Harm Reduction Policies Are Adopted Inconsistently Across Substances
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Overview
Most potential harms attributable to substance use stem from two distinct causes of risk: the substance itself (including how it is used) and the prohibition of the substances or related equipment. Harm reduction has been shown to effectively mitigate the risks associated with a wide range of behaviors and substances. Some common harm reduction interventions include:
- Naloxone (opioid antidote) distribution
- Electronic nicotine delivery system (ENDS) products
- Regulated cannabis markets
- Syringe services programs (SSPs)
Harm Reduction in the States
In some states, tight restrictions on ENDS products directly contradict established harm reduction strategies for opioids and cannabis, creating a conflicting prohibitionist environment.
RSI examined state harm reduction policies targeting three substances: tobacco, opioids, and cannabis.
The Policies
| TOBACCO | OPIOIDS | CANNABIS |
|---|---|---|
| – State bans on flavored ENDS products – States with local bans on flavored ENDS products – States with local bans on all ENDS products | – State authorization of SSPs – State decriminalization of drug-checking equipment – State regulation of methadone that exceeds federal guidelines | – State legalization of medical cannabis (including low THC/CBD products) – State legalization of regulated adult-use cannabis markets |
| THR Policy in All States + D.C. Restrictive (11.8%) Moderate (13.7%) Permissive (74.5%) | OHR Policy in All States + D.C. Restrictive (15.7%) Moderate (37.3%) Permissive (47.1%) | Cannabis Policy in All States + D.C. Restrictive (23.5%) Moderate (29.4%) Permissive (47.1%) |
Regardless of Partisan Leanings, States Are Inconsistent in Their Adoption of Harm Reduction Policies*
Republican states tend to be fairly permissive of tobacco harm reduction (THR) but moderate to restrictive of opioid harm reduction (OHR) and regulated cannabis. Democratic states lean the opposite way, with laws that are more permissive of OHR and regulated cannabis markets but more restrictive of reduced-risk nicotine products.
Republican State Governments (23 states)
| tobacco harm reduction | opioid harm reduction | cannabis harm reduction | |
|---|---|---|---|
| Permissive Number of States | 21 (91%) | 5 (22%) | 4 (17%) |
| Moderate Number of States | 2 (9%) | 12 (52%) | 11 (48%) |
| Restrictive Number of States | 0 (0%) | 6 (26%) | 8 (35%) |
Democrat State Governments (16 States + D.C.)
| tobacco harm reduction | opioid harm reduction | cannabis harm reduction | |
|---|---|---|---|
| Permissive Number of States | 6 (35%) | 13 (76%) | 15 (88%) |
| Moderate Number of States | 5 (30%) | 4 (24%) | 2 (12%) |
| Restrictive Number of States | 6 (35%) | 0 (0%) | 0 (0%) |
Divided State Governments (10 states)
| tobacco harm reduction | opioid harm reduction | cannabis harm reduction | |
|---|---|---|---|
| Permissive Number of States | 10 (100%) | 6 (60%) | 5 (50%) |
| Moderate Number of States | 0 (0%) | 2 (20%) | 2 (20%) |
| Restrictive Number of States | 0 (0%) | 2 (20%) | 3 (30%) |
Our Integrated Harm Reduction Team
Our program focuses on harm-reduction approaches that recognize that harmful behaviors may continue to happen even as policies are enacted to help mitigate—if not eliminate—those harms. We connect the dots between historically siloed issues such as: tobacco, cannabis, sexual health, and illicit drug use.