Jose Lozada has a bachelor's in science nursing, also holds a Diploma in Drug policy and Human Rights, employed with Intercambios PR since 2018 with over 10 years' experience in the field specializing in harm reduction, substance abuse, mental health, wound care and community services.

Harm reduction focuses on improving safety and quality of life through strategies that meet people where they are. Traditional harm reduction approaches include needle exchange programs, overdose prevention education, and supervised consumption sites. Methadone clinics contribute to a reduction in opioid dependence and the risk of overdose, HIV, and Hepatitis C transmission by providing opioid agonist treatment (OAT). Studies show that stigma, discrimination, and bureaucratic barriers negatively affect retention access to medications for opiate use disorder (MOUD). Poverty, homelessness, lack of identification documents, difficulty accessing transportation, and previous negative experiences are significant barriers to retention in MOUD treatment. People who inject drugs (PWID) in rural Puerto Rico are particularly vulnerable to a lack of consistent treatment. (Abadie et al., 2021).

Since November 2023, Intercambios Puerto Rico has partnered with the Integrated Medication Assisted Treatment Center, a local methadone clinic. As an integrated mobile health service, Intercambios Puerto Rico offers medical, psychological, social work, peer support, and case management services. Alongside the methadone maintenance therapy, we provide safer drug use education, naloxone distribution, syringe exchange, and other harm reduction services to improve outcomes.

Preliminary data show that integrating harm reduction strategies in methadone clinics prevents overdoses, promotes treatment adherence, and enhances care through collaboration between clinical and outreach teams. This, evidenced by the provision of over 210 service encounters including harm reduction, case management, peer support and medical services, to forty-seven unduplicated participants over a 10-month period. By addressing the broader health and social needs of individuals with substance use disorders, these partnerships reduce stigma, improve engagement, and build trust in healthcare systems. Our experiences in eastern Puerto Rico display the potential synergy between methadone clinics and harm reduction teams to provide continuity of care and positively impact health outcomes. (other people and I we are going to be presenters)