Promoting Harm Reduction in Primary Care and in the Community
Harm reduction is an important part of caring for individuals with ongoing substance use disorders, with the goal to keep persons as safe and as healthy as possible until they are ready for the next steps toward recovery. Harm reduction promotes safer, managed use of substances through access to drug testing supplies (e.g., fentanyl test strips), needle exchange programs, and overdose reversal medications (e.g., Narcan). The harm-reduction perspective is to “meet people where they are” in terms of their substance use and recovery. This stigma-free strategy reduces barriers to treatment access and decreases drug overdose mortality rates.
With funding from SAMHSA through the Minnesota Department of Human Services, Robert Levy, MD, Tanner Nissly, DO, and Mary Lonergan-Cullum, PhD, have created a harm reduction program at University of Minnesota Physicians Broadway Family Medicine Clinic. Starting with fentanyl test strip distribution in the summer of 2022, the program has grown to keep pace with the needs of the community and patients. In the past six months alone, Dr. Levy’s team has distributed 1,500 test strips for fentanyl, as well as 1,400 test strips for xylazine - an emerging problem in the local drug supply. These harm reduction supplies, along with resource information and personal care items, are offered to patients on medications for opioid use disorder at University of Minnesota Physicians Broadway Family Medicine Clinic. Testing strips for fentanyl and xylazine have been shared for distribution at other Department of Family Medicine and Community Health-affiliated clinics, such as M Health Fairview Clinics Bethesda and Phalen Village.
In addition to test strips, Dr. Levy’s team has improved access to Narcan, a vital reversal agent for opioid overdoses, through connections with key community partners. Since recently purchasing Narcan for community distribution, Dr. Levy and Dr. Lonergan-Cullum have distributed over 700 cartons of Narcan nasal spray in three months. They partner with multiple community organizations to distribute Narcan more broadly to groups working directly with persons who use substances. This list includes Southside Harm Reduction, A Mother’s Love Initiative, Gateway Recovery, African-American Survivor Services, and Native American Community Clinic.
In cooperation with Southside Harm Reduction, Dr. Levy and Dr. Nissly hosted a Narcan training event at University of Minnesota Physicians Broadway Family Medicine Clinic for clinic staff, providers, and leadership. Additionally, Dr. Levy and Dr. Lonergan-Cullum have been invited to present at the 2024 conference of the Minnesota Society of Medical Assistants to discuss treatments for substance use disorders in primary care, how stigma negatively impacts care, the importance of harm reduction, and recognizing the signs of overdose and how to administer Narcan.
