Harm reduction strategies to fit your community health needs

In a recent data spotlight, CHR&R found that injury deaths have been leading contributors to early mortality over the last 10 years. Injury deaths due to poisonings (e.g., alcohol and drug overdose), firearms, and car crashes remain leading contributors to deaths at early ages, and demand coordinated public health responses.

The first rise in opioid overdose deaths — from drugs like prescription pain relievers, fentanyl, and heroin — began with a fourfold increase in the prescription of both natural and semi-synthetic opioids between 1999 and 2008. A second wave of opioid overdose deaths was seen in 2010, as many patients who became addicted to prescribed opioids turned to non-prescribed forms of opioids, such as heroin. In 2013, a third wave began when synthetic opioids like fentanyl, which are much more potent than other forms of opioids, were combined with other drugs or counterfeit prescription pills.

By the apex of 2022, around 217 people died each day from an opioid overdose in the United States, only to slightly decrease according to the most recent data. Accidental drug overdose is the leading cause of death for those under 55.

One of the most critical tools for combating the overdose crisis is harm reduction. Harm reduction strategies are preventative interventions that reduce the adverse effects of behaviors and promote health in communities. Our What Works for Health team has analyzed the evidence behind strategies like naloxone education & distribution programs and fentanyl test strip distribution programs for their effectiveness in decreasing overdose deaths. When naloxone is administered, it can reverse a drug overdose, and naloxone programs help increase community access to naloxone rather than relying on first responders and healthcare facilities. Providing communal access to other kinds of harm reduction tools, like fentanyl test strips, reduces overdoses by helping people detect the presence of fentanyl or other potentially harmful adulterants in illicit drugs. Both approaches inform the public and focus on health behaviors to reduce the risk of death caused by drug overdoses.

Additional harm reduction strategies that are likely to improve health include Good Samaritan drug overdose laws and syringe services programs.

Explore related data on our County Health Rankings & Roadmap’s website and over 400 additional evidence-informed strategies to fit your community health needs in our What Works for Health database.