Harm reduction is a way of preventing disease and promoting health that “meets people where they’re at” rather than making judgments about where they should be in terms of their health behavior choices. A harm reduction approach can be used with people who don’t want to change their substance using behavior and those who are currently (or strive to be) abstinent from all drugs, including alcohol. It acknowledges that some ways of using drugs are safer or less risky than others. The goals of harm reduction are to help people make choices that reduce the negative consequences of their drug use, to prevent the spread of diseases associated with use, like HIV and HepC, and to keep people alive by decreasing the chance of an overdose. Harm reduction interventions are heavily researched and backed with decades of evidence of their effectiveness.

Harm Reduction meets people “where they’re at.”

• Legal and illegal drug use is part of our world. We choose to work to reduce the harmful effects of drugs rather than simply ignoring or condemning them. -

• Harm reduction is non-judgmental, non-coercive.

• While the focus is meeting people where they’re at, harm reduction doesn’t ignore the risk associated with drug use. Instead, harm reduction strives to create and maintain kind, compassionate relationships with people and help break isolation often associated with drug use. These relationships help people talk about their drug use openly and encourages less risky behavior.

• Harm reduction uses the stages of change model to understand a person’s use. If someone is not willing and ready for change then harm reduction interventions address higher risk behavior (using clean syringes, sterile water, not sharing needles or other drug supplies, providing cookers or water, etc.). If someone is ready and willing to change, then they are supported for this choice. For example, if someone is not ready to stop using, the focus is on keeping them as safe as possible and not on encouraging detox or treatment unless it is asked for. For those asking for help, referrals and connections to care are made.

Harm reduction may include helping people who use drugs to use safer, manage their use, or discontinue use. Some examples of harm reduction include:

• Using new, clean syringes, not sharing works, and using fentanyl test strips.

• Knowing your tolerance and using lower amounts to reduce overdose risk, particularly if someone has not used for even just a couple days.

• Swallowing, snorting, or smoking a drug rather than injecting.

• Not using alone.

• Taking turns using when in a group so someone can respond if a person overdoses.

• Not mixing drugs like benzos, alcohol, and opioids like heroin.

• Having Narcan with you and communicating to your friends and family about how to use it, where it’s found, and what to do if you overdose.

• Using a tester shot to gauge potency, especially if it is a new batch.

• Accessing a Syringe Access Program.

Information with edits from: https://harmreduction.org/about-us/principles-of-harm-reduction/

Tips for Health Care Providers :

• Offer sense of safety by having an open and honest conversation about safe use.

• Be a resource broker by connecting people to syringe access programs, recovery centers, or detoxes in the area.

• Use the stages of change model to know the appropriate intervention based on the person’s willingness for behavior change.

• When an individual relapses, let the person describe to you what that experience means to them. Give the person space to explore their relapse triggers and what they want their next steps to be. Accept that this may not mean abstinence.

• Practice self-reflection: we all are somewhere in the spectrum of stigma. It is important to check where we are to continue being a better support.

• Get in the habit of assessing everyone for substance use, not just those who you may suspect.

• Learn the terminology used by persons who use drugs (PWUD).

Tips for Public Health

• Ensure that people who use drugs and those with a history of drug use have a real voice in the creation of programs and policies designed to serve them.

• Empower people who use drugs to share information and support each other in ways that acknowledge their life experience as expertise.

• Address socioeconomic factors such as poverty, class, racism, social isolation, past trauma, sex-based discrimination, and other social inequalities that increase the risk of drug use and make it harder for them in treatment.

• When creating policy and practice shifts within systems, collaborate with all sectors in the community.

Harm reduction views drug use as a complex issue and recognizes there are many reasons why people use. Harm reduction is about seeing people who use drugs as more than their drug use. It is about humanizing people, acknowledging their dignity and self worth, and allowing people to be the healthiest they can be, even if they are using drugs. Using a harm reduction approach when working with people who use drugs allows support professionals to value them and see them as more than their substance use. It emphasizes the continual work to build and maintain the relationships that are most important to each individual while they use and if they choose recovery. Stopping drug use is not the only measure of success for interventions and policies. Increasing feelings of well-being and quality of life is just as important. Through Harm Reduction, individuals have the opportunity to explore multiple pathways to recovery.