What the…? Breaking Down Harm Reduction Questions, Myths and Concepts
Most Americans don’t spend much time thinking about “harm reduction,” which makes my job building a coalition based around harm reduction interesting, to say the least. From friends and family to colleagues and beyond, I’ve come to realize that starting a conversation with “let’s talk about harm reduction” doesn’t always work. First, if people have ever heard of harm reduction, it’s likely only been in passing. Second, even organizations that practice what we would call harm reduction don’t always use the phrase—they may take evidence-based steps to help keep their communities safer in the face of health risks, but they don’t see themselves as “harm reduction organizations.” Third, the concepts underlying harm reduction—e.g., the War on Drugs, fentanyl in our drug supply, the relative risks of smoking versus vaping, efforts to legalize cannabis and psychedelics, medicines to prevent HIV—can be confusing. Finally, sensationalized and sometimes misleading media coverage and political rhetoric do not help matters, creating a cloudy picture rife with misconceptions and flawed data.
A brief detour in the wayback machine: Harm reduction as a named concept started in the 1980s with clean needles for people who injected drugs. It was a pragmatic, compassionate approach to keep people safer from HIV and Hepatitis C risk, regardless of whether they were ready or able to stop using drugs at that moment. That’s why, when someone says “harm reduction,” people might assume the topic is syringe services programs—what some still think of as “needle exchanges.” Or people might think the discussion is focused on Narcan, the brand name for a nasal spray medicine that can reverse opioid overdoses. These assumptions make sense, because harm reduction as we know it today started with drug use, and the War on Drugs, and there is much work still to be done in that space.
But in the decades since the 80s, harm reductions applications have grown: Today it encompasses all kinds of pragmatic tools, including in education, health care and criminal justice reform. These tools cover a range of health risks, including drug use, smoking and sexual health. In the “What the…?” series within our Safer From Harm blog, we’ll cover myths, questions and explanations in all of those areas, and in the underlying factors and health risks that make harm reduction so necessary in the first place.
Our first post in this series is about a topic that’s constantly in the headlines, but still confusing to many of us: If fentanyl is so deadly, why are people who make illegal drugs putting it in the products they sell? The answer—spanning economics, logistical practicalities, unintended consequences and human behavior itself—might surprise you.
Have a burning harm reduction question you’d like to see covered from a layperson’s perspective? Send it to Jessica Shortall at jshortall@rstreet.org.