Recent research has highlighted the significant success the harm reduction approach has had in reducing death and disease from opioid use, however these programs often rest on assumptions of access to treatment for infectious diseases, mental health conditions, and basic primary care services that are often not accessible to individuals who use drugs. Access is limited by stigma, transportation issues, complexity of health conditions, and many other barriers, and this life saving treatment is often unavailable to the most vulnerable individuals.

This presentation will explore the process and findings of this landscape analysis, sharing some key case study videos and highlighting the various creative ways that programs have integrated MAT treatment into existing models even if they do not have a prescribing provider onsite. Participants will become familiarized with the meaning and significance of low barriers services in an MAT setting, and will discuss various ways that MAT programs have been successful in preventing overdose and improving the overall health and wellness of their clients through provision of MAT.

The opioid and stimulant epidemics continue to pose major public health challenges in the U.S., claiming over 107,500 lives in 2023 despite a slight 3% decline in overdose deaths—the first decrease since 2018 (CDC). This evolving crisis requires close collaboration between physicians and law enforcement to continue to decrease and cease these preventable deaths.

This session dives into how a Syringe Exchange Program in the Twin Cities, Minnesota, tackled the alarming reality of drug overdoses not decreasing locally, despite what the CDC and the Minnesota Department of Health (MDH) reports on national trends. In our community, we faced significant challenges with the government’s data collection, which only takes into consideration 911 calls, EMS and Police reports for data collection.

This conversation centers harm reduction not as a checklist, but as a justice-rooted framework, a commitment to dignity, autonomy, and survival in a world that often withholds those things. We’ll explore how harm is exacerbated by systems of criminalization, medical neglect, stigma, and control, especially for people who use drugs, sell sex, live with chronic illness, or navigate poverty, racism, and ableism. We’ll interrogate how harm reduction gets watered down, co-opted, or professionalized into meaninglessness, and what it means to reclaim it as a radical, liberatory practice.

In April 2024, San Diego County launched its Harm Reduction Services Program (HRSP), the region’s first government-run syringe service initiative. Designed to address the intersecting crises of overdose, HIV, and hepatitis C among people who use drugs, HRSP operates through a mobile delivery model, providing low-barrier, stigma-free services in underserved communities identified through a comprehensive Community Readiness Assessment.