Sarah Febres-Cordero, PhD, RN, combines lived experience with research methods and community engagement. Using innovative strategies, she views her world and research through a harm-reduction lens. She leverages art for public health messaging to reduce stigma, improve overdose response, and improve community health outcomes.

Background: There are 16.7 million workers in the US leisure and hospitality industry. The rate of overdose death in the food industry is higher than the general workforce, 39.5 deaths per 100,000 workers, compared to 25 per 100,000 workers. While bar, music venue, and restaurant service industry workers are often uninsured and lack sick leave and are a population vulnerable and devastated by opioid overdoses, these workers are also uniquely positioned to reduce preventable opioid overdose deaths. Assuring optimal education of laypersons in food and service industries is a critical intervention in reducing deaths by opioid overdose.

Methods: Qualitative one-on-one interviews and ethnographic fieldwork with service industry workers in Little Five Points (L5P), Atlanta, who had encountered an overdose in their place of work were conducted from October 2019- April 2020.

Results: Servers in L5P (N=15) have insight into the needs of people who rescue from an overdose during work, including training in overdose identification and naloxone distribution. They also have insight into the needs of people who use drugs as servers in our sample had experience with illicit drug use, including heroin. Testing personal supplies of illicit drugs, knowledge of protective laws, stigma, and police involvement were primary concerns.

Conclusions: We used the findings from these interviews to collaborate with an artist to design a graphic (visual) novel that teaches people to identify and respond to an opioid overdose, confronts stigma, and discusses the complexities of drug use. The graphic novel was exhibited at Science Gallery Atlanta and will form part of multiple harm reduction strategies moving forward. Beyond these initiatives, a graphic novel that addresses the opioid epidemic and teaches the public about harm reduction has the potential to reach a wide audience and change the discussion surrounding drug use and addiction in the US.