Harm reduction

A guide to harm reduction

Understand the significance of harm reduction services for drug users and learn about harm reduction services, kits, and how to find local support resources.

Ophelia team
A guide to harm reduction
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Arthur Robin Williams, MD

Harm reduction services are becoming more prominent throughout the United States thanks to the efforts of activists, researchers, and community groups pushing for more humane and sensitive treatment of people who may be dependent on drugs. This life-saving approach is now even being used at the governmental level as part of the Overdose Prevention Strategy outlined by the United States Department of Health & Human Services. 

What is harm reduction?

As a philosophy, harm reduction recognizes that many of the dangers of drug use stem from social conditions as much as they do from drug use itself. As a strategy, harm reduction bolsters social support for people using drugs and reduces dangerous and deadly outcomes associated with drug use. The core principle of harm reduction is to encourage patients to achieve any positive change that promotes their health and safety.

Advocates of harm reduction argue that drug use is part of our society and is not a moral failing; social stigma around drug use and lack of support for drug users lead to worse outcomes. Harm reduction services are designed to reduce the potential harm associated with drug use. These services include safe use sites, fentanyl tests, naloxone and overdose kits, and needle exchange programs. 

What is harm reduction? Examples of harm reduction services.

Why are harm reduction services so important?

Historically, prohibition, criminalization, and ostracization do not stop people from using drugs or forming drug habits. Instead of unproductively trying to force people to not use drugs, harm reduction emphasizes making drug use safer and providing social support to those who need it. This means fewer overdoses, better social conditions for drug users, lower rates of disease transmission due to intravenous drug use, and lower rates of drug-related crime. 

Offering these outlets can also help people with drug use disorders seek help and stay safer. With over 100,000 overdose-related deaths in the U.S. in 2022 and with treatment being highly inaccessible, harm reduction offers a crucial avenue toward safer outcomes for people who use drugs.

What is in a harm reduction kit?

Many harm reduction efforts include handing out free harm reduction kits, which can be used by people who use drugs. Family members and the general public are also encouraged to receive harm reduction kits to help keep drug use safer for loved ones and respond to emergency situations. 

The exact contents of these kits vary, but there are a few common items you can expect to see. First is naloxone, also known by the brand name Narcan, and is usually found as a nasal spray, which is an opioid antagonist. It binds to the opioid receptors in the brain, forcing out pre-existing opioids and reversing the effects of an overdose, helping to restore breathing and heart rate. You’ll also find single-use items, like tourniquets, fresh syringes, breathing barriers for CPR, and bags. Many kits also include a small black box that can be used to safely store used syringes.

Example of a harm reduction kit with Narcan.
Example of a harm reduction kit with Narcan.

How to find harm reduction services

Funding for and availability of harm reduction services varies greatly by state, but many cities and towns have local harm reduction programs that can help. Simply searching for “harm reduction near me” can help you identify local services, or you can use the National Harm Reduction Coalition's online locator, which maintains a list of active harm reduction services across the country. 

If there are no viable harm reduction services in your area, it’s possible to get help through online resources. For example, individuals and organizations can request free fentanyl test strips through the Matters Network, and groups like NEXT Distro provide harm reduction kits through the mail all across the country. 

In most cases, these services are available to the community at large, not just to individuals currently using drugs. You may also want to check with your primary care provider to see if they are able to provide any harm reduction supplies free of charge. Many clinics are able to provide naloxone upon request.

How to respond to an opioid overdose

Recognizing and overdose. Opioid overdose response guide.
How to administer Narcan/naloxone


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