Harm Reduction

Harm reduction is a strategy which minimizes the impacts of drug use and drug-related harms. Harm reduction supports interventions which are aimed at reducing negative effects without necessarily completely extinguishing potentially harmful behaviors. In a substance use disorder setting, harm reduction seeks to keep individuals alive while minimizing negative health impacts that can result from active substance use. It is not the primary goal of harm reduction strategies to get someone into treatment and recovery.

Harm reduction does not fall neatly within any single domain within the Institute of Medicine's (IOM) Continuum of Care, but rather supplements the prevention, treatment, and recovery strategies. Therefore, it is useful for anyone working within any of the IOM domains to be familiar with a harm reduction approach. Since it incorporates a number of innovations within the substance use disorder field, some of the strategies are controversial and have historically been met with community resistance. This makes it even more important for all behavioral health practitioners to be informed about the full spectrum of harm reduction strategies.

SAFE Solutions outlines strategies of the major approaches to harm reduction and includes an article on the incarcerated population and the unique substance use issues associated with a second specific population — people who are pregnant or parents of newborns.

• "Expand Harm Reduction Practices," provides the definition and principles of harm reduction promoted by the National Harm Reduction Coalition. It introduces the four major approaches that are implemented in harm reduction.
• "Increase Access to Overdose Reversal Medications" covers the most common harm reduction strategy. While the use of naloxone in preventing death by overdose has been adopted by pharmacists, EMS, law enforcement, and even public libraries, it has also received significant resistance to its adoption.
• "Expand Drug Testing Options" covers another major strategy in harm reduction — the use of testing strips (FTS). In addition to reducing the number of overdoses, the distribution of FTS provides opportunities for drug users to become aware of other treatment and recovery services. As research and science evolve, more options for testing strips are becoming available.
• "The Linkage Between Syringe Use and Infectious Disease" is associated with the complex topic of syringes. It provides a context for understanding the health risks associated with injecting drugs and the need to address the behavioral health issues of substance use within the arena of public health in curbing the spread of Hepatitis C, HIV, and AIDS.
• "Increase Access to Syringe Services Programs" details a variety of types of syringe service programs (SSPs) and documents the positive results and cost-benefits associated with SSPs.
• "Expand Number of Safe Injection Sites" makes a case for national adoption of a harm reduction practice which has been proven successful in a variety of international settings.
• "Adopt Harm Reduction Practices in Jails and Prisons" addresses concerns associated with one of two specific populations addressed by SAFE Solutions. While there are several articles with a focus on criminal justice across this place," this article addresses unique concerns linked to harm reduction.
• "Minimize Substance Use During Pregnancy" addresses the broad spectrum of issues facing an increasingly prevalent population having high risks for both parent and child. It ranges from increased chance of unintended pregnancies associated with substance use disorder to statistics on use during pregnancy to challenges and barriers unique to the perinatal period.