Public Health Approaches to Overdose Prevention and Harm Reduction

Abstract

Harm reduction aims to reduce the negative consequences of drug use in people unable or unwilling to stop. This chapter focus on harm reduction policies, programs, and practices that have been employed in Vancouver, British Columbia, including the controversial introduction of supervised injection sites. Using data from the Vancouver experience, the authors describe successful harm reduction efforts that have resulted in no overdose deaths in Vancouver’s supervised injection facilities. The authors stress that harm reduction approaches are meant to be complementary to prevention and treatment approaches, acknowledging that it is not currently possible to prevent or treat all cases of problematic substance use and also that addiction is a relapsing chronic condition. Other harm reduction strategies include drug checking and alerting, take-home naloxone, injectable therapies, hydromorphone distribution, and peer engagement.