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HARM REDUCTION TOOLKIT


Harm reduction is a treatment and prevention approach that encompasses individual and public health needs, aiming to decrease the health and socio-economic costs and consequences of addiction-related problems without necessarily requiring abstinence.1 The rise of the opioid overdose epidemic has prompted many policymakers to consider legislation to implement and expand harm reduction strategies such as naloxone access, syringe exchange, and interventions to reduce transmission of infectious diseases.

ASAM advocates on the national and state levels in support of evidence-based harm reduction strategies. Below you will find information and resources to help you advocate for policies to expand evidence-based harm reduction strategies.


NALOXONE

Drug overdoses are the current leading cause of accidental death in the U.S., having surpassed traffic fatalities. Opioid addiction is driving this epidemic. In 2016, there were 63,632 lethal drug overdoses, with 19,413 related to synthetic opioids and 15,469 related to heroin. Naloxone is an FDA-approved opioid antagonist that can reverse the effects of an opioid overdose, thus saving the life of the overdose victim when administered in time. Use these resources to advocate for providing opioid overdose education and naloxone to persons who use drugs and who might be present at an opioid overdose in order to reduce opioid overdose mortality. 


Relevant ASAM Policy Statement

 

Public Policy Statement on Use of Naloxone for the Prevention of Drug Overdose Deaths

Learn more about ASAM's recommendations and broader policy position regarding naloxone use and access.
 

Resources

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The ASAM National Practice Guideline

The ASAM National Practice Guideline and associated resources provide information on evidence-based treatment of opioid use disorder and the use of naloxone to prevent opioid overdose deaths.

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Naloxone Overdose Prevention Education (NOPE) Working Group: Naloxone Legislation Drafting Guide

Created by the Naloxone Overdose Prevention Education (NOPE) Working Group, this resource outlines key regulations and provisions to include in state or federal legislation to increase access and use of naloxone.

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Surgeon General’s Advisory on Naloxone and Opioid Overdose

This advisory issued by the Surgeon General encourages more individuals, including family, friends, and those at risk for opioid overdose, to keep on hand naloxone, an FDA-approved medication that can reverse opioid-induced respiratory depression.


INFECTIOUS DISEASES

HIV

According to the National Institute on Drug Abuse (NIDA), human immunodeficiency virus (HIV) is the virus that causes acquired immune deficiency syndrome (AIDS) and is transmitted through contact with infected blood and bodily fluids. Drug abuse and addiction have been inextricably linked with HIV/AIDS since the beginning of the epidemic. While intravenous drug use is well known in this regard, less recognized is the role that drug abuse plays more generally in the spread of HIV by increasing the likelihood of high-risk sex with infected partners. Nearly one-quarter of AIDS cases stem from intravenous drug use, and one in four people living with HIV/AIDS in the period of 2005 - 2009 reported use of alcohol or drugs to an extent that required treatment. Drug abuse and addiction can also worsen the progression of HIV and its consequences, especially in the brain. For example, in animal studies, methamphetamine increased the amount of HIV virus present in the brain; and in human studies, HIV caused greater neuronal injury and cognitive impairment in methamphetamine abusers compared to non-drug users.

Hepatitis C

According to NIDA, hepatitis C is a viral disease that destroys liver cells, and is the most common blood-borne infection in the United States. People become infected with the hepatitis C virus (HCV) through direct contact with an infected person's blood. Injecting drug users (IDUs) contract hepatitis C by sharing contaminated needles and other drug injection paraphernalia. Although this contact can occur in a number of ways, injection drug use now accounts for at least 60 percent of HCV transmission in the United States, according to the Centers for Disease Control and prevention (CDC). Because HCV is highly transmissible through the blood, anyone who has ever injected drugs is at risk for liver disease and should be tested for the virus.


Relevant ASAM Policy Statement

 
HCV

Hepatitis C Infection

Learn more about ASAM's recommendations regarding the prevention, treatment, and insurance coverage of HCV.

 

Resources

DrugFacts: HIV/AIDS and Drug Abuse: Intertwined Epidemics

This resource created by the National Institute on Drug Abuse (NIDA) provides background information on the link between substance use and HIV transmission as well as other infectious diseases.

HIV Basics 

The Centers for Disease Control and Prevention (CDC) created this resource to provide education on what HIV/AIDS is, how it is transmitted, and the proper treatment.


Viral Hepatitis—A Very Real Consequence of Substance Use

This resource created by the National Institute on Drug Abuse (NIDA) provides background information on the link between substance use and viral hepatitis.


Recommendations for Testing, Managing, and Treating Hepatitis C

The American Association for the Study of Liver Diseases (AASLD) and the Infectious Diseases Society of America (IDSA) have developed a web-based process for the rapid formulation and dissemination of evidence-based, expert-developed recommendations for hepatitis C management.

Sources
1 American Society of Addiction Medicine. Public Policy Statement on Terminology Related to Addiction, Treatment, and Recovery. Rockville, MD: American Society of Addiction Medicine; 2013.