Five Questions for Counties Considering Harm Reduction as an Opioid Abatement Strategy

Introduction

Since 1999, more than one million people have died of a drug overdose in the U.S. The nature of this crisis has evolved rapidly in recent years, with synthetic opioids, such as fentanyl, now dominating the drug supply. Amid an evolving and increasingly life-threatening substance use environment, harm reduction has become a pillar of America’s overdose prevention strategy. Harm reduction is an evidence-based approach to engage and meet the needs of people who use drugs. For America’s counties, harm reduction complements prevention, treatment and recovery services to create a more holistic and effective system of care.

Harm Reduction: 

"a practical and transformative approach that incorporates community-driven public health strategies – including prevention, risk reduction, and health promotion – to empower people who use drugs and their families with the choice to live healthier, self-directed, and purpose-filled lives."

— U.S. Substance Abuse and Mental Health Services Administration

Through the national opioid settlements, counties have access to flexible resources that can enhance our existing opioid response strategies, including incorporating or expanding the role of harm reduction in our systems of service. How counties can integrate harm reduction depends on the policy environment, including on whether counties have broad authority, limited authority or face state-imposed barriers. 

To help counties assess the utility and feasibility of harm reduction in our jurisdictions, this resource explores five questions from counties in different policy contexts: 

1. What is harm reduction and what would it mean for our community?

   Question in Action: Graves County, Ky.

2. What if our county isn’t involved in the delivery of substance use services?

   Question in Action: Arapahoe County, Colo.

3. What if community-based organizations already offer harm reduction services?

   Question in Action: Allegheny County, Pa.

4. What if harm reduction is restricted at the state level?

   Question in Action: Bexar County, Texas

5. How can opioid settlement funds support harm reduction?

   Question in Action: Hennepin County, Minn.

Each example includes information about the state’s policy context, so that counties can assess which context is most similar to their own.