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Harm Reduction for Substance Use Disorder

Harm reduction encompasses policies, practices, and programs that are designed to reduce the overall impact of substance misuse and substance use disorder, both on people and on society.1 It is based on positive change in order to improve the lives of people who use substances, and to reduce the effects of substance use and addiction.1, 2

What is Harm Reduction

Harm reduction is a person-centered approach to public health. The main goal of harm reduction policies is to reduce the harms generated by substance use on both individuals and communities. 1, 6

Abstinence from substances is one way to reduce harm, but improved individual health and functioning is the main goal or primary outcome of harm reduction practices. Care providers “meet people where they are at” and collaborate with people who use substances in their efforts to make their lives healthier. Harm reduction policies and practices may help reduce the negative impact of alcohol and drug use in many ways, such as by promoting awareness, reducing stigma, offering education and alternatives, and providing advocacy for social changes.1

Common harm reduction strategies include:

  • Overdose education, prevention, reversal, and supply distribution, such as naloxone distribution.1, 4
  • Needle and syringe access and exchange.1
  • Fentanyl test strips.4
  • Supervised drug consumption rooms and spaces.1
  • HIV and hepatitis prevention, testing, treatment, and care services.4
  • Reducing the stigma associated with substance use and co-occurring disorders.4
  • Providing linkages to treatment.4

Principles of Harm Reduction

Different organizations such as Harm Reduction International (HRI) and the National Harm Reduction Coalition (NHRC) have outlined their own principles of harm reduction, but the underlying aim is the same – to reduce the potential harms that can be caused by substance use in an effort to improve the health and functioning of the individual.1, 3

HRI’s principles of harm reduction:

  • Respecting the rights of people who use drugs.1
  • A commitment to evidence.1
  • A commitment to social justice and collaborating with networks of people who use drugs.1
  • The avoidance of stigma.1

NHRC’s principles:

  • Accepting that drug use is part of the world and choosing to reduce the harm associated with substance use rather than ignoring or condemning it.5
  • Accepting that substance use is complex and multi-faceted and involves a wide range of behaviors –from severe use to total abstinence – and recognizing that certain ways of using drugs are clearly safer than others.5
  • Establishing that the quality of individual and community life and well-being — not necessarily stopping all drug use — are the criteria for successful interventions and policies.5
  • Requesting non-judgmental, non-coercive provision of services and resources to people who use drugs and the communities in which they live in order to assist them in reducing harm.5
  • Ensuring that people who use drugs and those with a history of drug use have a real voice in the creation of harm reduction programs and policies.5
  • Affirming that people who use drugs are responsible for reducing the harms of their drug use and empowering them to share information and support each other in strategies which meet their actual conditions of use.5
  • Recognizing that social inequalities affect both people’s vulnerability to and capacity for effectively dealing with drug-related harm.5
  • Avoiding attempts to minimize or ignore the harm and danger that can be associated with illicit drug use.5

The harm reduction approach can be specifically helpful for people because it can connect them to evidence-based treatment or practices that can improve their health and functioning, even if complete abstinence is not on the immediate horizon.4

However, as mentioned above, the approach is not designed to stop people from using substances but rather to minimize the potential harms that can be caused by ongoing substance use.1, 4, 5

Is Harm Reduction Effective?

Research has shown that, in general, harm reduction practices and policies may both reduce individual and community harm as well as improve individual health and functioning caused by substance use.2 For example, one study found that harm reduction treatments were effective in reducing overall levels of alcohol consumption and alcohol-related problems.2

Additionally, the Substance Abuse and Mental Health Services Administration (SAMHSA) explains that a harm reduction program may help prevent drug-related deaths and offer access to healthcare, social services, and treatment, which can decrease overdose fatalities, serious infections related to unsterile drug injection, and chronic diseases such as HIV/HCV.4

How to Find Harm Reduction for Substance Abuse

You can find harm reduction programs through organizations like the National Harm Reduction Coalition, or by talking to your doctor.

You can search for addiction treatment programs using the SAMHSA treatment locator, an online resource that lets people search for treatment by zip code. Addiction helplines, such as the one operated by American Addiction Centers, can also help you find harm reduction and addiction treatment programs. Don’t delay, call us now at .

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