Overdose Prevention and Harm Reduction:
Just like with any behavior that carries risk, the only way to completely prevent an overdose is by not consuming any opioids, but that is not always realistic. However, we can learn specific techniques to reduce the risk of overdose (see here). These techniques are overdose prevention strategies and fall under the broad heading of a harm reduction approach to drug use.
History of OEND programs/Harm reduction philosophy and effectiveness:
Harm Reduction Philosophy:
- The goal of harm reduction is to use practical strategies intended to reduce negative consequences that result from drug use. Additionally, the harm reduction movement has pushed for social justice for the rights of individuals who use drugs.
*For more information about harm reduction, please visit here.
Overdose Education and Naloxone Distribution (OEND) Effectiveness:
Below are descriptions and links to a small subset of the research conducted on the effectiveness and impact of OEND initiatives:
- Those who received naloxone rescue kits as part of OEND had higher rates of calling 911, administering naloxone, and staying with the victim until help arrived than those who did not receive naloxone (Dwyer et al., 2015)
- Providers/staff have a generally positive reception of the program (Samuels, 2014), which is a shift compared to past surveys (Beletsky et al., 2007).
- Community naloxone distribution reduces overdose at a population level, increases preparedness to respond effectively (Walley et al., 2013), but does not increase levels of drug use (e.g., Dwyer et al., 2015).
- Conducting OEND with chronic pain patients on opioids reduces opioid-related ER and hospital visits and overdose events at 6 months and 1 year post intervention, with opioid dosage levels remaining stable(Coffin et al., 2016)
For information on opioid overdose prevention and education:
- Access the SAMHSA Opioid Overdose Toolkit
- Review the Opioid Overdose Basics including recognizing an opioid overdose, responding to an opioid overdose, and risks and prevention strategies
- Visit StopOverdose to learn about opioid overdose and naloxone
- Access information on overdose prevention and naloxone access
- Review information on Safe and Effective Opioid Prescribing
To learn more specific to harm reduction philosophies and approaches, we suggest visiting the following sites:
- Drug Policy Alliance – Harm Reduction
- Harm Reduction Coalition
- Open Society Foundations
- Video – Example of peer-to-peer harm reduction work in Baltimore
Not all people with a substance use disorder are ready for treatment or have access to treatment. The video below shows the importance of making realistic plans with people who use drugs for how to prevent overdoses:
The video below talks about some positive changes a person with substance use disorder can make to stay healthy and stay alive:
One specific harm reduction strategy is the distribution of naloxone (an overdose reversal medication) to aid in the prevention of fatal overdoses. For information on naloxone:
- SAMHSA- naloxone
- Naloxone Resources and Training Materials
- Naloxone Prescribing
- For specific information about Narcan, see the FDA approval for Adapt Pharma’s Narcan nasal spray and the official Narcan Nasal Spray website with detailed information on the device
For information about overdose prevention among veterans through the national VA Overdose Education and Naloxone Distribution program, please see the following: OEND Fact Sheet and OEND: Preventing and Responding to an Opioid Overdose Presentation
For Overdose Education and Naloxone Distribution (OEND) literature, visit the following sites:
- Opioid overdose prevention and naloxone rescue kits: what we know and what we don’t know
- No evidence of compensatory drug use risk behavior among heroin users after receiving take-home naloxone
- Prescribe to Prevent for monthly OEND articles
Information provided on this site is not intended to cover everything –there are many places to find helpful information about overdose prevention and harm reduction.