Harm Reduction Strategies

The number of fatalities from prescription drug overdose has risen over the past years.1 Harm reduction strategies focus on reducing fatality rates, by targeting individuals who are at high risk for overdose, current users of opioids or heroin. These types of strategies entail enactment of policies that provide users access to antidotes and protection from legal repercussion of use. For example, state naloxone access laws allow the prescribing and dispensing of naloxone2 to substance users or to lay administrators.3 Implementation of these laws have been associated with greater use of 911 in the event of an overdose4, and increased ability to recognize an overdose when it is happening.5 Incidentally, individuals sometime wonder whether these laws actually increase use, research suggests that they have not led to an increase in drug use or high-risk behavior.6 In addition, a second harm reduction strategy listed in this document, Abuse Deterrent Drug Formulations, involves reformulating the prescription drugs chemically, so that the properties of the drug change and users are less likely to experience a “high” when taken not as prescribed. This strategy has been associated with a decrease in OxyContin abuse and misuse; however the positive effects are short lived because research found that participants moved on to misusing other opioids.7

Harm reduction strategies, summarized here, include the following:

1 United States General Accounting Office. (2003). OxyContin abuse and diversion and efforts to address the problem: Highlights of a government report. Journal of Pain & Palliative Care Pharmacotherapy18(3), 109. Retrieved from https://www.gao.gov/new.items/d04110.pdf

2 an opioid receptor antagonist that reverses opiate overdose

3 non-medical first responders, potential overdose bystanders, and family and friends of opioid users

4 Banta-Green, C. J., Kuszler, P. C., Coffin, P. O., & Schoeppe, J. A. (2011). Washington’s 911 Good Samaritan drug overdose law—Initial evaluation results. Seattle, WA: Alcohol and Drug Abuse Institute, University of Washington. Retrieved from http://stopoverdose.org/evaluation-of-washington-good-samaritan-law/

5 Haegerich, T. M., Paulozzi, L. J., Manns, B. J., & Jones, C. M. (2014). What we know, and don’t know, about the impact of state policy and systems-level interventions on prescription drug overdose. Drug and Alcohol Dependence, 145, 34–47.

6 Haegerich, T. M., Paulozzi, L. J., Manns, B. J., & Jones, C. M. (2014). What we know, and don’t know, about the impact of state policy and systems-level interventions on prescription drug overdose. Drug and Alcohol Dependence, 145, 34–47.

7 Cicero, T. J., Ellis, M. S., & Surratt, H. L. (2012). Effect of abuse-deterrent formulation of OxyContin. New England Journal of Medicine, 367(2), 187–189. doi: doi:10.1056/NEJMc1204141