Notes on harm reduction and the opioid epidemic in the United States

Don C. Des Jarlais, Jonathan Feelemyer, Hayley Berg, David C. Perlman

Research output: Chapter in Book/Report/Conference proceedingChapter


In this chapter, we present notes on the harm reduction approach to drug use with special focus on the current opioid epidemic in United States. Harm reduction is the most recent, and we believe the most effective, framework for addressing the problems of psychoactive drug use in large, complex societies. Harm reduction arose in opposition to previous perspectives on psychoactive drug use, including an ethnocentric condemnation of people who use certain types of drugs, and an insistence that persons with problematic drug use should not use any psychoactive drugs, including medications. We then examine specific principles of current harm reduction. Harm reduction addresses both illicit and licit drugs, which is vital given the recent prescription opiate epidemic in the United States. Harm reduction incorporates scientific knowledge about drugs. Harm reduction is continuously evolving. We then present an historical timeline for major events in the development of harm reduction in the United States. Finally, we discuss harm interventions for addressing the current opioid epidemic and provide tips for healthcare providers for working with people who use drugs.

Original languageEnglish (US)
Title of host publicationThe Opioid Epidemic and Infectious Diseases
Number of pages10
ISBN (Electronic)9780323683289
ISBN (Print)9780323683296
StatePublished - Jan 1 2020


  • Harm reduction
  • Opioid epidemic
  • Persons who inject drugs
  • Persons who use drugs
  • United States

ASJC Scopus subject areas

  • General Medicine


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