Harm Reduction as an Essential Psychiatric Mental Health Nursing Skill

In 2023, over 20 million individuals in the United States experienced a mental health condition and a co-occurring substance use disorder. As many as 42% of individuals with a mental health condition report past-year illicit drug use, and as many as 6% report past-year opioid use. Given the high rates of psychiatric comorbidity and mortality associated with opioid use disorder, it is imperative that psychiatric mental health nurses not only view opioid use disorder as a brain-based, chronic remitting-relapsing disease but also leverage non-stigmatizing clinical approaches to improve patient outcomes. Harm reduction is a practical and transformative approach that seeks to empower people who use drugs with the choice to live healthy, self-directed, and purpose-filled lives. This article provides an overview of theoretical harm reduction approaches and tangible harm reduction interventions to inform psychiatric mental health nursing practice.

Relevant literature was reviewed related to harm reduction and its role in psychiatric mental health nursing practice.

Harm reduction as an ethos is discussed, in addition to practical harm reduction strategies such as opioid antagonists for overdose reversal, fentanyl test strips, syringe service programs, and supervised consumption sites. The importance of patient engagement is highlighted as necessary in improving health outcomes among those who use substances.

Given the conclusive evidence that a harm reduction approach and associated interventions are lifesaving, it is the ethical duty of psychiatric mental health nurses to implement and advocate for harm reduction across the healthcare continuum.