Harm Reduction: Supporting the Safer Use of Substances

Apr 24, 2023

Harm reduction is a range of options or practices that an individual or a community can employ to reduce the negative consequences of substance use. Harm reduction is also a movement for social justice built on a belief in, and respect for, the rights of people who use substances.

The effect of substance use disorder on New Hampshire.

two people hugging smilingThe introduction of fentanyl into the drug supply has been a game changer in how we prevent overdoses. More people are focusing on practical strategies and ideas to keep people who use drugs engaged, safe, and alive while minimizing the harm resulting from substance use. In New Hampshire (NH), and across the country, there is an urgent need to reach out to people who are experiencing substance use and offer them hope and options around safe use, treatment, and recovery.

It is a sad reality that few people with substance use disorder (SUD) receive the care or treatment they need. This calls on all of us to be prepared with strategies that can help individuals who use substances keep themselves and others safe and alive until they are ready for treatment.

NH has a strong and caring network of nonprofits and community-based groups.

Peer recovery, harm reduction, and other essential services are available to all individuals that are vulnerable. Organizations are working together to reduce the negative consequences of substance use by providing options such as naloxone, sterile syringes, and housing.

nh harm reduction coalition logoThe Power of Prevention Podcast talked with Phoebe Axtman, Director of Education with the NH Harm Reduction Coalition (NHHRC) in our recent podcast, ‘Harm Reduction: Supporting the Safer Use of Substances’. NHHRC is a statewide organization dedicated to the implementation of public health strategies that reduce the harms associated with drug use. Phoebe’s primary role is to educate NH residents on the importance of harm reduction and apply evidence-based practices for preventing overdose.

“I look at prevention as meeting the needs of an individual and preventing disease and death and thinking about harm reduction, really sitting in that third tier of prevention. Providing people with the information on how to ensure safety will not increase their drug use. It’s just going to make things safer for them,“ says Phoebe.

Harm reduction keeps people alive and safe, and it doesn’t encourage substance use.

Whether someone uses drugs occasionally, regularly, or never, having options to keep yourself safe, healthy, and well is important. The concept of harm reduction can be difficult to understand, and for some, the concept brings up resistance, misunderstanding, and stigma.

“There’s a common misconception that providing these life-saving tools are going to encourage people to use drugs and enable them,” said Phoebe. “I think it’s important to point out that naloxone is legal to carry, and it’s a really simple thing to implement properly. Even if you don’t use drugs, having access to naloxone as a member of your community is important. There are people around you, your friends, family, who might be using drugs. Your neighbor might be using drugs. You might be taking your dog for a walk and come across someone who’s overdosing. And not having naloxone with you means that you can’t save that person’s life. So I do stress that it is really important to carry. Access to naloxone does not increase the amount or frequency that someone is using drugs. It is just a best practice in saving people’s lives.”

A key tenet of the harm reduction approach is to accept a person unconditionally where they are in terms of their drug use with no expectations or assumptions for treatment. The goal is to keep the person alive. Harm reduction is an important public health strategy that can be safely implemented in every community.

It’s never too early to start the conversation with the young adults in your life.

“Simply telling a kid to just say no is taking a lot of beneficial conversation out of the picture,” Phoebe explained. “I think there are a lot of things that we can talk with youth about in case they’re faced with this social dilemma of being offered drugs or the opportunity to use drugs. What are things that you would want them to know to prevent them from dying?”

Explore more on the topics and themes discussed in this episode:

  • Never Use Alone is a free phone service where a real person stays on the line to help a person use substances safely. The number to call is 1-800-484-3731.
  • SAMHSA: Preventing, Recognizing, and Treating Opioid Overdose
  • 2-1-1 NH is a comprehensive source of information about local resources and services to help you take care of yourself.
  • Drug Policy Alliance provides the Safety First, Real Drug Education for Teens, which is the nation’s first harm reduction-based drug education curriculum for high school students.


Phoebe Axtman

Phoebe Axtman HeadshotPhoebe is the Director of Education for the NH Harm Reduction Coalition. Her primary role is educating NH residents on the importance of harm reduction, and how to apply evidence-based practices for preventing overdose. Phoebe transitioned into substance use treatment because of the high need for co-occurring therapists and her personal interest. Now a Licensed Independent Social Worker (LISW) and Master’s Level Drug and Alcohol Counselor, she is passionate about providing ethical and compassionate care to people at high risk and in need.

The Power of Prevention PodcastThe Power of Prevention Podcast provides important information about the prevention of alcohol, tobacco, and other substances. Produced by The Partnership @drugFreeNH, each episode features some of the great work taking place in the Granite State in the prevention arena. The Power of Prevention Podcast series is available on Stitcher, Apple Podcasts, Spotify, and Google Podcast, or at The Partnership @drugfreeNH’s website. You can subscribe to the series wherever you listen.

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