The Evolution of Harm Reduction: How Are we Doing Now?

In July, the CDC announced the 2020 death toll due to drugs: 93,000, up nearly 30% from 2019. “This is a staggering loss of human life,” Brown University’s Brandon Marshall told AP. More than 900,000 people have died of drugs since 1999.

And, yet, MAT (MOUD) treatment has been increasing radically. Opioid use disorder (OUD) treatment increased in Medicaid recipients from 2014 to 2018. And it’s still growing. The proportion of people with opioid use disorder who received buprenorphine (Buprenex), methadone, or naltrexone (Revia) increased from 48% to 57% across that period.

Is harm reduction working? “Harm reduction is more than just a package of interventions,” said Judy Chang, executive director of INPUD (International Network of People who Use Drugs). “Harm reduction is linked to social justice and human rights, as a movement for radical love and acceptance.”

But because harm reduction is often associated with specific public health policies—such as providing resources like sterile syringes and naloxone, establishing safe spaces for drug use, or increasing access to safer alternatives from methadone to nicotine vapes—public discourse around it often loses sight of that bigger philosophical vision.

“I think people understand the immediate need for harm reduction. I’m not always clear if people get the underlying tenets of self-determination and choice,” said Kassandra Frederique, executive director of the Drug Policy Alliance (DPA). “We need safer consumption spaces, so we don’t see the person using heroin. And all those things can be true. But they’re not the driving reason why we do these things. The driving reason why we do these things is because we’re trying to create a world that recognizes that people use drugs.”

This is our vision of harm reduction. Not specific policies. Not abstinence or not. And certainly not MAT/MOUD. It’s about the functioning and feeling human being, irrespective of whether they’re using drugs, what kind of drugs they’re using, and how much.

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Please let us know your thoughts in the comments below – we would love to hear from you.  Have you used psychedelics to improve your life? To get over an addiction?

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