Written by: Nathaniel Schwartz, MD

Benjamin Franklin first wrote “an Ounce of Prevention is worth a Pound of Cure” when talking about fire safety in 1735 (“Founders Online: On Protection of Towns from Fire, 4 February 1735”). This still rings true today. Stopping something bad from happening proactively is always a better idea than just responding to it after the fact, especially when it comes to people’s health. One term in the public health field that is used for this is harm reduction. Harm reduction is defined as an action that decreases the chance of harm from some behavior. Driving or riding in a car is a behavior that carries some risk, but wearing a seat belt reduces the chance that someone is seriously injured if in a car accident. The same is true for preventing negative health outcomes that can come from opioid use. This applies to both those who are prescribed opioids and those who use illicit opioids.

For those who use opioids, taking the lowest effective dose for the shortest amount of time is the best way to prevent problems that can arise with prescription opioids. This decreases the chance of developing physical dependence and lower doses of medicine are less likely to cause dangerous side effects.  Keeping opioids stored safely and away from children, pets, and other people is also important. Using a lock box helps reduce the risk of others being exposed to these potentially dangerous medicines unintentionally. People who have asthma or other breathing problems, kidney issues, liver issues, and HIV are at higher risk for an overdose. Naloxone is an opioid antidote that is available without a prescription at many pharmacies. One form of this is Narcan, which is a nasal spray that can save someone’s life from an overdose. Having access to this life saving medicine is one great way to prevent overdose deaths from opioids. (“Dose of Reality: Safer Use”) These recommendations apply to all people who use opioids. In addition, people who use illicit opioids should remember the following to prevent harm from opioids. Using alone increases the chance of dying from an overdose.  If a trusted family member or friend is around and alert, they can look for the signs of an overdose and administer naloxone should an overdose occur. One of the dangerous things about using illicit opioids is the uncertainty of what substance is being used. Fentanyl test strips are legal to use in Wisconsin. Fentanyl is a synthetic opioid that is 50 times stronger than heroin and 100 times stronger than morphine which means that it needs a much lower amount to cause an overdose. A map with locations where people can access free fentanyl test strips can be found at www.dhs.wisconsin.gov/opioids/facts.htm  (“Dose of Reality: Get the Facts on Opioids”).  Safe injection practices, including using sterile injection equipment, also go a long way to prevent HIV, Hepatitis C, and other infections that are associated with injection opioids.

Another part of harm reduction for people who use opioids is having treatment available for those who have developed opioid use disorder. This treatment can include medications like buprenorphine and methadone, counseling with a therapist, group therapy, or support from peer specialists. A certified specialist is “an individual with experience in the mental health and substance use services system trained to provide support to others struggling to find a path to recovery” (“Peer Services: Peer Specialists | Wisconsin Department of Health Services”).  At Western Wisconsin Health, we’ve partnered with St. Croix County to improve access to all of these different treatment modalities for our patients. From preventing serious injuries in car accidents by wearing seat belts, to recommending routine vaccination to prevent diseases that we should be able to relegate to the history books, to increasing access to harm reduction strategies and treatment for opioid use disorder, it’s easier to stop something from happening in the first place than to repair the damage after it has happened. Talking to your family doctor frankly about any opioid use is a great first step to accessing treatment. If you don’t currently have a family doctor or any primary health provider, call us at (715-684-1111) to schedule an appointment.

Western Wisconsin Health provides a comprehensive program to treat those suffering from substance use disorder, which illicit opioid use is a part. If you, or someone you know, is struggling with substance use disorder and ready to make a change in your life to find the healthier you, call today to schedule an appointment and join our program. Call WWH at 715-684-1111 and ask to be scheduled in our Recovery Support Solutions program.

Bibliography

“Dose of Reality: Get the Facts on Opioids.” Wisconsin Department of Health Services, 30 Jan. 2022, www.dhs.wisconsin.gov/opioids/facts.htm

“Dose of Reality: Safer Use.” Wisconsin Department of Health Services, 19 Sept. 2021, www.dhs.wisconsin.gov/opioids/safer-use.htm.

“Founders Online: On Protection of Towns from Fire, 4 February 1735.” Founders.archives.gov, founders.archives.gov/documents/Franklin/01-02-02-0002.

“Peer Services: Peer Specialists | Wisconsin Department of Health Services.” Www.dhs.wisconsin.gov, 6 Aug. 2021, www.dhs.wisconsin.gov/peer-services/peer-specialists.htm.