Compassionate Conversations in SUD Care: Drug Supply Trends, Overdose Response, and Stigma Reduction - May 15, 2026

A 4-Hour Training with Stephen Murray, MPH, NRP

8:30am-1:30pm

North Conway Community Center (Conference Room), 78 Norcross Cir, North Conway, NH 03860

Presentation: Part 1: Long-term recovery is often framed as permanent abstinence, moral transformation, and lifelong vulnerability to relapse. While this narrative has helped many, it can also create unintended harm. Research consistently shows that periods of abstinence-particularly after treatment, incarceration, or detoxification- significantly increase overdose risk due to loss of tolerance. Yet this reality is rarely integrated into recovery messaging.

The presentation reframes drug use as a logical human behavior shaped by context, supply, tolerance, and safety-not moral character. It challenges the “good drug vs. bad drug” binary and highlights how prohibition and unstable supply chains create many of the risks attributed to substances themselves. Participants will explore evidence showing that people with established substance use disorder may, in some contexts, demonstrate protective behaviors such as tolerance awareness, safer sourcing practices, harm reduction utilization, and peer spotting. We will introduce the concept of “recovery without conditions”—an approach centered on autonomy, safety planning, and unconditional connection rather than abstinence as the sole marker of success. Participants will leave with a reframed understanding of recovery identity, practical strategies for reducing stigma in clinical and peer environments, and tools to integrate unconditional overdose prevention into treatment and recovery settings.

Part 2: The contemporary illicit drug supply in the United States is no longer defined solely by fentanyl contamination. It is increasingly characterized by a complex and evolving mixture of veterinary sedatives, synthetic opioids, benzodiazepines, local anesthetics, antihistamines, and cardioactive compounds. These adulterants alter overdose presentation, complicate reversal, and produce severe chronic health consequences for people who use drugs. The training dispels misinformation surrounding “naloxone-resistant overdose,” clarifying that naloxone effectively reverses opioid activity-including nitazene derivatives-but does not affect non-opioid adulterants. Participants will explore how airway adjuncts, bag-valve-mask ventilation, and hypoxia correction remain central to survival. Additionally, the session examines how adulterants such as quinine and lidocaine can contribute to arrhythmias and QT prolongation, particularly in patients on methadone.

Beyond emergency response, the presentation discusses implications for treatment settings, documentation practices, language use, and patient engagement. Attendees will gain practical tools to educate patients, collaborate with law enforcement partners, integrate drug checking information, and implement harm reduction-informed overdose prevention strategies. This session equips professionals with the knowledge necessary to respond effectively and compassionately to overdose in an increasingly complex drug environment.

As a result of this training, participants will be able to:

1. Describe the impact of fentanyl, xylazine, and other adulterants on overdose risk, presentation, and response strategies;
2. Recognize overdose signs and apply appropriate response techniques, including naloxone administration, rescue breathing, and post-reversal care;
3. Distinguish between common misconceptions (e.g., fentanyl exposure myths, “addiction crisis” framing) and evidence-based perspectives on substance use; and
4. Engage people who use drugs using stigma-reducing language and harm reduction principles to improve trust, safety, and care outcomes.

4 Contact Hours Available

CRSW Performance Domains: 1-4
LADC/MLADC Categories of Competence:  4-5 & 13-18
Certified Prevention Specialist Domains: 2 & 6
NBCC: LICSW/L-MFT/LCMHC (Category A) & Psychologist (Category A) 

NH Alcohol & Drug Abuse Counselors Association has been approved by NBCC as an Approved Continuing Education Provider. ACEP No 6754. Programs that do not qualify for NBCC credit are clearly identified. NHADACA is solely responsible for all aspects of the program.

This course has been approved by New Hampshire Alcohol & Drug Abuse Counselors Association (NHADACA), as a NAADAC Approved Education Provider, for educational credits. NAADAC Provider #23792, NHADACA is responsible for all aspects of the programming.

This training is financed under a contract with the State of NH, Department of Health and Human Services, with funds provided in part by the State of NH and/or such funding sources as were available or required, e.g., the United States Department of Health and Human Services.