Substance Use and Harm Reduction


What is the opioid epidemic?

 Watch Vox video “Painkillers Now Kill More Americans than any Illegal Drug” (1) - (4min)

What does it mean to declare substance use a public health emergency?

 Listen to The Daily podcast “The Opioid Epidemic” (2) - (25min)

What is the harm reduction approach to substance use?

 Watch “Harm Reduction and Abstinence Based Treatment, ‘Bridging the Gap’” (3) - (2min)

How is the response to the opioid epidemic different from the response to the crack epidemic in the 1980s?

Listen to WNYC Here and Now broadcast “Race, Class and the Response to Today’s Heroin Epidemic” (4) - (11min)

How has the War on Drugs contributed to mass incarceration?

Watch Vox video “How Mandatory Minimums Helped Drive Mass Incarceration” (5) - (4min)


How is this relevant to Harlem Hospital?

Central Harlem has almost double the rate of drug and alcohol-related hospitalizations compared to Manhattan overall (3528 per 100,000 compared to 2109 per 100,000) (6). Further, Central Harlem has 1038 per 100,000 psychiatric hospitalizations compared to 755 per 100,000 for Manhattan overall.6 In a 2013 community focus group conducted at Harlem Hospital, residents cited smoking, alcohol and substance use, and depression/mental health as three out of the top 10 greatest health care needs in their community (7).


How is this relevant to The Allen Hospital?

Washington Heights and Inwood have similar rates of alcohol-related hospitalizations compared to Manhattan overall (1055 per 100,000 compared to 1084 per 100,000) (6). The rate of drug-related hospitalizations is lower than the Manhattan rate at 779 per 100,000 adults, compared to 1025 per 100,000 (6). However, drug-related deaths are the 10th leading cause of death in the community, and the incarceration rate for Washington Heights is higher than the citywide rate (6).


How is this relevant to Stamford Hospital?

As compared to the state of Connecticut, Stamford has lower drug-related age-adjusted mortality rates, but similar rates of alcohol-related mortality (8). In a 2015 community survey, 8% of Stamford residents felt they needed to reduce their use of drugs or alcohol (8).


If I am interested in this topic, where can I learn more?

Check out Fresh Air podcast “’Unbroken Brain’ Explains Why ‘Tough’ Treatment Doesn’t Help Drug Addicts” (9) - (36min) 

This podcast talks with journalist and former drug user Maia Szalavitz about the different approaches to substance use treatment, including harm reduction.

Check out Radiolab podcast “The Fix” (10) - (44min)

This podcast explores the science and psychology behind addiction and substance use.

Check out Columbia neuroscientist Carl Hart’s TedMed Talk “Let’s quit abusing drug users” (11) - (19min) 

Dr. Hart discusses his controversial views on the roles of substance use, crime, and racial injustice.



1.       Lopez, G. (2016, March 09). Painkillers now kill more Americans than any illegal drug. Watch why. Retrieved March 16, 2017, from

2.       Barbaro, M. (2017, October 27). Listen to ‘The Daily’: The Opioid Epidemic. Retrieved January 10, 2018, from

3.       Asher, V. (2017, August 25). Harm Reduction and Abstinence Based Treatment, 'Bridging the Gap'. Retrieved January 11, 2018, from

4.       Race, Class And The Response To Today's Heroin Epidemic. Retrieved January 11, 2018, from

5.       Vox. (2015, September 03). How mandatory minimums helped drive mass incarceration. Retrieved January 11, 2018, from

6.       New York City Community Health Profiles. Retrieved February 21, 2017, from

7.       HARLEM HOSPITAL CENTER - Retrieved February 20, 2017, from

8.       2016 Stamford Hospital Community Health Needs Assessment. Retrieved January 07, 2018, from

9.       'Unbroken Brain' Explains Why 'Tough' Treatment Doesn't Help Drug Addicts. (2016, July 07). Retrieved March 16, 2017, from

10.    The Fix. Retrieved March 16, 2017, from

11.    Hart, Carl. Let's quit abusing drug users. Retrieved April 10, 2017, from