Integrating harm reduction conversations into primary care visits can help to provide education, resources, and support for behavioral change for the patient, their family, and their community. Patients are already considering their safety related to substance use and pain control but may not know all the facts or strategies to keep themselves and their loved ones safe. Asking patients without judgment about how they control pain and use substances can open communication between patients and healthcare providers.

Increased screening around substance use and medication misuse has led to patients receiving and utilizing naloxone and fentanyl test strips and distributing them to their friends, family, and neighbors. It also helps patients understand the risks related to medication and drug interactions and the drug adulterants like xylazine. Additionally, screening and support during medical visits allows for withdrawal management support and induction of medication assisted treatment (MAT), like naltrexone and suboxone immediately when patients express readiness to quit.

Managing MAT in primary care helps to break down barriers to effective substance use treatment that otherwise would require a referral to outpatient, intensive outpatient, or residential drug and alcohol treatment that can delay or deter patients accessing care. There will be reflection and analysis of different interventions used by a behavioral health consultant in an HIV primary care setting.