Harm Reduction 101
What is harm reduction?
According to the National Institutes of Health, harm reduction helps people who use drugs avoid negative effects, like infection or overdose. But it’s also more than that. In addition, “many understand harm reduction as a way to meet people where they are with kindness and respect.”
Harm reduction puts people first.
The movement is centered in respect and compassion, rather than coercion and punishment. Total abstinence is not required to receive harm reduction services. There are several core principles, including meeting people where they are, encouraging any positive change, and including people with lived experience of addiction and drug use as leaders and decision-makers within harm reduction spaces.
Harm reduction allows people with substance use disorders to create their own goals.
For some, abstinence from drugs and alcohol may be their goal. For others, the goal may be to first reduce use, or to stop using one substance entirely without swearing off others. Goals don’t have to strictly apply to substance use and can include things like reconnecting with family or finding stable housing. All kinds of goals for positive change are welcome and embraced in harm reduction spaces. This helps empower patients and increases their chances of success.
Many harm reduction programs are currently operational in communities across the country. Here are a few examples.
Naloxone and fentanyl test strip access programs
Naloxone, also known by the brand name Narcan, is a safe, easy-to-use medication that can reverse an opioid overdose and save a life in minutes. Fentanyl test strips can help people understand if potent, life-threatening fentanyl is unexpectedly present in their supply of heroin, pressed pills, or cocaine. Together, these two tools can prevent a lot of fatal overdoses.
Community programs directly distribute both naloxone and test strips to the people who need them most: Those who use drugs and their loved ones. Some programs are mobile, driving around town to meet people in various locations, while others operate out of offices or community centers. Some programs use the mail, and can send overdose safety information as well as naloxone doses and fentanyl test strips directly to your door. New York City has even established public health vending machines to help citizens easily access supplies.
Research shoes that bystanders are more likely to be called upon to use naloxone than CPR. With that in mind, there's one simple thing you can do to save lives: carry naloxone. Will you take the pledge to carry naloxone?
Syringe services programs (SSPs)
These programs give people who inject drugs a place to safely discard used syringes and acquire new ones. SSPs are associated with a 50% reduction in HIV and acute Hepatitis C infections, per the CDC. They also have a high success rate in terms of treatment and recovery: “the majority of SSPs offer referrals to medication-assisted treatment, and new users of SSPs are five times more likely to enter drug treatment and three times more likely to stop using drugs than those who don’t use the programs.”
SSPs “also protect first responders and the public by providing safe needle disposal and reducing the presence of discarded needles in the community. Studies in Baltimore and New York City have also found no difference in crime rates between areas with and areas without SSPs.”
Safe Consumption Sites (SCFs) or Overdose Prevention Centers (OPCs)
These centers provide a legally sanctioned space into which individuals can bring their own drugs and use them under the supervision of medical staff, who are always prepared to administer overdose reversal drugs if necessary. These facilities also offer sterile injection or smoking supplies, proper disposal containers for waste related to drug use, and referrals to treatment as well as other supportive programming.
Studies show that OPC clients have an increased likelihood of initiating addiction treatment. This research also shows that OPCs are not associated with increases in crime, violence, or drug consumption in surrounding areas. In fact, residents and business operators near one such program in Sydney, Australia saw significant community improvement following the opening of the facility, with less drug use and syringe waste in public places over time.
Harm reduction does not “enable” drug use. Instead, it replaces coercion with compassion.
Research shows that involuntary addiction treatment is not effective and can increase the risk of overdose. Harm reduction is so valuable because it empowers people with substance use disorders to make their own decisions about their lives and health, which in turn increases rates of treatment initiation and long-term success in recovery. As we’ve seen with the examples above, harm reduction programs are consistently associated with lower rates of infection and overdose, as well as higher rates of successful referrals to treatment.
These programs are safe and constructive — not just for people with substance use disorders, but also for broader communities.
Research shows that harm reduction programs keep drug use and paraphernalia off the streets. They don’t increase crime, and, in many cases, are associated with reductions in crime. They save communities money in both the short and long term. And best of all, they save and improve the lives of our neighbors and loved ones who struggle with addiction.
If you would like more information or to access harm reduction services, talk to your local health department and check out these organizations:
National Harm Reduction Coalition