Researchers: Primary Care Can Advance Drug Harm Reduction Efforts

A team of researchers has examined the issue of how best to achieve the healthcare policy goal of harm reduction for those who are actively using drugs—referred to as “PWUDs”—“people who use drugs”—and has concluded that community health centers are optimally positioned to improve outcomes for PWUDs.

Writing in the Forefront (commentary) section of Health Affairs online on Sep. 17, researchers Mia Shenkman and Tonantzin E. Juarez write in “Health Centers Are Uniquely Positioned To Facilitate Harm Reduction’s Integration Into Primary Care,” that, “As the overdose death rate rampantly grows, with the Centers for Disease Control and Prevention (CDC) reporting 107,941 drug-involved overdose deaths in the U.S. in 2022, mainstream public health officials increasingly endorse harm reduction as a legitimate strategy to address this crisis. Among the common strategies included in harm reduction are syringe services programs (SSPs), safer injection facilities, overdose prevention initiatives, and Medications for Opioid Use Disorder (MOUD) in addition to relational components, like non-judgmental, non-coercive service provision.

The authors note that the Biden-Harris Administration incorporated harm reduction into its Overdose Prevention strategy two years ago, allocating $30 million in federal grants for Narcan distribution, fentanyl test strips, and harm reduction research; and that step, they say, elevated people who use drugs (PWUD) as “battling a chronic condition and deserving of unequivocal access to compassionate, non-judgmental care—represent a radical departure from traditional medical models.”

Importantly, the researchers write, “Health Centers (HCs) are uniquely positioned to lead harm reduction’s integration into primary care. Not only are the populations HCs serve disproportionately impacted by the overdose crisis, but these health centers already share common values with harm reduction—including serving as leaders in delivering whole person, integrative care with a historic interest in community engagement. Yet, work remains to be done.” The researchers emphasize that programs like that at the Center for Key Populations (CKP) in Connecticut, which is embedded within a health center, reduce barriers to care. Ultimately, they conclude, healthcare providers must create a culture of destigmatization and harm reduction.