bulk Purchase Fund Prioritization Plan

Beginning May 31, 2024, the Colorado Department of Public Health and Environment (CDPHE) began implementing a prioritization plan to maximize resources so that individuals most at risk of experiencing or witnessing an overdose receive priority to receive naloxone. 

Libraries are listed among eligible entities for naloxone standing orders as Category 3 Medium Need organizations. “Medium Need” is defined as: “Eligible entities occasionally encounter people who use drugs and distribute naloxone via general public outreach.”

This plan seeks to ensure that people who are most likely to experience or witness an overdose have access to naloxone, reducing the number of fatal overdoses in Colorado. The plan requires eligible entities to access other available resources, encourages collaboration, and improves efficiency in the bulk fund program.

Key Considerations

• Eligible entities must demonstrate they are working directly with or interacting with people who use drugs (PWUD).
• Eligible entities must have a naloxone distribution plan and be able to share data regarding the number of naloxone kits distributed.
• Users of the Naloxone Bulk Purchase Fund must make all reasonable efforts to find any available alternative sources of naloxone or funding for naloxone if a third party (including a government agency) is authorized or legally obligated to pay for naloxone. Alternative resources include opioid settlement funds, other state agency grant programs, federal funding, public or private insurance, or private foundation funding.
• CDPHE may implement a cap on the amount of naloxone available to request. As of March 2024, CDPHE resumed limits on how much naloxone may be requested per order for Bulk Fund entities.
• Naloxone products that are the most cost-effective will be prioritized.

How Libraries Can Access the Naloxone Bulk Purchase Fund

To effectively address the opioid crisis within library settings, it’s essential to understand the guidelines and resources available for acquiring and distributing naloxone. The following information outlines the Colorado Department of Public Health and Environment’s (CDPHE) Naloxone Bulk Purchase Fund application process with specific considerations for libraries:

1. First, request a standing order from CDPHE for your library to begin accessing naloxone by emailing cdphe_naloxone@state.co.us. 
   Eligible entities must first have standing orders issued to them before placing an order to the bulk fund. The standing order will arrive to you in a PDF format and needs to be included when you submit your online application.
2. After you receive your standing order for naloxone, you may apply for an order of naloxone from the Naloxone Bulk Purchase Fund. To apply, complete an online application.  

It’s that simple!

Questions and Assistance

If you have questions or need additional support please visit CDPHE’s website outlining the Naloxone Bulk Purchase Fund. You may also find the answer to your questions in CDPHE’s FAQ document. 

If you need additional assistance,please contact the External Relations Strategist for your region on the Community Engagement page of the Colorado Consortium for Prescription Drug Abuse Prevention’s website.

Section 3: Legislation & Library Protections

“Libraries changed my life. They gave me the tools to learn, to grow, and to become the person I am today.” – Dolly Parton

Colorado has several laws that protect people who administer naloxone to reverse an overdose from legal liability. You should become familiar with these laws.

The 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 associated with an overdose event when 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, or if the person aids or seeks aid for the person experiencing the overdose;
• Remains at the scene of the event until a law enforcement officer or an emergency medical responder arrives, or if the person remains at the facilities of the medical provider until a law enforcement officer arrives;
• Identifies themselves and cooperates with the responding party.

The immunity described above also extends to the person who suffered an emergency drug or alcohol overdose event. There are limitations to immunity based on possession and/or distribution of specific amounts of substances (refer to C.R.S. 18-1-711 for details).

What does this mean for libraries? The Good Samaritan Law provides legal protection to library staff and patrons who take action to assist someone experiencing an overdose. This includes:

• Calling 911
• Administering naloxone (if available)
• Remaining on the scene and cooperating with emergency responders

Action Steps for Libraries to Consider:

• Ensuring library staff are familiar with the Good Samaritan Law and the protections it provides
• Providing links to and information about this and relevant laws in onboarding or staff-facing documents
• Posting clear protocols for overdose response in staff workspaces
• Documenting which staff are trained on both the law and naloxone administration 
• Consider posting information about the Good Samaritan Law (PDF) in public areas

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

The Third Party Naloxone law allows for a person other than a healthcare provider or healthcare facility who acts in good faith to administer naloxone to another person whom the person believes to be suffering an opiate-related drug overdose. The individual who administers naloxone shall be immune from criminal prosecution for such an act – amended July 13, 2020, to extend immunity to individuals administering expired naloxone. 

What does this mean for libraries? The Third Party Naloxone law, particularly with the 2020 amendment regarding expired naloxone, has significant implications for Colorado libraries:

• Legal Protection:
  • Third party naloxone provides legal protection to library staff or volunteers who administer naloxone in good faith to someone they believe is experiencing an opioid overdose. This protection is crucial as it removes the fear of legal repercussions for attempting to save a life.  
  • The amendment regarding expired naloxone further reduces anxiety about using available resources, even if they are past the expiration date printed on the box. This is very important for libraries that may have difficulty replenishing naloxone supply.

Action Steps for Libraries to Consider:

• Develop a policy and procedure for naloxone or opioid reversal medication and/or edit existing policy and procedure to include mention of naloxone for opioid reversal medication.
  • Example: Broomfield Library’s Policy  (News article, Nov. 2024)
• Schedule regular naloxone administration training for staff.
  • Refer to local public health, community health organizations, or trained medical professionals for facilitation of this training.
  • Consider including online materials like videos and documents on identifying signs of overdose and/or administration of opioid reversal agents among existing staff training materials.
• Maintain documentation on staff training.
• Develop a naloxone management plan and designate a staff member responsible for naloxone inventory.
  • Ensure this plan is communicated to staff.

Prescribing or dispensing opioid antagonists  (C.R.S. §12-30-110) 

This legislation allows certain individuals and entities to possess and administer opioid antagonists (like naloxone). More specifically, they can provide these antagonists to family, friends, or others who may assist someone at risk of an overdose. They can also administer the antagonists to individuals experiencing or believed to be experiencing an overdose. 

What does this mean for libraries? While libraries are not explicitly listed as “first responders” or “law enforcement,” the phrase “others as outlined in Prescribing or dispensing opioid antagonists (C.R.S. §12-30-110)” does include libraries as libraries are public spaces serving diverse populations. 

Action Steps for Libraries to Consider:

• Make naloxone available in your library
• Create a substance use disorder reading list and/or resource for patrons

Opiate Antagonist Bulk Purchase Fund (C.R.S. 25-1.5-115)

Opiate Antagonist Bulk Purchase And Standing Orders states that a unit of local government, harm reduction organization, law enforcement agency, first responder, or others may obtain naloxone through the fund pursuant to a standing order and protocol.

What does this mean for libraries? Depending upon availability of the naloxone supply within the Naloxone Bulk Purchase Fund, libraries could potentially obtain naloxone through these standing orders (see “Section 4: Accessing Naloxone” below). This legislation could be particularly relevant given that libraries are public spaces that serve diverse populations, and unfortunately, opioid overdoses can occur anywhere.

Action Steps for Libraries to Consider:

• Apply for access to the Naloxone Bulk Purchase Fund
• Locate a public health agency or community health organization as a potential partner for providing naloxone and/or maintaining resupply 
• Make naloxone available in your library
• Explore alternative means of distributing or hosting distribution sites for naloxone, such as:
  • Hosting a vending machine that supplies free naloxone and fentanyl test strips to the community (Rampart Library District, Woodland Park)
  • Stock free naloxone  and fentanyl test strips on a community supply shelf in the library lobby (Berthoud Community Library)
  • Give away free harm reduction brown bag kits (Clear Creek Library District) 
  • Repurpose kiosks for the library lobby or communal outdoor spaces (Lamar Public Library, Delta County Libraries, Montrose Regional Library, etc.) 
• Create a Substance Use Disorder reading list and/or resource for patrons
  • Substance Use Resources from Jefferson County Public Library 
  • Naloxone Fact Sheet (PDF) from Jefferson County Public Library

For more information and additional legislation, visit Colorado Department of Public Health and Environment. 

Section 4: Overdose Response

“Really, the first thing a library needs to do is understand who it’s serving and what their needs are. Not only the people who come to the door, but the other people in its service area.” – Jill Hurst-Wahl

Important Notes:

• Naloxone is temporary (30-90 minutes) and may wear off
  • Medical attention is necessary even if the person wakes up
• The person may experience withdrawal symptoms upon waking
• You cannot harm someone by giving naloxone, even if opioids are not present

*Remember: Administering naloxone is legal under Colorado’s Good Samaritan law.

Naloxone Administration Tutorials

To ensure effective response in overdose situations, it’s crucial to have readily accessible and easily understood training materials. A variety of online resources, including the following, provide clear instructions on naloxone administration and overdose recognition.

Other videos and training materials are available on the Colorado State Library Adult Services webpage (see: “Overdose Prevention”). Additional support can be located through Colorado Consortium and other local community organizations, including a free overdose prevention presentation and facilitators guide. 

If you need additional assistance, please contact the External Relations Strategist for your region on the Community Engagement page of the Colorado Consortium for Prescription Drug Abuse Prevention’s website.

Section 5: Resources

“When I was young, we couldn’t afford much. But, my library card was my key to the world.” —John Goodman

This section provides comprehensive resources for ongoing education about naloxone, opioid overdose prevention, and harm reduction. Whether you’re looking to train staff, educate community members, or connect with support organizations, these materials will help your library expand its knowledge and capability in addressing the opioid crisis. 

Additional Learning & Resources

Libraries, as trusted community hubs, can significantly impact overdose prevention by providing accessible training and informational resources. The following materials are tailored to empower both library staff and patrons with the knowledge and skills needed to respond effectively to opioid overdoses. Click to expand the list.

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• American Medical Association: How to Administer Naloxone (video)
• Community Opioid Overdose Reversal Medications Planning Toolkit (PDF) (SAMHSA, Jan 2025)
  • Comprehensive planning resource for implementing overdose reversal medication programs in community settings – like libraries!
• CPR Colorado First Aid/ AED/ CPR Training
  • In-person and virtual options for First Aid/ AED/ CPR and other emergency response classes and certifications. 
• Drug Overdose Informational Resources 
  • It provides essential, evidence-based materials that help library staff and patrons recognize overdose symptoms, understand effective response protocols, and access prevention strategies that can save lives in your community. 
• Get Naloxone Now: online resource to train people to respond effectively to an opioid overdose emergency
  • Interactive online training platform teaching overdose recognition and response protocols. 
• Map of Naloxone Providers (from StopTheClockColorado.org)
  • Geolocation tool to find nearby naloxone access points throughout Colorado.
• NaloxoFind Mobile App
  • Smartphone application for quickly locating naloxone providers and emergency resources on the go.
• National Harm Reduction Coalition: Responding to Opioid Overdose Guide
  • Provides information on how to respond to an opioid overdose and administer naloxone nasal spray. 
• Opioid Overdose Response Training (30-minute course)
  • This comprehensive 30-minute Opioid Overdose Response Training equips library staff with the essential knowledge and confidence to recognize overdose symptoms, administer naloxone correctly, and follow proper emergency protocols, ensuring your team is prepared to respond effectively during critical situations.
• Opioid Safety and How to Use Naloxone Brochure

How libraries can utilize these resources: 

• Create a webpage on the library website for overdose prevention or add to existing health information pages.
• Use videos for staff training.
• Feature these training and education resources in flyers, posters, and other materials for community members.
• Post to your social media and/or include in email newsletters for National Fentanyl Awareness Day (April 29), International Overdose Awareness Day (August 31) or Recovery Month (September). 

Educational Campaigns & Curricula

Libraries play a vital role in community education regarding substance use and overdose prevention. The following educational campaigns and curricula offer valuable resources for libraries seeking to inform and empower their patrons:
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• Drug Policy Alliance Safety First: Real Drug Education for Teens
• Natural High Curriculum
  • Positive youth development program encouraging health choices and substance-free lifestyles.
• Rise Above Colorado Not Prescribed
  • Colorado-specific educational initiative focused on prescription drug misuse prevention.
• SAFE Project No Shame Education Program
  • Stigma-reducing educational materials promoting compassionate approaches to substance use disorders.
• Take Meds Seriously (prescription drug safe use, safe storage, safe disposal)
  • Practical guidance for responsible medication management to prevent misuse.
• 988 – Colorado Mental Health Line

How libraries can utilize these resources: 

• Host age-appropriate community education programs for responding to an overdose for teens, parents, and older adults.
• Invite school nurses and local pediatric or family medicine providers to share age-appropriate health information.
• Invite elder and senior care medical, health, and nursing providers to share age-appropriate health information.
• Post to your social media and/or include in email newsletters for National Fentanyl Awareness Day (April 29), International Overdose Awareness Day (August 31) or Recovery Month (September). 

Harm Reduction & Support Organizations

Libraries serve as crucial access points for harm reduction resources and support services, connecting community members with vital organizations and initiatives. The following list provides key organizations and resources that libraries can utilize to support those affected by substance use.

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• Bring Naloxone Home Campaign
• Expired Naloxone Donation Program
  • Sustainable program for proper disposal and replacement of expired naloxone supplies. 
• Harm Reduction Coalition: Overdose Prevention and Naloxone Manual
  • Comprehensive guide to implementing harm reduction principles in community settings. 
• PrescribeToPrevent.org
  • Resources for healthcare providers on overdose prevention and naloxone prescribing practices.
• StopTheClockColorado.org
  • Colorado’s central resource for naloxone information, training, and access points. 
• Syringe Access Programs in Colorado 
• Syringe access programs are public health initiatives that provide people who use drugs with clean injection equipment, safe disposal options, and connections to health services in order to reduce the transmission of bloodborne diseases, prevent overdoses, and create pathways to treatment and recovery.

How libraries can utilize these resources: 

• Display informational materials from these and other harm reduction and public health organizations.
• Create online or print resource guides with these and other resources for learning about harm reduction. 
• Establish referral lists for frontline library staff and librarians to share or distribute to patrons seeking assistance.
• Post posters or flyers from these other harm education and public health organizations in restrooms and other highly trafficked areas. 
• Post to your social media and/or include in email newsletters for National Fentanyl Awareness Day (April 29), International Overdose Awareness Day (August 31) or Recovery Month (September). 

Need more assistance or not sure where to start?

Contact the Colorado Consortium for Prescription Drug Abuse Prevention’s External Relations team to discuss your library’s specific training needs.