Opioid harm reduction and stigma: proposed methods to improve the perception of people with addiction

Abstract

In the last two decades, the opioid overdose crisis has attracted attention in the United States, and several treatments, prevention, and information programs have emerged, but despite this awareness, overdose death rates continue to increase (1).For example, in 2020, opioid-related overdose deaths reached 70,000, and by 2021, the number increased by 15% (2).The COVID-19 pandemic has resulted in a notable increase in drug overdose deaths, with 96,779 deaths occurring from March 2020 to March 2021 in the US alone (3).The devastating war on drugs has not produced results in terms of reducing drug consumption, nor has it succeeded in breaking up drug cartels.People who carry or consume drugs are criminalized, resulting in an estimated 65% of incarcerated people having a diagnosed substance use disorder (SUD) and 20% are incarcerated for drug-related crimes (4).Unfortunately, many lives could be saved or rehabilitated if the medical field, the criminal system, and our cultural perspective incorporate the fact that SUD, and more specifically opioid use disorder (OUD) is a disease, not a moral failure (5, 6) and that there are many harm reduction techniques that are effective in saving lives.Both the disease itself and harm reduction techniques are stigmatized.SUD is a treatable chronic medical disease that involves complex interactions between brain circuits, genetics, the environment, and an individual's life experiences (7).The underpinning of this stigma is the scientifically unfounded belief that the taking of compulsive drugs by people with addiction reflects ongoing deliberate antisocial or deviant choices.This belief contributes to the continued criminalization of drug use and addiction (7).The following argument is based on evidence that supports the use of harm reduction techniques to reduce the staggering statistics above.We believe that the underuse of harm reduction techniques across the country can be primarily attributed to the stigma surrounding addiction. . Harm reductionHarm reduction can be interpreted as any approach that aims to reduce risk, promote safety, and prevent disease or disability [(8) p. 50-51].Two effective harm reduction Frontiers in Psychiatry frontiersin.org

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