Harm Reduction 101
January 4, 2023
As overdose deaths in the US continue to climb, additional evidence-based policies are needed. Harm reduction practices have been increasingly adopted to fill this need and mitigate the public health crisis. To help explain this movement, we spoke with Sabrina Gattine, a master’s student at the Bloomberg School of Public Health working with the Bloomberg Overdose Prevention Initiative. She most recently worked in harm reduction at the Philadelphia Department of Public Health.
What is harm reduction?
Conceptually, harm reduction consists of programs, policies, and practices that decrease the associated risks of activities. Everyday examples of harm reduction strategies include seat belts and bike helmets. In the case of drug use, the aim of harm reduction is to reduce the negative consequences from using drugs. Harm reduction practices recognize that not everyone is ready or able to stop using drugs and encourage any incremental change in behavior towards safer use. These practices give people the tools to make informed decisions about their health and care based on their own needs and preferences. Harm reduction organizations can also help link people to care or treatment when they are ready. The harm reduction movement works towards reducing the stigma of substance use and increasing access to a wider range of supports. Read more about what overdose survivors have to say about harm reduction here.
Why is harm reduction important?
The United States reported its highest number of fatal overdoses ever in 2021, surpassing 100,000 overdose deaths in the past year. To combat the overdose crisis, the Biden Administration enacted the American Rescue Plan Act of 2021, which includes $30 million of grant funding for harm reduction services. The implementation of these services is a necessary component of a comprehensive overdose strategy as harm reduction practices reduce drug-use fatalities and harm reduction programs can connect individuals to the care and treatment they need.
What are some benefits of harm reduction practices?
- Fewer fatal overdoses
- Greater access to social services and medical treatment
- Reduction in new Hepatitis C and HIV cases (and connection to care for existing cases)
- Safe disposal of used syringes
- Reduction in sexually transmitted infections
What does harm reduction look like?
Harm reduction practices include:
- Syringe services programs
- Programs that facilitate the use of sterile supplies and the safe disposal of used syringes. These programs reduce rates of Hepatitis C and HIV and facilitate access to treatment.
- Fentanyl test strips
- Fentanyl test strips allow people to test drugs for the presence of fentanyl, a synthetic opioid that is 50x more potent than heroin. Test strips help reduce overdoses. (Read more about fentanyl here.)
- Access to Narcan (naloxone)
- Naloxone is an FDA-approved medication that reverses the effects of a drug overdose. Access to this medication saves lives.
- Supervised consumption services
- Supervised consumption services, also known as overdose prevention sites, provide people who use drugs with a safer space to use with access to sterile equipment. Trained responders are available onsite in the event of an overdose. This reduces fatal overdoses from using alone or using without access to naloxone.
Harm reduction programs often also provide other supplies and services that individuals may need. These may include safer sex supplies like condoms, dental dams, and lubrication which are essential in reducing the rates of sexually transmitted infections and bloodborne diseases. Programs also regularly provide connection to housing, food, or other social services.
Doesn’t harm reduction encourage drug use?
No, although this is a misconception that some people have. Harm reduction programs understand that stopping drug use is a process and aim to give people the tools to be safer in their use. These programs build trust with the people they serve by consistently providing essential social services and medical care. These relationships can then help harm reduction programs facilitate access to treatment when wanted. There is no evidence that harm reduction programs lead to increased drug use.
Are punitive policies more effective?
No – in fact, punitive policies have actually been shown to deter people who use drugs from seeking treatment due to fear of punishment. Additionally, punitive approaches to substance use are often unsuccessful in the long term, increasing recidivism and the risk of overdose within the first year of release. Regardless of the legal consequences, substance use will continue to be prevalent. Harm reduction focuses on reducing negative consequences associated with substance use rather than taking a punitive approach.
Where can I learn more?
Here are some resources to continue learning about harm reduction: