Harm reduction is the philosophy and practice of respectfully collaborating with people to assist any positive change as a person defines it for themself. It starts where the person is at, with no biases or condemnation for the person’s lifestyle.

What is harm reduction?

Harm reduction is a way to helping people reduce the risk of harm when doing something dangerous, like using drugs or alcohol, or engaging in certain sexual behaviors. It is a way to meet a person where they are at, and to provide safe and judgment-free help. Harm reduction is used to prevent disease and promote health at a level that is comfortable and realistic to the person being helped. These strategies help keep the person from contracting a disease and/or spreading a disease (like Hepatitis C and HIV), and it also helps lower the risk of overdose.

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

Meeting people where they are at means that:

  • You understand that people using substances (legally and illegally) are a part of our world and do not ignore the issue or rebuke those struggling with addiction
  • It acknowledges that everyone has their own reason for using drugs
  • It acknowledges that each person that uses substances is in their own stage of use– some may be willing to quit substances while others may not. By meeting people where they are at it allows you to see that just because a person is opening up about their use does not mean they are ready to stop using. This is where harm reduction comes into play– if they are ready to stop using you are able to provide the resources to help them do so 
  • It is about listening to the person and providing non-judgmental and non-coercive help. As an example: if a person is not ready to stop using then you would provide information of reducing harm and not trying to convince them to go to treatment.
  • It is about supporting the person with steps they feel comfortable taking and providing a safe place for them to talk openly about their drug use to provide a way out of isolation that is common among drug users
  • Using harm reduction and meeting people where they’re at means that you may help people who use drugs in a safer way, help in managing their use, or help them to stop using

Some harm reduction strategies include:

  • Use fentanyl test strips
  • Use new syringes and don’t share syringes
  • Use new and clean works every time!
  • Use a tester shot to figure out potency and start off with a smaller amount– you can also use more but you can’t take away some if it turns out to be too much
  • Use drugs another way other than injecting (smoking, snorting, or swallowing)
  • Don’t use alone and take turns so that a person can respond if someone overdoses
  • Have Naloxone
  • Don’t mix drugs, especially benzos, alcohol, and opioids
  • Talking to friends and family about when and how to use naloxone if you overdose and what to do if you overdose 
  • Go to a syringe access program 

Why is harm reduction important?

Harm reduction is important because it recognizes that each individual has their own story and their own reasons as to why they use drugs. It is about promoting health and supporting people to be as healthy as they can, even while using drugs, by providing them with support, options in how to recover if they choose to do so, provide non-judgmental care, and allow the person to be seen and heard without the fear of being chastised.

How can service providers use harm reduction?

Harm reduction and Health Care Providers

  • Be aware of the resources in your area like syringe access programs, detox, medication for opioid use disorder facilities, and more
  • Provide a space that allows for open, honest, and non-judgmental conversation about their drug use and how they can use more safely
  • Don’t push someone to change before they are ready to– instead listen to them and see where they’re at with their drug use and make suggestions that make sense for that stage
    • For example: a person come to you and says they are worried about Hep C but that they are not ready to stop using.  At this stage they are not looking for detox facilities but rather information on how to protect themselves by not sharing needles and where to get new needles
  • When a relapse happens provide a space for the person to talk about it, what the relapse means to them, and what they want their next steps to be
  • Be aware of your own stigma
  • Assess everyone for drug use, not just the ones you suspect are using

Harm reduction and Public Health

  • When talking about programs and policies make sure that people who are a part of that community (people who use drugs and those with a history of drug use) are invited to the table and are represented and heard
  • Encourage those who use drugs to share information and support within their community and to use their own experiences as expertise
  • Work with all areas of the community when talking about new policies and practices
  • Address the factors that can increase the risk of drug use and that make it harder for treatment (like poverty, class, racism, housing, past trauma, sex-based and sexual orientation discrimination, and other social inequities)

Learn More About Harm Reduction:

Harm Reduction Coalition

Chicago Recovery Alliance

New England Users Union