Harm reduction refers to interventions aimed at reducing the negative effects of health behaviors without necessarily extinguishing the problematic health behaviors completely. 

Harm reduction, or harm minimization, refers to a range of intentional practices and public health policies designed to lessen the negative social and/or physical consequences associated with various human behaviors, both legal and illegal.

harmreduction.org

Harm reduction is a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use. Harm Reduction is also a movement for social justice built on a belief in, and respect for, the rights of people who use drugs.

Harm reduction incorporates a spectrum of strategies that includes safer use, managed use, abstinence, meeting people who use drugs “where they’re at,” and addressing conditions of use along with the use itself. Because harm reduction demands that interventions and policies designed to serve people who use drugs reflect specific individual and community needs, there is no universal definition of or formula for implementing harm reduction.

However, National Harm Reduction Coalition considers the following principles central to harm reduction practice:

1. Accepts, for better or worse, that licit and illicit drug use is part of our world and chooses to work to minimize its harmful effects rather than simply ignore or condemn them

2. Understands drug use as a complex, multi-faceted phenomenon that encompasses a continuum of behaviors from severe use to total abstinence, and acknowledges that some ways of using drugs are clearly safer than others

3. Establishes quality of individual and community life and well-being — not necessarily cessation of all drug use — as the criteria for successful interventions and policies

4. Calls for the 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 attendant harm

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

6. Affirms people who use drugs (PWUD) themselves as the primary agents of reducing the harms of their drug use and seeks to empower PWUD to share information and support each other in strategies which meet their actual conditions of use

7. Recognizes that the realities of poverty, class, racism, social isolation, past trauma, sex-based discrimination, and other social inequalities affect both people’s vulnerability to and capacity for effectively dealing with drug-related harm

8. Does not attempt to minimize or ignore the real and tragic harm and danger that can be associated with illicit drug use

SAMHSA defines harm reduction as a practical and transformative approach that incorporates community-driven public health strategies — including prevention, risk reduction, and health promotion — to empower PWUD and their families with the choice to live healthier, self-directed, and purpose-filled lives.

https://tlp-lpa.ca/

Harm reduction is an umbrella term for policies and practices that are focused on reducing problematic effects of alcohol and other drug use. It can take place on the individual, community, or societal level. Harm reduction is focused on minimizing consequences without needing the activity to stop.

SAMHSA

Harm reduction is an evidence-based approach that is critical to engaging with people who use drugs and equipping them with life-saving tools and information to create positive change in their lives and potentially save their lives. Harm reduction is a key pillar in the U.S. Department of Health and Human Services' Overdose Prevention Strategy.

Harm reduction emphasizes engaging directly with people who use drugs to prevent overdose and infectious disease transmission; improve physical, mental, and social wellbeing; and offer low barrier options for accessing health care services, including substance use and mental health disorder treatment.

Harm Reduction Stats:

One-for-one exchange can lead to people reusing needles, but harm reduction reduces the risk of HIV and hepatitis C virus (HCV) transmission among people who inject drugs. In fact, a 2020 study showed incident rates for infections can drop by as much as 90% among at-risk populations.

safeproject.us

Most importantly, harm reduction treats individuals with substance use disorders (SUD) with dignity and respect using a social justice and health equity lens. Harm Reduction International describes it as “policies, programs, and practices that aim to minimize negative health, social and legal impacts associated with drug use, drug policies, and drug laws.”

More simply, harm reduction services meet people with substance use disorder “where they are.” If a person with substance use disorder isn’t ready to go into treatment, their lack of readiness doesn’t make them any less deserving of health care and support.

It is remarkably different from abstinence-only programs. Instead of “Just Say No,” you’re likely to hear, “How can we best help you stay safe, healthy, and alive?” Harm reduction is a connector between addiction and recovery, and is evidence-based. A recent study in the Journal of Pediatrics points to “Decades of evidence have revealed that many harm reduction strategies are highly effective in decreasing the transmission of infectious diseases, preventing overdose, and reducing other sources of morbidity and mortality among people who use substances, including young people who use illicit drugs. Harm reduction programs can also serve as critical access points for additional resources, health care, and treatment.”

Low Barrier

'Low barrier' means improving access to shelter services by lowering barriers to entry such as: sobriety requirements. Income requirements. space for couples. space for pets.

You can use it whenever you are discussing a situation in which a barrier or obstacle needs to be lowered or removed.

Low barrier care models often incorporate a whole health approach that encompass a range of medical, behavioral, and social services to address the multifaceted needs of individuals with SUDs, including access to medications for opioid use disorder (MOUD) and medications for alcohol 

aamc.org

people who use SSPs are three times more likely to reduce or stop drug use than those who don’t, according to the Centers for Disease Control and Prevention.

CDC.gov

• Syringe services programs (SSPs) are proven and effective community-based prevention programs that can provide a range of services.

• SSPs protect the public and first responders by facilitating the safe disposal of used needles and syringes.

Approximately 3.7 million Americans report having injected a drug in the past year9. In 2019, 14.3% of high school students reported using opioids without a prescription and 1.6% reported having ever injected drugs10.

SSPs reach people who inject drugs, an often hidden and marginalized population. Nearly 30 years of research has shown that comprehensive SSPs are safe, effective, and cost-saving, do not increase illegal drug use or crime, and play an important role in reducing the transmission of viral hepatitis, HIV and other infections1112. Research shows that new users of SSPs are five times more likely to enter drug treatment and about three times more likely to stop using drugs than those who don't use the programs13.

The majority of SSPs offer referrals to MAT25, and people who inject drugs who regularly use an SSP are more than five times as likely to enter treatment for a substance use disorder and nearly three times as likely to report reducing or discontinuing injection as those who have never used an SSP132627.

People who use SSPs show high readiness to reduce or stop their drug use29.

https://www.aamc.org/news/drug-overdoses-soar-more-providers-embrace-harm-reduction

Today, distributing clean syringes is more vital than ever, experts say. That’s because the effects of the synthetic drug fentanyl — which now dominates the opioid supply in several areas — fizzle out faster than those of other opioids.

“To avoid withdrawal, users need to inject twice as often, typically six to 10 times a day, greatly increasing their risk,” says Gaeta, who serves as chief medical officer of Boston Health Care for the Homeless Program.

Even if people who use opioids stay relatively healthy, they still face the risk of overdosing. That’s why distributing the reversal medication, naloxone, is a mainstay of harm reduction efforts.

Whatever the drug-related service, harm reduction experts say the approach relies on one crucial tool: respect.

“We cannot be telling people they have to change in order to get support,” says Susan Collins, PhD, co-director of the Harm Reduction Research and Treatment Center at the University of Washington (UW) School of Medicine in Seattle.

UW’s program, run out of Harborview Medical Center, was created with significant input from people who use drugs. In it, patients identify their own harm reduction and quality-of-life goals. Then, counselors check in regularly to help participants track progress and change behaviors.

And though abstaining is not always a goal, about half of her Harborview patients eventually stopped using, says Collins. Often, people are able to quit because they are no longer “immersed in shame or feelings of failure about their drug use.”

SAMHSA 6 Pillars of Harm Reduction

https://www.samhsa.gov/sites/default/files/harm-reduction-framework.pdf

1. Is led by people who use drugs (PWUD) and with lived experience of drug use

2. Embraces the inherent value of people

“All individuals have inherent value and are treated with dignity, respect, and positive regard.”

3. Commits to deep community engagement and community building

4. Promotes equity, rights, and reparative social justice

5. Offers most accessible and noncoercive support

6. Focuses on any positive change, as defined by the person