Harm Reduction Strategies for Opioid Use

Opioids have been involved in most overdoses in the United States over the past several years. These include heroin, morphine, prescription opioids (e.g., Percocet, Oxycontin, Vicodin) and synthetic opioids like fentanyl. While you may wish that your loved one not use opioids at all, if they do, here are some harm reduction strategies for opioid use that you can share with them to reduce their risk of illness and death.

Fentanyl test strips

Fentanyl test strips are paper strips used to detect the presence of fentanyl, a deadly synthetic opioid, in injectable substances, powders and pills. They are used by dipping a strip into a mix of water and the substance and will indicate whether fentanyl is present or not.

Use clean and sterile needles

Using clean needles when using injecting opioids can help prevent infection and the spread of diseases like HIV. Most states have legal or locally permitted needle exchange sites where people can trade in their old needles for clean ones. Organizations like NEXT Distro can mail supplies to your loved one if needed.

Safe consumption sites

There is a service in New York City where people can use the substances they bring under the safety and support of trained personnel. They also offer other services that can improve a loved one’s wellbeing.  Many people are advocating to offer these services in other parts of the country.

Don’t use alone

Using substances with others is always better than being alone in the event of an overdose. Encourage your loved one to be with individuals they trust whenever possible. If using substances alone, support apps like the Brave App or Canary can virtually alert another person if help is needed. There is also a free service called Never Use Alone that a loved one can call and their volunteers will stay on the call as long as needed to ensure safety.

Additionally, if using opioids in a group, try to stagger use so that there is always someone sober enough to recognize signs of overdose.

Safe smoking kits

Safe smoking kits include clean smoking supplies like:

• New glass stems and pipes
• Alcohol wipes to clean hands, injection sites and used products
• Plastic mouth pieces to prevent burning from a pipe or other smoking device
• ChapStick or Vaseline to soothe lips and prevent chapping and open sores

Provide oxygen

When someone is overdosing on opioids, they require oxygen. Learn how to do rescue breathing and chest compressions in the event of an overdose.

It is also possible to purchase cans of oxygen over-the-counter (product examples include Boost Oxygen, which can be purchased at drugstores). This can help provide someone with additional oxygen in the immediate aftermath of an overdose.

Go slow

It is always best to test one’s reaction to a substance before using more of it, especially given many substances are filled with worrisome cutting agents or other chemicals. Using a smaller amount of opioids at a slower pace is always safer than doing them in large quantities. It is also good to use it less after periods of not using it or when feeling sick.

Moderation strategies

Many people who use opioids may not have an interest in stopping completely but might be willing to cut back. It’s possible they might be open to stopping opioid use but may continue to use substances with a far smaller overdose risk like marijuana.

Don’t mix substances

Mixing opioids with other substances can cause an overdose, which can lead to serious illness and even death. This includes legally prescribed medications like benzodiazepines (e.g., Xanax, Valium, Klonopin). Encourage them to check with a healthcare provider to learn about negative drug interactions.

Use PrEP

HIV can be easily contracted through the use of shared needles and other products. PrEP is a highly effective prevention medication for people at risk of getting HIV.

Carry naloxone (e.g., Narcan)

Naloxone, usually known by its brand name Narcan, can reverse an opioid overdose. Encourage your loved one and everyone around them to carry it.  It is available over the counter and for free from many community organizations. Click here to learn how to administer it.

Medications

Medications to treat opioid use disorder can help your loved one reduce or stop their use. These include naltrexone, buprenorphine and methadone. They are the most effective way to treat opioid use disorder as part of a complete treatment plan. Your loved one may also be interested in wearable ear devices that can reduce withdrawal symptoms. They may also respond better to treatments like the Bernese Method, where buprenorphine is administered in gradually increasing amounts while the patient tapers off of opioids. You can learn more about them here.

Safeguard medications

If you are medically prescribed an opioid, be sure to keep it out of sight and safely secured. When you are done, you can safely dispose of them.

Remember that any step to reduce the risks of opioid use is a step in the right direction.