Researchers: Primary care can advance efforts to reduce drug harm

A team of researchers examined how best to achieve the public health goal of harm reduction for active drug users (people who use drugs, or PWUDs). The team concluded that community health centers are best positioned to improve outcomes for PWUDs.

Writing in the Forefront section (comment) by Health matters online on September 17, researchers Mia Shenkman and Tonantzin E. Juarez write in “Health Centers Are Uniquely Positioned To Facilitate Harm Reduction's Integration Into Primary Care”: “With overdose deaths rapidly rising and the Centers for Disease Control and Prevention (CDC) reporting 107,941 drug-related overdose deaths in the United States in 2022, public health officials are increasingly advocating harm reduction as a legitimate strategy to address this crisis. Common harm reduction strategies include syringe service programs (SSPs), safer injection facilities, overdose prevention initiatives and medications for opioid use disorder (MOUD), as well as relational components such as non-judgmental, non-coercive service delivery.

The authors point out that the Biden-Harris administration already incorporated harm reduction into its overdose prevention strategy two years ago by allocating $30 million in federal grants for the distribution of Narcan, fentanyl test strips and harm reduction research. This move, they say, has elevated the status of people who use drugs (PWUD) as “individuals battling a chronic illness who clearly deserve access to compassionate, nonjudgmental care – representing a radical departure from traditional medical models.”

Importantly, the researchers write, “Health centers (HCs) are uniquely positioned to advance the integration of harm reduction into primary care. Not only are the populations served by HCs disproportionately affected by the overdose crisis, but these health centers already share common values ​​with harm reduction—including their leadership in providing holistic, integrative care with a historic interest in community engagement. Yet much work remains to be done.” The researchers emphasize that programs like the one at the Center for Key Populations (CKP) in Connecticut, which is embedded in a health center, are reducing barriers to care. Ultimately, they conclude, health care providers must create a culture of destigmatization and harm reduction.