Nov. 6, 2023 – The growing enthusiasm for harm reduction, both as a philosophy and in its practical applications like overdose prevention centers and needle exchanges, may lead to these initiatives expanding more rapidly than our capacity to adequately research and sustainably integrate them.

In early 20th century America, a trend-driven movement arose and dissolved around American alcohol asylums, when facilities reported impressive recovery rates that did not reflect reality. The overstatement of the abilities of treatment facilities resulted in widespread skepticism and a growing pessimism about the entire addiction treatment system, which ultimately propelled national policies towards the criminalization of substance use.

Harm reduction programs may similarly be overstating their promises, as interventions lack the diversity of voices and range of research settings we see available for other evidence-based interventions for addiction. A systematic review conducted in 2022 concluded that existing qualitative literature lacks “the perspectives of safe consumption site staff and other community members who might be able to provide additional insight into factors influencing the implementation and sustainability of this promising public health intervention.”


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