U.S. substance use harm reduction efforts: a review of the current state of policy, policy barriers, and recommendations

作者：Bailey Pridgen, Andrew Bontemps, Audrey R. Lloyd, William P. Wagner, Emma Sophia Kay, Ellen Eaton, Karen L. Cropsey · 发表于：Harm Reduction Journal · 年份：2025 · DOI：10.1186/s12954-025-01238-4 · 被引用次数：27 · 研究领域：Opioid Use Disorder Treatment、Substance Abuse Treatment and Outcomes、HIV, Drug Use, Sexual Risk

A wealth of research demonstrates that harm reduction interventions for substance use (SU) save lives and reduce risk for serious infectious diseases such as HIV, hepatitis C, and other SU-related health conditions. The U.S. has adopted several harm reduction interventions at federal and state levels to combat SU-related harm. While several policy changes on the federal and state levels decriminalized interventions and further support their use, other policies limit the reach of these interventions by delaying or restricting care, leaving access to life-saving interventions inconsistent across the U.S. Federal and state policies in the U.S. that restrict access to medications for opioid use disorder (MOUD), criminalize possession of drug paraphernalia, prevent syringe service programs and overdose prevention centers from operating, and limit prescribing of pre-exposure prophylaxis (PrEP) pose significant barriers to harm reduction access and implementation. This paper aims to bridge publications and reports on current state and federal harm reduction intervention policies and discuss policy recommendations. Federally, the DEA and SAMHSA should expand certification for methadone dispensing to settings beyond dedicated opioid treatment programs and non-OTP prescribers. Congress can decriminalize items currently categorized as paraphernalia, permit purchasing of syringes and all drug checking equipment using federal funds, amend the Controlled Substances Act to allow for expansi...