Substance Use Disorders & Harm Reduction Programs


Drug abuse is one of the most troublesome societal issues in the modern world. Despite the decline of HIV/AIDS incidence across the globe, the number of people who contact the infection remains relatively high, with approximately 50,000 new annual cases in the United States alone (Kulikowski & Linder, 2018). The source of this issue, while linked with drug usage, is not caused by substances directly, implying the necessity to examine peripheral causes. The need for the reduction of the ongoing damage done to public health by drug abuse calls for the implementation of a more immediate solution than battling the addiction itself (Palumbo, 2019). As the phenomenon of substance abuse was studied further, issues accompanying this behavior appeared to be more damaging than the drug by itself (Moreira et al., 2019). Moreira et al. (2019) state that “drugs ceased being considered a central problem and abstinence was no longer the sole purpose of treatment” (p. 313). However, further studies are essential to determine a complete list of harmful effects, both physical, mental, and social, accompanying drug abuse. This essay examines the factors related to harm reduction programs, including their efficiency, promotion, and reception.

Main body

The articles chosen for this paper depict several crucial developments in harm reduction among people with substance use disorders and highlight the underlying causes for their efficiency. The studies also connect societal issues with medical ones to create a framework for harm reduction programs. Kulikowski and Linder (2018) argue that “an increased presence of public health leadership is essential in the implementation of NEPs and other harm reduction programs” (p. 50). At the same time, they recognize the challenges that prevent healthcare organizations in the United States from reaching the goals of these programs and attempt to prove the need for change.

Due to the history of this societal issue, it is essential to consider the influence of government initiatives related to drug abuse. One of the primary problems for self-harming behavior in people with a substance abuse disorder is the criminalization of drug consumption which started in the late 20th century (Moreira et al., 2019). It led to the stigmatization of drug users, who were left without proper medical assistance and whose issues were not within the scope of scientific studies.

As several policies implemented under the war on drugs remain, it is difficult for harm reduction programs to establish the proper infrastructure required to assist people with substance use disorders. As a result of this global campaign, no organization was able to create a supervised injection site (Kulikowski & Linder, 2018). At the same time, research shows that supervised injection sites do not cause any increases in drug use in their local areas (Kulikowski & Linder, 2018). The conflicting policies regarding this problem prevent healthcare organizations from achieving their full potential in helping drug users.

The benefits of harm reduction programs are largely underestimated and left out of the scope of drug addiction research, as it often targets rehabilitation through abstinence. Several studies have confirmed a positive impact of supervised injection sites on both individual and community health, as they lead to a more responsible behavior from drug users and better control of transmittable diseases (Kulikowski & Linder, 2018). The distribution of sterile needles and syringes significantly decreases the likelihood of HIV/AIDS and HCV transmission (O’Keefe et al., 2019). Additional training in harm reduction among medical personnel can improve community health on a large scale, especially among underserved populations (Kulikowski & Linder, 2018). Moreover, the widespread government support of harm reduction programs will reduce the tax expenditures on medical services for people who harm their health as a result of drug consumption in an inappropriate setting (Kulikowski & Linder, 2018). However, these benefits rarely outweigh the concerns regarding assistance in drug use.

There are numerous other barriers that prevent access to harm reduction programs. The establishment of such an initiative implies helping people who use illicit substances, which technically makes medical workers involved in these programs criminals (Moreira et al., 2019). Aside from legal concerns arising from government policies, there is a significant ethical concern in providing assistance with drug consumption due to the detrimental effects of these substances on one’s mental and physical health (Moreira et al., 2019). Therefore, the implementation of harm reduction programs must involve a coordinated effort from government law structures, healthcare organizations, and local communities across the country in order to make them accepted in society.


In conclusion, it is essential for the U.S. healthcare system to recognize the efficiency of harm reduction programs and promote this type of assistance for people with substance abuse disorders. Palumbo (2019) states that healthcare organizations need “to recognize the stigma surrounding substance abuse and the results of that stigma on caregiver attitudes” (p. 236). Humanizing practices toward drug users are necessary for the reduction of preventable diseases accompanying uncontrolled substance use. Educating people regarding the positive effects of harm reduction programs is a critical strategy in promoting healthier practices among people who suffer from substance abuse disorders.


Kulikowski, J., & Linder, E. (2018). Making the case for harm reduction programs for injection drug users. Nursing, 48(6), 46-51. Web.

Moreira, C. R., Soares, C. B., Campos, C. M., & Laranjo, T. H. (2019). Harm reduction: Trends being disputed in health policies. Revista Brasileira de Enfermagem, 72(suppl 3), 312-320. Web.

O’Keefe, D., Bluthenthal, R. N., Kral, A. H., Aitken, C. K., McCormack, A., & Dietze, P. M. (2019). Measures of harm reduction service provision for people who inject drugs. Bulletin of the World Health Organization, 97(9), 605-611. Web.

Palumbo, R. (2019). A call to action: Defining the acute care nurse’s role in harm reduction for persons with substance use disorder. Journal of Addictions Nursing, 30(4), 236-237. Web.