Working Together to Reduce Harm and Improve Safety for People Who Use Substances (2025-2026 Recording)-Working Together to Reduce Harm and Improve Safety for People Who Use Substances Recording

Video Transcription

Video Summary

The session focused on harm reduction in addiction medicine and how clinicians can reduce risk and improve safety for people who use substances. Dr. Alexander Wally defined harm reduction as practical, evidence-based strategies that minimize harms without requiring abstinence, emphasizing that abstinence is not a prerequisite to care and that any positive change counts.<br /><br />He reviewed the scale and evolution of the overdose crisis in the U.S., including the four waves: prescription opioids, heroin, fentanyl, and now fentanyl mixed with stimulants. He highlighted inequities in overdose burden across racial and ethnic groups and noted the encouraging but still-unexplained drop in opioid overdose deaths in 2024.<br /><br />Major harm reduction strategies discussed included syringe service programs, naloxone distribution, overdose safety planning, compassionate overdose response, supervised consumption/overdose prevention sites, virtual spotting services like SafeSpot, and fentanyl/drug checking. He stressed that naloxone is essential but not sufficient, especially for people using alone, and advocated for patient-specific safety plans that include using with others, taking turns, carrying naloxone, and checking the drug supply.<br /><br />The second half featured a panel of people with lived and professional experience in recovery and harm reduction. They discussed how lived experience helps them connect with patients, the importance of humility, avoiding stigma, and the need to meet people where they are. They also addressed inequities affecting Black, Brown, and Indigenous communities, and shared innovations they are excited about, including telehealth/Zoom recovery meetings, expanded methadone access, SafeSpot, and more inclusive workplace policies. The session ended with a SafeSpot demo and a reminder that harm reduction should be integrated into all addiction care.

Keywords

harm reduction

addiction medicine

overdose crisis

naloxone

syringe service programs

supervised consumption sites

fentanyl

drug checking

overdose prevention

substance use

recovery

stigma reduction

lived experience

telehealth recovery meetings

methadone access