Overdose Awareness: How Harm Reduction Is Reducing Overdose Deaths in New Hampshire
August is Overdose Awareness Month, culminating with National Fentanyl Prevention and Awareness Day on August 21, International Overdose Awareness Day on August 31, and National Opioid Awareness Day on September 21.
Throughout the period, you’ll hear more about overdose and what various NH communities do for harm reduction – and how they remember those who have lost their lives from opioid overdose.
Veterans are one group impacted by opioid overdose and the Veterans Association (VA) has many harm reduction programs in place to help.
As it relates to substance use, harm reduction is not an alternative to abstinence or treatment (just as using a seatbelt is not an alternative to careful driving). Rather, it is part of a continuum of options that helps reduce the risk of death and other negative health consequences stemming from substance use.
Harm reduction measures provided by VA include:
The medication naloxone to reverse opioid overdose.
Sterile needles and injection equipment to prevent infection.
Test strips to identify drugs containing fentanyl or xylazine.
As with helmets or seatbelts, harm reduction for substance use does not suggest VA is encouraging dangerous behavior—merely that VA is acknowledging and trying to mitigate the risk. For example, syringe services programs are associated with a 50% reduction in the transmission of HIV and hepatitis C among people who inject drugs, and research shows that regular users of these programs are five times more likely to enter treatment for substance use disorder.
Preventing Opioid Overdose Deaths With Naloxone
Unhealthy use of opioids—such as using them without medical supervision or for longer, in higher doses, or greater frequency than prescribed—comes with a significant risk of overdose – resulting in death or brain injury. It is important for Veterans and their family members and caregivers to learn the signs of overdose and how to administer the medication naloxone.
Veterans using nonprescribed stimulants should also talk to their health care provider about having naloxone on hand. Why? Because nonprescribed stimulants are often mixed with opioids like fentanyl, which can be deadly, even in small doses.
Opioid Overdose Education and Naloxone Distribution Program
VA’s Opioid Overdose Education and Naloxone Distribution (OEND) program teaches Veterans how to prevent, recognize, and respond to an opioid overdose or poisoning. Learn more about the OEND program by talking to your VHA provider today.
Preventing Infections With Syringe Services Programs
Sharing needles and syringes means using them after someone else used them to inject drugs or medicine or for tattoos or piercings. Because of use of shared needles, people who inject drugs are 20 times more likely than the general U.S. population to be infected with HIV. They are also more likely to acquire other serious infections, such as acute hepatitis C (a viral infection leading to inflammation of the liver). Syringe services programs (SSPs) help reduce the spread of these infections.
Testing Drugs for Hidden Dangers
The presence of the drugs fentanyl or xylazine in a drug you are taking without medical supervision can be extremely dangerous -- even lethal, as it increases your risk of death by overdose. Fentanyl is about 50 to 100 times more potent than morphine, and even a small dose can kill you. Xylazine, in addition to increasing overdose risk, can cause severe skin wounds that spread and worsen quickly.
Unfortunately, people who take drugs without medical supervision are usually unaware when the drug has been mixed with fentanyl or xylazine. You cannot detect the presence of fentanyl or xylazine by sight, smell, taste, or touch. That is why test strips can be critical for reducing your risk. Knowing the source your drug came from—even if you have used it in the past—does not mean it is safe.
The Good News: Opioid-Related Deaths In NH Are Declining
Overdose fatalities across New Hampshire have fallen steadily since 2022, according to a report released by the New Hampshire Department of Health and Human Services (DHHS). A growing prevalence of overdose-reversal medications, like NARCAN, and recent legislative changes at the state level have contributed to the downward trend.
One of those changes was the 2024 decriminalization of fentanyl and xylazine test strips, which allowed nonprofits to provide open guidance on avoiding laced substances.
State agencies also worked to increase the availability of naloxone (NARCAN) and nalmefene (Opvee), both of which save lives by temporarily reversing the effects of an opioid overdose. The public can pick up the medications at any of the nine Doorways locations throughout New Hampshire, and both are typically available with or without prescriptions at local pharmacies.
New Hampshire began using federal funding from State Opioid Response grants to purchase NARCAN in 2018. Five years later, it became the first state in the country to launch widespread placement of Naloxboxes. The state’s DHHS authorized pharmacies can also dispense nalmefene.
Fatalities have fallen with additional access to both medications, but they cannot reverse the effects of non-opioid overdoses, including cocaine.