Snapshot Addressing Overdose Deaths with Harm Reduction Measures

Harm reduction policies target negative outcomes of substance use and are part of a comprehensive prevention strategy and continuum of care for people who use drugs. Some examples of strategies include overdose education, comprehensive syringe services programs, prescription drug misuse prevention programs and providing access to substance use treatment and recovery services, naloxone and fentanyl-detecting test strips.  

States use multiple models and combinations of strategies to best fit the needs of their constituents. More rural states may benefit from different strategies compared to states with larger urban populations. 

Stigma may prevent people from seeking treatment and recovery services. Methods to reduce stigma include using non-judgmental language to describe people with an opioid use disorder and training health care providers to develop skills to more effectively work with stigmatized groups, such as motivational interviewing and increasing their knowledge about medications for opioid use disorder. 

The FDA recently approved a nasal spray formulation of the opioid antagonist naloxone used to treat known or suspected opioid overdoses for over-the-counter purchase. This change may affect current and future state naloxone purchasing and distribution plans and agreements.

The National Harm Reduction Technical Assistance Center, a collaboration between the Substance and Mental Health Services Administration and the CDC, provides technical assistance and access to experts who can support state efforts to expand capacity, increase effectiveness and improve performance of evidence-based harm reduction programs.

Allow and encourage the distribution of naloxone, a non-addictive opioid reversal drug, by pharmacists and first responders to people at risk of overdose or a family member or friend who may be able to help someone at risk of overdose. Examples include Alabama and Colorado. 

Consider encouraging emergency departments to provide care coordination or initiate medication-assisted treatment for opioid use disorder using FDA-approved medications including methadone, buprenorphine and naltrexone for people presenting with an opioid overdose, such as Kentucky and Rhode Island.

Examine, allow or expand syringe services programs and evaluate their effectiveness. Programs like Kentucky’s Syringe Services Program Expansion Project and Minnesota’s Syringe Service Programs evaluation demonstrated positive outcomes including increased referrals to treatment and care and expanded service reach, among others.

Create transition programs for people with a history of opioid use disorder upon reentering the community from incarceration, which have been shown to reduce the rate of overdose upon release. Ohio and New Jersey have other models of state-supported transition programs.

Promote multiple opportunities for someone to receive information about preventing overdose, and access to treatment and recovery services including through general healthcare providers, social service providers and volunteer support groups.