By Andrea Orest, Public Health Educator, Cook County Public Health and Human Services 

Harm reduction happens every day when we wash our hands, wear a seat belt or bike helmet, use the sidewalk, or stay home when we’re sick. The basic premise of harm reduction holds for all these programs – there are inherent risks involved with any behavior, and there are interventions that, when followed, reduce these risks for those who choose to engage in the behaviors. This same concept can be applied to preventing stigma and risk around substance use as Harm Reduction Strategies.

Related: Cook County Connections: Avoiding Substance Misuse: Risk and Protective Factors

Harm Reduction Strategies regarding substance use require unconditional positive regard, an attitude of complete acceptance and love, whether for yourself or someone else. Nothing they do can give reason to stop supporting them or working with them. That doesn’t mean you accept every action they take, but you do accept who they are at a level deeper than surface behavior of substance use. The strategies are built on the belief in, and respect for, people who use substances. Harm reduction principles incorporate safer use, managed use, meeting people where they are at, and addressing conditions of use along with the use itself.

According to the National Harm Reduction Coalition, the following principles apply to Harm Reduction:

• Accepts that licit and illicit substance use is part of our world and chooses to minimize its harmful effects rather than condemn or ignore them. 
• Establishes quality of life and community life and well-being as the criteria for successful intervention and policies, not necessarily cessation of all substances.
• Ensures people who use substances and those with a history of use have a real voice in the creation of programs and policies designed to serve them.
• Recognizes that the realities of poverty, class, racism, social isolation, past trauma, sex-based discrimination, and other social inequalities effect both people’s vulnerability to and capacity for effectively dealing with substance-related harm.
• Understands substance use as a complex, multi-faceted phenomenon that encompasses a continuum of behaviors from severe use to total abstinence and acknowledges that some ways of using substances are clearly safer than others.
• Calls for the non-judgmental, non-coercive provision of services and resources to people who use substances and the communities in which they live to assist them in reducing harm.
• Affirms people who use substances themselves as the primary agents of reducing the harms of their use and seeks to empower them to share information and support each other in strategies which meet their actual conditions of use.
• Does not attempt to minimize or ignore the real and tragic harm and danger that can be associated with illicit drug use.

Because harm reduction requires that interventions and policies designed to serve people who use drugs reflect specific individual and community needs, there is no universal definition of or formula for implementing harm reduction.

Harm reduction supplies and services help to minimize the harmful effects of substance misuse.  Some of the supplies can include safe use education, distribution of overdose reversal medications such as Naloxone or Narcan, sterile supplies to reduce disease transmission, substance testing supplies such as Fentanyl and Xylazine test strips, sharps disposal and medication disposal kits, and nicotine cessation supplies. Services can include overdose reversal education and training, navigation of services between agencies that provide services, testing for HIV and hepatitis A/B, safe use locations, syringe exchange programs.

Cook County Public Health and Human Services and Grand Portage Human Services collaborate on offering harm reduction supplies to our local community. Supplies can include sterile syringes, Fentanyl and Xylazine test strips, Naloxone kits and Narcan. Naloxone training is available monthly, in collaboration with Cook County Higher Education, at no cost. 

Those seeking assessment and treatment for substance abuse for themselves, or a family member may access more information about where to start by contacting Cook County Public Health and Human Services at 210-387-3620 or Grand Portage Human Services at 218-475-2453.

In October of 2022 the Health Resources & Services Administration (HRSA) awarded $1,000,000 to the University of Minnesota, in partnership with The Grand Portage Band of Lake Superior Chippewa, Sawtooth Mountain Clinic and Cook County Public Health and Human Services (PHHS) to strengthen and expand substance-related disorder services including opioid use disorder prevention, treatment, recovery and harm reduction services in Grand Portage and Cook County. As part of this grant Cook County PHHS is inviting interested community members to join a recently formed Substance Misuse Prevention Coalition. A Substance Misuse Prevention Coalition is a group of individuals and organizations from various sectors of the community that work together to prevent or reduce substance use and its negative consequences in a community. This can be done by raising awareness, changing policies, providing education, and supporting treatment and recovery. The first meeting of the Substance Misuse Prevention Coalition is on March 19 at 1:00 p.m. on Zoom. If you are interested in learning more about this initiative, contact Andrea Orest, Cook County Public Health Educator, [email protected], 218-220-5536.

County Connections is a column on timely topics and service information from your Cook County government. Cook County – Supporting Community Through Quality Public Service.