Executive Summary

To combat rising rates of drug overdoses, the United States government has begun to embrace a public health response that has been saving lives for decades: harm reduction. This pragmatic public health approach aims to mitigate the health risks associated with a range of behaviors rather than insisting people quit them altogether.

Despite the benefits of harm reduction programs, stigma, paraphernalia laws and weak or inconsistent protections from such laws can undermine the uptake of their services. In addition, a small but growing body of evidence indicates that, despite the legalization and expansion of these programs, successful implementation may also be limited by outdated local, state and federal policy.

To better understand how outdated policy might create barriers to providing optimal harm reduction services, we interviewed 10 harm reduction providers serving diverse populations across the United States. These interviews revealed two primary areas of concern that harm reduction providers perceived as hindering the services they offered, both of which relate to government overreach: the overregulation of operations and the excessive restrictions on how funding can be used.

To remove these barriers and enable harm reduction organizations to save more lives, we suggest that—instead of supporting legislation that regulates the details of harm reduction practice—lawmakers support bills that emphasize organizational autonomy for these groups. Doing so would allow harm reduction providers to tailor programs as needed, remain flexible in the face of changing science and provide more effective services to their communities.

Press release: Harm reduction policy can save lives. But government overreach is getting in the way.

Image credit: Илья Подопригоров