Harm reduction strategies receive pushback

In recent trending conversations, some claim people who use drugs “don’t deserve help.”

This past week, online conversation about opioids focused on recently announced harm reduction strategies, as well as the story of a 94-year-old patient who was allegedly denied opioids in the hospital. While social media posts about these topics received little engagement, comments on the posts reflect the ongoing controversy surrounding harm reduction and misunderstandings about the dangers of opioids. These conversations provide an opportunity for public health communicators to educate about the importance of harm reduction tools like Narcan and how substance use disorder can affect anyone at any time.

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What’s trending nationally in conversations about opioids

On July 11, the Massachusetts Bay Transportation Authority announced that Narcan access cabinets will soon be installed at five transit stations to “increase public access to lifesaving medication that can reverse an opioid overdose.” The MBTA shared the announcement on Facebook, where the post received 61 likes and 13 comments as of July 17. One social media user commented, “Narcan puts off the next overdose … those people don’t deserve our help or pity. They did it to themselves.” Online conversation about opioids continued on July 11 when the U.S. signed a memorandum with three major social media companies aiming to prevent the distribution of synthetic drugs online. A post from X’s Global Government Affairs team sharing the announcement received 84,700 views, 602 likes, 116 reposts, and 64 comments as of July 17. Most social media users who commented on the post expressed gratitude for the new measures, but some questioned why these measures were important.

On July 14, a post on X claimed that a 94-year-old patient with several broken bones was denied opioids at the hospital due to doctors’ concerns that she would become addicted. Part of the post read, “Why would a 94-year-old become addicted? Opioid hysteria continues to ravage the country.” The post received 7,022 views, 327 likes, 134 reposts, and 45 comments as of July 17. Some commenters claimed to have had similar experiences and echoed the original post’s view. One comment read, “Even if she did magically get addicted - so!? SHE’S 94.”

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Recommendations for public health professionals

Each week, the Infodemiology.com team will provide messaging recommendations in response to some of the trending narratives outlined above. These helpful tips can be used when creating content, updating web and FAQ pages, and developing strategy for messaging about mental health.

Trending conversations about opioid risks and Narcan provide an opportunity for public health departments, community organizations, and other partners to educate the public about who is at risk of substance use disorder and overdose, how to recognize the signs of an opioid overdose, and how to access and use naloxone.Messaging may emphasize that substance use disorder can affect anyone at any time, regardless of age. As many as one in four patients receiving long-term opioid therapy prescribed by a primary care physician struggles with opioid use disorder. Anyone can overdose on opioids, but some populations face higher risk, including people who have a history of substance use disorder, sleep apnea, or kidney or liver failure; people who take benzodiazepines; and people who are 65 or older.

Outlining the signs of an opioid overdose—as well as where to access naloxone and how to use it—is recommended. Messaging may emphasize that an opioid overdose is a medical emergency that requires immediate attention and that many states have Good Samaritan laws that protect people who seek medical care in the event of an overdose.