This article was first published on August 29, 2022.
A harm reduction approach may make some people uncomfortable. But, we should realize that though we may be trying to get these persons to stop using illicit substances, if they are not ready to stop, they are likely to use these substances anyway. Learning safer practices does not encourage the use of illicit substances. Rather, it reduces complications like overdose deaths (which are occurring in staggering numbers), infections, and disease transmission.
Reduce the risk of overdose
– Education about factors that increase the risk of overdose, for example, fentanyl/ fentanyl analogs being mixed into the substance they are using, the loss of tolerance, and so on.
– Fentanyl test strips: Educate people who use substances about why and how to use fentanyl test strips. Please see Why and how to use fentanyl test strips
– Supervised injection facilities (Levengood et al., 2021)
– Encourage the use of routes other than intravenous
– On-site pill testing, for example, at music festivals (Scott and Scott, 2020).
Reduce the risk of dying from an overdose
Provision of naloxone kits and training to persons who use opioids, their family members, first responders, and others to carry naloxone.
Reducing other risks
– Needle exchange programs
Referrals for treatment
– For substance use disorders
– For the treatment of infectious diseases like HIV, viral hepatitis, etc.
– For vaccination against hepatitis A, hepatitis B, etc.
Harm reduction messages for patients
Source: National Institute on Drug Abuse (link)
Never use alone
Test your drugs
Gugala E, Briggs O, Moczygemba LR, Brown CM, Hill LG. Opioid harm reduction: A scoping review of physician and system-level gaps in knowledge, education, and practice. Subst Abus. 2022;43(1):972-987. doi: 10.1080/08897077.2022.2060423. PMID: 35426772.
Johns Hopkins Bloomberg School of Public Health. What is harm reduction? Last accessed on August 29, 2022.
Johns Hopkins Bloomberg School of Public Health. 5 Things to Know About Overdose Prevention Sites. Last accessed on August 29, 2022.
Levengood TW, Yoon GH, Davoust MJ, Ogden SN, Marshall BDL, Cahill SR, Bazzi AR. Supervised Injection Facilities as Harm Reduction: A Systematic Review. Am J Prev Med. 2021 Nov;61(5):738-749. doi: 10.1016/j.amepre.2021.04.017. Epub 2021 Jul 1. PMID: 34218964; PMCID: PMC8541900.
Marshall BD, Milloy MJ, Wood E, Montaner JS, Kerr T. Reduction in overdose mortality after the opening of North America’s first medically supervised safer injecting facility: a retrospective population-based study. Lancet. 2011 Apr 23;377(9775):1429-37. doi: 10.1016/S0140-6736(10)62353-7. Epub 2011 Apr 15. PMID: 21497898.
National Harm Reduction Technical Assistance Center. Last accessed on August 29, 2022.
SAMHSA. Harm reduction. Last accessed on August 29, 2022.
Scott IA, Scott RJ. Pill testing at music festivals: is it evidence-based harm reduction? Intern Med J. 2020 Apr;50(4):395-402. doi: 10.1111/imj.14742. PMID: 31908122.
Copyright © 2022, Simple and Practical Medical Education, LLC. All rights reserved. May not be reproduced in any form without express written permission.
Disclaimer: The content on this website is provided as general education for medical professionals. It is not intended or recommended for patients or other laypersons or as a substitute for medical advice, diagnosis, or treatment. Patients must always consult a qualified health care professional regarding their diagnosis and treatment. Healthcare professionals should always check this website for the most recently updated information.