In any discussion about drug use and prevention and treatment services, harm reduction is likely to come up. One of the major reasons harm reduction is so controversial? The thinking goes that if you make drugs safer to use by expanding access to things like an overdose antidote, or sterile syringes, more people might use drugs. Or they won't have such a big incentive to quit because they won’t see their addiction as a risk. But when the morality police are steering these decisions, we miss the bigger picture and the science-based evidence: harm reduction keeps more people alive and healthy.
Understanding the principles of harm reduction is key to treating and managing opioid use disorder (OUD). But the term is often misunderstood and misused, which can create public perception problems and leave people confused about the options and treatments available to them. We’re here to explain what exactly harm reduction means and how it is put into practice.
What is harm reduction?
Harm reduction, at its core, is about keeping people who use drugs safe—taking steps to address and decrease the harm they face. Different individuals can have different perspectives about what that looks like, though.
For example, one New York Times contributor emphasized the importance of recognizing medication-assisted treatment as a valid treatment option for opioid dependency. Just a few years ago, medication for opioid use disorder (MOUD) was only seen by many people as a short-term option instead of the gold standard of care. But limiting access to treatment only does more harm than good.
Ophelia clinician Shoshi Aronowitz takes a broader view:
“[Harm reduction is] a lot more than treatment. It’s a whole philosophy. It’s about really listening to and respecting people's goals for themselves and their drug use, whether those goals include ceasing use or not. It’s about the belief that people deserve to be safe regardless of their drug use and about making tools available so that people can do that.”
Those who promote harm reduction do not view drug use as a personal failing. Instead, harm reduction programs acknowledge that drugs are widely available, and we must take steps to decrease the harm that can be associated with drug use, particularly overdose-related deaths. Harm reduction stands in stark contrast to traditional law enforcement and rehabilitation approaches to drug dependency.
What are some harm reduction strategies?
Harm reduction strategies can take many different forms. Making fentanyl test strips more available, for instance, can help people who use drugs easily determine whether there’s any of this potentially deadly drug in the substances they plan to use.
Other harm reduction services include:
- Safe consumption sites
- Syringe access programs
- Community naloxone (Narcan®) distribution and education
- Access to medical, legal, and mental health services
- Low threshold medication-assisted treatment (MAT)
Safe consumption sites have become an essential part of the harm reduction plan in Rhode Island. Project Weber—an organization dedicated to helping drug users in Providence—plans to open the first state-legalized supervised drug consumption site in the U.S. later this year. People who use drugs can come to these sites and use under the supervision of healthcare providers instead of doing so alone or in a riskier environment. The goal of opening drug consumption sites is to reduce overdose deaths and the spread of infectious diseases by making safer drug use possible. And despite criticism, harm reduction experts say “research has already shown that the sites do not lead to upticks in crime or community drug use.”
Harm reduction and opioid addiction
According to preliminary data from the Centers for Disease Control (CDC), more than 109,000 people died of a drug overdose between March 2021 and March 2022. Most of those deaths involved synthetic opioids, like fentanyl.
Applying harm reduction techniques to opioid addiction starts by acknowledging that opioid dependency is just a facet of a person’s life, not the entirety of their being. It also acknowledges that opioid use disorder (OUD) is a long term disorder, and patients may benefit from treatment, such as MAT. OUD treatment programs that emphasize abstinence as the singular goal of treatment do not address the core principles of harm reduction.
Evidence-based care that puts your well-being first
At Ophelia, harm reduction is a central part of how we treat opioid addiction. Our goal is to help those with OUD and other substance use disorders reach their goals surrounding their own drug use. Ophelia’s private, personalized approach to treatment is designed to fit into your life and adapt to your needs. Our virtual model gives you the privacy and flexibility to feel empowered and supported by a dedicated clinical team.