AD-vice: Transforming Healthcare Through Harm Reduction

Curated by: Aanchal Gupta, Program Coordinator, NaRCAD

Tags: ADvice, Harm Reduction

​Harm reduction has gained significant traction, especially as an area of focus in AD, with campaigns encouraging clinicians to provide preventive care, discuss harm reduction services with their patients, and connect their patients to related community initiatives. In this edition of AD-vice, we explore the evidence supporting harm reduction strategies, the broader approach that shifts the narrative from stigmatization to inclusivity, and the crucial role of clinician-patient communication. 

EVIDENCE & IMPACT OF HARM REDUCTION STRATEGIES

• “Various harm reduction approaches have been proven to prevent overdose and death, injury, infectious disease transmission, and substance misuse. There is nearly 30 years of research that has shown that syringe services programs decrease transmission of viral hepatitis, HIV, and other infections.” - Anna Morgan-Barsamian, NaRCAD
  
  
• “There are tons of examples of harm reduction that are built into everything we do. Seatbelts, masks, fire escapes, smoke detectors, vaccines, and the FDA regulatory agency are all forms of harm reduction. As a society, we’ve never looked at substance use through this lens because using drugs is so stigmatized.” - Shuchin Shukla, North Carolina Technical Assistance Center

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HARM REDUCTION APPROACH

• “Harm reduction offers a powerful framework that facilitates a shift within communities that moves away from moralization and stigmatization of individuals who use drugs. It’s easy to blame individuals for their behavior, but it’s far more challenging to critically reflect on how systems and decisions put people in those circumstances in the first place.” - Adriane Apicelli, University of New Hampshire, College of Health and Human Services

 

• “We’re reducing harm, saving lives, and preserving a sense of family and community. When we reduce harm, we allow a mom to be a part of her family again, we allow her to get a job, we allow her to get off the street and out of harm’s way. Harm reduction can allow people to return home.” - Lindsey C. Beardsley, Individual in Recovery

 

• “Communication and empathy are two huge pieces to consider with this topic. We spent a lot of time asking clinicians about the conversations they have with patients and the types of questions they ask about substance use. We really wanted to understand what was going well and where there were gaps that we could help fill with resources and support.” - Meghan Breckling, University of Arkansas for Medical Sciences

 

• “With this topic, paying attention to the emotions of the clinician you're detailing and acknowledging those emotions before jumping into your key messages is much more important than any other topic I’ve worked on. Be patient and empathetic – every visit counts toward making a change.” - Shuchin Shukla, North Carolina Technical Assistance Center

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CLINICIAN-PATIENT SUPPORT & COMMUNICATION

• “Clinicians need to have open, non-judgmental, inclusive discussions. That starts with asking all patients about their mental health and substance use history. Educators can provide clinicians with scripting tools if they feel uncomfortable having these conversations.” - Lindsey C. Beardsley, Individual in Recovery

 

• “We provided clinicians with screening tools to help identify patients with mental health conditions and SUD to determine who could benefit from additional services. We even created a local resource guide for clinicians to easily connect patients to community services. The clinicians found that these accessible tools helped them have open conversations with patients.” - Meghan Breckling, University of Arkansas for Medical Sciences

 

• “Patients seem grateful that I approach conversations in a straightforward way that doesn’t stigmatize their use of drugs. I’ve never had a patient be offended or confused about why I was talking to them about harm reduction. Their eyes usually widen when I ask them things like how they use their drugs, how they cook their drugs, or where they get their drugs from.” - Shuchin Shukla, North Carolina Technical Assistance Center

 

• “… peer support in the plan of care can help take some of the stress off of the clinician. This can include reviewing community resources and continuing the conversation with patients, while also educating the clinician on substance use through sharing personal experiences.” - Lindsey C. Beardsley, Individual in Recovery

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We hope these insights inspire you to consider harm reduction approaches in your detailing work. If you’re interested in learning more, join us at our 2nd annual AD Virtual Summit where we will dive into these areas further!
 
​Best,
The NaRCAD Team