Harm Reduction: Shifting from a War on Drugs to a War on Drug‐​Related Deaths, Policy Analysis By Jeffrey A. Singer

The U.S. government’s current strategy of trying to restrict the supply of opioids for nonmedical uses is not working. While government efforts to reduce the supply of opioids for nonmedical use have reduced the volume of both legally manufactured prescription opioids and opioid prescriptions, deaths from opioid overdoses are nevertheless accelerating. Research shows the increase is due in part to substitution of illegal heroin for now harder‐​to‐​get prescription opioids. Attempting to reduce overdose deaths by doubling down on this approach will not produce better results.

Policymakers can reduce overdose deaths and other harms stemming from nonmedical use of opioids and other dangerous drugs by switching to a policy of “harm reduction” strategies. Harm reduction has a success record that prohibition cannot match. It involves a range of public health options. These strategies would include medication‐​assisted treatment, needle‐​exchange programs, safe injection sites, heroin‐​assisted treatment, deregulation of naloxone, and the decriminalization of marijuana. Though critics have dismissed these strategies as surrendering to addiction, jurisdictions that have attempted them have found they significantly reduce overdose deaths, the spread of infectious diseases, and even the nonmedical use of dangerous drugs.