Harm Reduction and Overdose Prevention

Harm reduction is a strategy for overdose prevention. According to SAMHSA, harm reduction can or should happen across the full continuum of health and social care. In networking with other providers, harm reduction initiatives, programs, and services work to build relationships and trust with health and social care partners that embrace supporting principles. To help achieve this, organizations practicing harm reduction utilize education and encourage policies that facilitate interconnectedness between all parties.

Principles of this evidence-based strategy include:

Recognizing the inherent value of people.
Connecting people who use drugs (PWUD) to education, resources, and treatment
Providing access to overdose-reversing drugs (naloxone)
Reproductive health education, services and supplies, and sexually transmitted infection screening and treatment
Reducing stigma
Training for providers

Opioid Overdose Prevention toolkit

Co-prescribing naloxone is recommended for patients at risk for opioid overdose.

Naloxone to reverse overdose

Naloxone Standing Order

Pharmacies are encouraged to use the naloxone standing order to help ensure naloxone is readily available. Members of AmeriHealth Caritas Florida can get naloxone for a $0 copay.

When to Offer Naloxone to Patients

A doctor or pharmacist can show patients, their family members, or caregivers how to administer naloxone.(PDF)

Patients given an automatic injection device or nasal spray should keep the item available at all times. It is important to remember to replace medication when the expiration date passes and if exposed to temperatures below 39°F or above 104°F.

Naloxone is effective if opioids are misused in combination with other sedatives or stimulants. It is not effective in treating overdoses of benzodiazepines or stimulant overdoses involving cocaine and amphetamines.

Billing time for overdose prevention

The codes for Screening, Brief Intervention, and Referral to Treatment (SBIRT) can be used to bill time for counseling a patient about how to recognize overdose and how to administer naloxone. For counseling and instruction on the safe use of opioids, including the use of naloxone outside the context of SBIRT services, the provider should document the time spent in medication education and use the Evaluation and Management (E&M) code that accurately captures the time and complexity.

For example, for new patients deemed appropriate for opioid pharmacotherapy and when a substantial and an appropriate amount of additional time is used to provide a separate service such as behavioral counseling (e.g., opioid overdose risk assessment, naloxone administration training), consider using Modifier 25 in addition to the E&M code.

Reducing stigma

Part of harm reduction involves removing stigma or negative attitudes about people with substance use disorders, including opioid use disorder. Referring to treatment as “medication-assisted treatment” can imply that the use of the medicines is an aid or adjunct, and instead, it should simply be called “treatment” or “recovery,” per American Addiction Centers.

Language Matters to Reduce Stigma

Instead of...	Use...	Because...
Opioid substitution replacement therapy Medication-assisted treatment (MAT)	Opioid agonist therapy Pharmacotherapy Addiction medication Medication for a substance use disorder Medication for opioid use disorder (MOUD)	The term "medication-assisted treatment (MAT)" implies that medication should have a supplemental or temporary role in treatment. Using "medication for opioid use disorder (MOUD)” aligns with the way other psychiatric medications are understood (e.g., antidepressants, antipsychotics), as critical tools that are central to a patient’s treatment plan.

Providers