Harm Reduction Approaches for Opioid Use Disorder

Abstract

An estimated 15.5 million people have an opioid use disorder across the globe resulting in tremendous morbidity and mortality. In the United States, the toll of untreated opioid use disorder has led to an epidemic of overdose deaths resulting in a decline in life expectancy over the past three years. Much of the focus in responding to the opioid overdose crisis has been on supply reduction or expanding the existing treatment system. Supply reduction or expansion of the existing treatment system may not target the needs of people who are actively using drugs and at highest risk of harm or death. In contrast, harm reduction offers a practical approach which focuses on reducing negative consequences and improving the lives and health of people who use opioids. Harm reduction is a philosophy and an approach which focuses on minimizing harm and promoting health, rather than necessarily reducing drug use. A broad range of harm reduction interventions has been studied and found to be successful, including syringe service programs, supervised consumptions sites, naloxone distribution, safer use education, low-threshold treatment models, and prescription heroin programs. Many components of these specific interventions can be incorporated into clinical practice. In addition, the general principles of harm reduction can inform a patient-centered care model both within addiction treatment programs and general medical settings to improve the health of and clinical outcomes for patients. This approach embraces the notion that people who continue to use drugs deserve equitable and dignified care delivered with respect and without judgment.