What is Harm Reduction?
Harm reduction is a proactive and evidence-based approach to reduce the negative personal and public health impacts of behavior associated with alcohol and other substance use at both the individual and community levels.
Harm reduction is an important part of the Biden-Harris Administration’s comprehensive approach to addressing substance use disorders through prevention, treatment, and recovery where individuals who use substances set their own goals. Harm reduction organizations incorporate a spectrum of strategies that meet people “where they are” on their own terms, and may serve as a pathway to additional prevention, treatment, and recovery services. Harm reduction works by addressing broader health and social issues through improved policies, programs, and practices.
Why are Harm Reduction Services Needed?
The U.S. is experiencing the most significant substance use and overdose epidemic it has ever faced, exacerbated by a worldwide pandemic, and driven by the proliferation of highly potent synthetic opioids containing primarily fentanyl and other analogues.
Provisional data from CDC show that we have crossed the tragic milestone of a predicted 100,000 overdose deaths in 12 months from May 2020 to April 2021; this represents a nearly 29 percent increase compared to the same window of time last year.
Harm reduction services save lives by being available and accessible to people, and emphasizing the need for humility and compassion toward people who use drugs. Harm reduction plays a significant role in preventing drug-related deaths and offering access to healthcare, social services, and treatment. This results in a reduction of overdose fatalities, acute life-threatening infections related to unsterile drug injection, and chronic diseases such as HIV/HCV.
Harm Reduction's Place in and Among Prevention, Treatment, and RecoveryA comprehensive prevention strategy, harm reduction is part of the continuum of care. Harm reduction approaches have proven to prevent death, injury, disease, overdose, and prevent substance misuse or disorder. Harm reduction is an effective approach to addressing the public health epidemic involving substance use as well as infectious disease and other harms associated with drug use. Specifically, harm reduction services can:
- Connect individuals to overdose education, counseling, and referral to treatment for infectious diseases and substance use disorders.
- Distribute opioid overdose reversal medications (e.g., naloxone) to individuals at risk of overdose, or to those who might respond to an overdose.
- Lessen harms associated with drug use and related behaviors that increase the risk of infectious diseases, including HIV, viral hepatitis, and bacterial and fungal infections.
- Reduce infectious disease transmission among people who use drugs, including those who inject drugs by equipping them with accurate information and facilitating referral to resources.
- Reduce overdose deaths, promote linkages to care, facilitate co-location of services as part of a comprehensive, integrated approach.
- Reduce stigma associated with substance use and co-occurring disorders
- Promote a philosophy of hope and healing by utilizing those with lived experience of recovery in the management of harm reduction services, and connecting those who have expressed interest to treatment, peer support workers and other recovery support services.
Harm Reduction Activities and Intended Outcomes
Incorporating harm reduction can reduce negative effects on health and social wellbeing due to use of alcohol, other drugs, and related behaviors.
Prevention Goals Related Harm Reduction Activities*
- Reduce the spread of sexually transmitted and other blood-borne infections, including HIV and viral hepatitis
- Increase knowledge around safer sex and sexual health
- Access to PrEP
- Access to HIV and viral hepatitis testing and treatment
- Access to condoms
- Comprehensive sex education
- Reduce overdose deaths and other early deaths among people who use substances, including alcohol
- Increase knowledge around safer substance use
- Syringe service programs
- Fentanyl test strips
- Naloxone and overdose education kits
- Reduce sharing of substance use equipment
- Improve physical health
- Reduce the spread of infectious diseases
- Sterile syringes and other injection equipment to prevent and control the spread of infectious diseases
- Syringe Service Programs
- Safe smoking supplies
- Medical care including wound care
- Use of masks, social distancing, and vaccines
- Reduce stigma and increase access to health services
- Increase referrals to support programs and health and social services (including treatment and recovery support services)
- Motivational interviewing
- Low threshold medication for opioid use disorder
- Fentanyl test strips
- Naloxone and overdose education kits
- Peer support specialists
- Case managers
*Note: Sample harm reduction activities can meet multiple prevention goals.
SAMHSA is now accepting applications for the first-ever SAMHSA Harm Reduction grant program and expects to issue $30 million in grant awards. This funding, authorized by the American Rescue Plan, will help increase access to a range of community harm reduction services and support harm reduction service providers as they work to help prevent overdose deaths and reduce health risks often associated with drug use. SAMHSA will accept applications from State, local, Tribal, and territorial governments, Tribal organizations, non-profit community-based organizations, and primary and behavioral health organizations.
SAMHSA will distribute $10 million per year over the next three years. Grant recipients must use the funds to support harm reduction services. Harm reduction service providers will be asked to develop or expand evidence-based services that may include, but not be limited to: the provision of sterile syringes, safe sex kits, prevention education about synthetic opioids and other substances, overdose prevention kits including naloxone distribution, peer worker engagement, medical services, case management and referral to treatment. Warm handoffs that facilitate engagement in care and referrals to treatment for individuals seeking these support services are also critical components of this grant program. Harm reduction services will be trauma-informed and guided by harm reduction stakeholder groups and other community members.
Prospective applicants can email their questions to DTPHarmReduction@samhsa.hhs.gov. Questions received by December 15, 2021 will be addressed during the Harm Reduction Notice of Funding Opportunity Webinar
When: Wednesday, January 26, 2021 at 2 pm ET
Topic: An overview of the grant program, eligibility criteria, required/allowable activities, data collection, funding limitations, and application evaluation criteria. Additionally, frequently asked questions and responses will be shared with prospective applicants.
Registration is not required.
Or One tap mobile:
US: +16692545252,,1601277702#,,,,*366700# or +16468287666,,1601277702#,,,,*366700#
Dial (for higher quality, dial a number based on your current location):
US: +1 669 254 5252 or +1 646 828 7666 or +1 551 285 1373 or +1 669 216 1590
Webinar ID: 160 127 7702
Harm Reduction Notice of Funding Opportunity Webinar
When: Dec. 20, 2021 - 2 pm ET
Topic: Harm Reduction Prospective Applicant Webinar
SAMHSA is also collaborating with CDC on their National Harm Reduction Technical Assistance Center to provide a comprehensive approach to harm reduction through syringe services programs (SSPs) and to improve access to prevention and intervention services to prevent infectious disease consequences of drug use. Going beyond education and technical assistance efforts related to needle exchange, SAMHSA’s support of CDC’s existing National Harm Reduction Technical Assistance (TA) Center will enable the Center to also address also a variety of other individual and community factors related to harm reduction, such as, for example, naloxone distribution and administration, safe sex kits, HIV/VH testing, HEP-C, COVID-19 response, community stigma, and opportunities for collaboration between harm reduction and other community efforts (e.g., peer-delivered recovery support efforts). Through the collaboration with SAMHSA, the TA Center will support efforts to expand capacity, increase effectiveness, and strengthen the performance and accountability of harm reduction approaches within a comprehensive prevention strategy at the state and community levels and provide technical assistance and consultation services to support implementation of effective, evidence-based harm reduction programs, practices, and policies in diverse settings.
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