Harm Reduction: How to Recognize, Respond to, and Prevent an Overdose

In 2023, there were more than 100,000 drug overdose deaths in the United States. Opioids – specifically synthetic forms such as fentanyl – were responsible for the highest percentage of those deaths. Opioid use disorder (OUD) is a national and worldwide problem, affecting millions of people and their loved ones.^1,2

Opioids are a type of drug that is used to relieve pain. These drugs can also bring about a sense of euphoria. They are highly addictive. When misused, opioids can lead to tolerance, dependence, and addiction.³

Studies show that people who have had at least 1 overdose are more likely to have another one. Preventing overdose through harm reduction practices is essential in the fight against the opioid epidemic.¹

Harm reduction is about keeping people safe. It focuses on reducing risks and saving lives, especially when it comes to drug use. Understanding harm reduction can help communities stay safe and reduce the risk of overdose.²

Recognizing and responding to an overdose

An overdose happens when someone takes too much of a drug and their body cannot handle it. Signs of an overdose can include:¹

• Slow or stopped breathing
• Pale, clammy, or bluish skin and lips
• Unresponsiveness or unconsciousness
• Gurgling or choking sounds
• Small, pinpoint pupils

If you think someone has overdosed, act quickly. Call 911 immediately. Tell them someone is not responding and may have overdosed. Try to stay calm and follow the 911 operator’s instructions.¹

If it is available, give the person naloxone (Narcan®). Naloxone is an opioid overdose reversal drug. It can be life-saving in the event of an opioid overdose. It is safe and easy to use.¹

Stay with the person. Keep them awake if possible. Roll them onto their side to prevent choking.¹

Narcan accessibility

Naloxone saves lives. It can reverse an opioid overdose in minutes. Naloxone is available as an injectable or as a nasal spray. Many states allow people to buy naloxone over the counter, without a prescription. More and more places are making it available for free at local health departments and community clinics.⁴

The nasal spray is very easy to use. Simply spray the medicine into 1 nostril while the person lies on their back. More than 1 dose may be necessary to reverse the overdose in cases where large amounts of the substance were ingested.⁴

If you or someone you care for is using opioids – even prescribed ones – consider keeping naloxone nearby. Some states require doctors to prescribe naloxone to people taking high-dose opioids or those in pain management programs. Find out how to get naloxone where you live.⁴

Testing materials

Drug testing materials can help people know what is in the substances they are using. Fentanyl test strips are a common example. They allow people to check for fentanyl, a powerful synthetic opioid. Fentanyl is often mixed with other drugs without a person’s knowledge. Testing materials are:²

• Affordable
• Easy to use
• Widely available in harm reduction programs

Using test strips can help prevent accidental overdoses. Always encourage others to use these tools when possible.²

Safe injection sites and needle exchange programs

Safe injection sites and needle exchange programs are critical parts of harm reduction. Research has proven that safe injection sites and needle exchange programs do not lead to increased drug use or crime. Rather, they:⁵

• Save lives by preventing overdose
• Reduce HIV and hepatitis C transmission and injection-related infections
• Increase access to medical and social services
• Keep communities safer
• Save money by reducing the need for emergency medical services

Safe injection sites

Safe injection sites provide a clean, supervised space for drug use. They are also called supervised consumption services. These sites reduce deaths and connect people to care. Staff are trained to respond to overdoses and offer health services.⁵

Needle exchange programs

Needle exchange programs allow people to trade used syringes for clean ones. This helps prevent the spread of diseases like HIV and hepatitis C. It also helps people avoid injection-related infections.⁵

Many programs and harm reduction sites provide free naloxone, test kits, and information about treatment options. Find harm reduction services near you.

Destigmatizing harm reduction resources

Stigma prevents people from getting the help they need. Many people fear judgment or punishment for seeking harm reduction services. This can lead to delayed OUD diagnosis, more overdoses, and serious health problems.¹

Harm reduction is not about promoting drug use. It is about keeping people alive and healthy. As long as people are alive, they can seek treatment. Destigmatizing harm reduction means:^2,5

• Speaking openly and kindly about these resources
• Providing non-judgmental health and medical treatment
• Supporting laws and policies that increase access
• Educating others about the benefits of harm reduction

How you can help

Harm reduction works. It saves lives, improves health, reduces stigma, and builds stronger communities. Here is how you can help:^2,5

• Learn how to use naloxone, and keep it on hand.
• Support harm reduction programs in your area.
• Share information about testing materials and safe injection sites.
• Treat everyone with compassion, empathy, and respect.