Substance Use Prevention and Harm Reduction
The national opioid epidemic began with widespread addiction to, and misuse of prescription painkillers. More recently, illegal drugs such as heroin and illicitly manufactured fentanyl are responsible for a majority of fatal overdoses. As well, a growing number of states are legalizing marijuana, still considered an illicit drug at the federal level, for medical and adult recreational use. Law and policy can help or hinder harm reduction and overdose prevention measures.
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Resources
Naloxone Prescription Mandates
Legality of Drug Checking Equipment in the United States
Supplantation in the Context of Opioid Settlement Funds
Policies in Schools to Reduce Overdose and Other Drug-related Harm
Healthcare Policies to Reduce Overdose and Other Drug-related Harm
Criminal and Legal Policies to Reduce Overdose and Other Drug-related Harm
Community-Based Policies to Reduce Overdose and Other Drug-related Harm
Characteristics of Statewide Naloxone Distribution Mechanisms
Cannabis Legalization: Critical Policy Issues Impacting the Health of Children
Harm Reduction Laws in the United States
Harm Reduction Laws in the United States – 2024 Update
Critical Public Health Issues in Cannabis Legalization
Spotlight
Regulated Cannabis Has a Hemp Problem
Racism in Local Drug Paraphernalia Laws: An Argument for Repeal
Harm Reduction Policies for Perinatal Substance Use Instead of Criminalization: Better Outcomes for Families
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A Closer Look at Substance Use Prevention and Harm Reduction
Opioids
The United States remains in the grip of an unprecedented epidemic of drug-related harm. In 2017, over 70,000 Americans were killed by drug overdose, surpassing the number lost at the height of the HIV/AIDS crisis. Opioids, both prescription painkillers and illegal drugs such as heroin and illicitly manufactured fentanyl, are responsible for most of these deaths.
States and localities have implemented a number of legal and regulatory interventions to address this epidemic. These include the creation and strengthening of prescription monitoring programs (PMPs), drug take-back programs and initiatives to increase access to naloxone, a medication that effectively reverses opioid overdose. States are also taking measures to increase access to evidence-based substance use disorder treatment, improve prescriber training, and evaluate whether existing programs are having the desired effect.
Marijuana
Marijuana, which is still considered an illicit drug at the federal level, is legal in 11 states for adults over the age of 21 for recreational use, and legal for medical use in 33 states as of January 2020. A broad spectrum of policy variables must be considered in the legalization of recreational marijuana, including advertising restrictions, personal cultivation regulations, social consumption sites, delivery services, local authority to limit or prohibit recreational marijuana enterprises within their communities, and social equity measures. For medical marijuana, policy questions include how to regulate its recommendation and dispensing, as well as how to register patients approved for medical marijuana use.
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