Harm Reduction — Frequently Asked Questions

Harm reduction is a public health framework that aims to reduce the negative health, social, and legal impacts of drug use without requiring abstinence. It includes practical strategies like drug checking, naloxone distribution, supervised consumption sites, and education on safer use practices.

Signs include unresponsiveness, slow or stopped breathing (fewer than one breath every five seconds), blue lips or fingertips, gurgling or choking sounds, and pinpoint pupils. Call emergency services immediately and administer naloxone if available.

Dissolve a small sample in water, dip the strip for 15 seconds, and wait 2–5 minutes. One line means fentanyl is detected; two lines means it was not detected at the test's sensitivity threshold. Zero lines means the test is invalid and should be repeated.

No. Test strips may not detect all fentanyl analogues, nitazenes, or other dangerous adulterants. Potency can also vary independently of contamination. Always use start-low-go-slow practices regardless of test results.

Naloxone (Narcan) is available without a prescription at most pharmacies in the United States and Canada. Many harm reduction organizations, health departments, and community programs distribute it for free. Ask your pharmacist or local health department.

Never Use Alone (1-800-484-3731) is a US hotline where operators stay on the line while you use substances alone. If you become unresponsive, they dispatch emergency services to your location. It is free and available 24/7.

Combining central nervous system depressants — opioids, alcohol, benzodiazepines, GHB — multiplies overdose risk because each substance suppresses breathing. Stimulant-depressant combinations also stress the cardiovascular system. Polydrug use is a leading cause of fatal overdose.

Tolerance drops quickly during breaks from use. Returning to a previous dose after even a short abstinence period is a major overdose risk. Start with a significantly lower dose — as little as 25% of what you previously used — and wait for full effects before considering more.