Harm Reduction in South Jersey
Harm reduction is a fundamental approach in caring for people who use drugs. This framework was originally developed by individuals who use drugs and engage in sex work, but because of its effectiveness has been adopted by community organizations, governmental services, and health care providers. Harm Reduction tools and techniques have been proven to increase the quality of life of users of drugs, slow the spread of diseases such as HIV or hepatitis, and reduce the overall number overdose deaths. This is an evidence-based approach that betters the health of an entire community while promoting the dignity of those who use drugs.
Harm reduction approaches and resources span from community settings to inpatient services.
Community Settings
Community groups are often the primary providers of harm reduction education, materials, and services, filling gaps between the existing health care systems and community need. There are many groups across South Jersey working to lessen the negative health impacts caused by drug use, while supporting those who use drugs and connecting them with resources. These community groups provide safe, non-stigmatizing and trauma-informed spaces for drug users to obtain safe and sterile equipment and overdose reversal agents, safely dispose of used equipment, and access services to treat substance use disorders and prevent the transmission of blood-borne and sexually transmitted diseases.
Drug-testing materials
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Fentanyl test strips can be obtained from harm reduction centers. Also, the New Jersey Harm Reduction Coalition will mail fentanyl testing kits to those who request via its website.
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New Jersey recently legalized the distribution of xylazine testing materials. Please contact your local Harm Reduction Center for availability.
Harm Reduction Centers/Syringe Service Programs
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Several programs in NJ provide a wide range of services including, but not limited to, the provision of new, unused hypodermic syringes and other sterile injection drug supplies, such as cookers, tourniquets, alcohol wipes, sterile water/saline, and sharps waste disposal containers.
These are organizations across the state that offer syringes and other harm reduction materials. A list of these HRCs can be found here.
Outpatient Clinical Settings
There are several ways outpatient or primary care offices can encourage harm reduction practices. These are often the first access points to care for people struggling with substance use, and play a crucial role in keeping individuals engaged in care.
Treating Opioid Use Disorder
The Substance Abuse and Mental Health Services Administration has a comprehensive guide for prescribing buprenorphine for opioid use disorder for providers in the primary care setting.
All practitioners who have a current DEA registration that includes Schedule III authority may now prescribe buprenorphine for OUD.
Overdose Prevention
Prescribe opioid overdose reversal medications (e.g. intranasal naloxone) to patients who use substances or are prescribed opioids
Educate patients on signs of overdose and how to administer opioid overdose reversal medications
Other Harm Reduction Informed Policies
Avoid an “abstinence only” approach
Celebrate incrementalism and progress
Avoid prescriptions contingent on abstinence or negative urine drug screens
Avoid stigmatizing language
Provide exible, low-barrier treatment services
Consider service in non-traditional settings (e.g. mobile, home or community visits)
Offer telehealth options when appropriate
Engage people with living and lived experience (e.g. peer specialists). Ask people what they are seeing in their community, how people are responding to new drugs or trying to prevent overdoses, and get their input on your clinic approaches and operations.
Urine Drug Screening: Providers can shift urine drug screening from a punitive strategy to monitor patient behavior, allowing for an opt-in policy that gives patients the opportunity to see what substances may be in their drug supply (xylazine, benzos, etc).
Practice trauma-informed care.
Refer patients to community partners and consider distributing supplies such as:
Fentanyl and/or xylazine test strips
Ensure that if patients are ‘discharged’ or choose to leave the program due to ongoing use, they have information about their local harm reduction center for ongoing access to syringes and/or wound care.
Inpatient Clinical Settings
⦿ Use warm handoffs between inpatient and outpatient teams for patients with SUDs who are being admitted
⦿ Appropriately manage pain and withdrawal
⦿ Do not stop buprenorphine unnecessarily during hospital stays
⦿ Use short-acting opioids for withdrawal
⦿ Confirm methadone doses quickly
⦿ Maximize multimodal analgesia for pain control (e.g. NSAIDs, acetaminophen, lidocaine patches)
⦿ Offer nicotine replacement
⦿ Avoid unnecessary precipitated withdrawal caused by naloxone use if a sedated patient has good respiratory rate and SpO2
⦿ Discourage stigmatizing language
⦿ Make patient stays less carceral
⦿ Minimize visitor and movement restrictions
⦿ Avoid unnecessary urine toxicology and obtain all needed toxicology with patient consent
⦿ Use security and police as a last resort for difficult behavioral issues
⦿ Prepare for a safe discharge
⦿ Have a patient-direct discharge plan, including alternatives for IV antibiotics
Links to key partners
New Jersey’s Harm Reduction Centers provide safe, stigma-free access to sterile syringes and other harm reduction materials such as fentanyl testing strips. HRCs in New Jersey are also staffed by Access to Reproductive Care Nurses (ARCH Nurses) who can test for HIV and hepatitis with connection to additional counseling and medical care.
Founded in 2017, NEXT Distro is an online and mail-based harm reduction service. This group will mail naloxone, fentanyl testing strips, or other harm reduction supplies to people or organizations across the nation.
This group is New Jersey’s statewide community naloxone distribution program and distributes this life-saving medication through the mail and various in-person settings. The NJHRC also provides training on naloxone administration and overdose response.
Imperfect Village provides harm reduction supplies, including sterile syringes, to various sites across Burlington County.