Changing Course in the Overdose Crisis Moving from Punishment to Harm Reduction and Health

Changing Course Square


Drug overdose is the leading cause of accidental death in the United States, and communities across the country are struggling to respond. But the punitive approach exemplified by the “war on drugs” has driven mass incarceration, exacerbated racial disparities within the criminal justice system, and devastated communities of color. The United States needs a new paradigm that prioritizes community health, harm reduction, and recovery. This report examines the intersection of problematic drug use and the criminal justice system. It offers practical guidance for practitioners, policymakers, and funders by compiling the wide range of interventions that communities can consider to minimize justice system contact for people who use drugs and improve public health and safety.

A Statement to the Harm Reduction Community

In June 2020, we at Vera learned of reports of abuse and harassment by Devin Reaves, co-founder and now former executive director of the Pennsylvania Harm Reduction Coalition (PAHRC), toward sex workers, PAHRC staff and interns, women, and others in the harm reduction and drug policy movements. Although Devin Reaves was interviewed and quoted as an expert in our Changing Course report released in February 2020, we in no way condone abuse or harassment. Like others, we were saddened to learn about incidents of sexual harassment and violence. We stand with sex workers and survivors and acknowledge that we must do more to center the experiences and leadership of those who are directly impacted by the criminal legal system in our efforts to end mass incarceration, criminalization, and the harms of the “war on drugs.”

We are committed to supporting accountability and justice in this moment and in the future.

Additional statements for reference:

Philadelphia Red Umbrella Alliance

Pennsylvania Harm Reduction Coalition — Part I

Pennsylvania Harm Reduction Coalition — Part II

Harm Reduction Coalition

Drug Policy Alliance

Key Takeaway

A new path forward requires bold leadership at the local level, where true transformation can occur, and sustained investment in community organizations led by people who are affected directly, centering racial equity and justice in all practices and policies.

Publication Highlights

  • People who use drugs or are directly impacted by drug use should be included in the development of policies and programmatic responses to the overdose crisis.

  • Police officers should support community-based harm reduction interventions, such as naloxone distribution, syringe service programs, and supervised consumption sites and they should also carry naloxone to prevent overdose deaths.

  • Legislation should focus on decriminalizing drug use and increasing resources and infrastructure for public health and community-based harm-reduction responses.

Key Facts