{"id":266255,"date":"2026-07-10T05:02:00","date_gmt":"2026-07-10T09:02:00","guid":{"rendered":"https:\/\/www.bu.edu\/sph\/?post_type=bu-article&#038;p=266255"},"modified":"2026-07-11T23:13:47","modified_gmt":"2026-07-12T03:13:47","slug":"why-is-harm-reduction-misunderstood-on-college-campuses","status":"publish","type":"bu-article","link":"https:\/\/www.bu.edu\/sph\/news\/articles\/2026\/why-is-harm-reduction-misunderstood-on-college-campuses\/","title":{"rendered":"Why Is Harm Reduction Misunderstood on College Campuses?"},"content":{"rendered":"\t<div class=\"wp-block-editorial-leadin sphnews-block-editorial-leadin is-style-text-over-image has-media has-box has-media-focus-center-middle has-text-position-x-right has-light-theme\">\n\t\t<div class=\"container-lockup\">\n\n\t\t\t<div class=\"wp-block-leadin-media\">\n\t\t\t\t\n\t\t\t\t<img width=\"2121\" height=\"1414\" src=\"\/sph\/files\/2026\/07\/CRP-hr.jpg\" class=\"\" alt=\"Public Needle Drop Box\" loading=\"lazy\" srcset=\"https:\/\/www.bu.edu\/sph\/files\/2026\/07\/CRP-hr.jpg 2121w, https:\/\/www.bu.edu\/sph\/files\/2026\/07\/CRP-hr-636x424.jpg 636w, https:\/\/www.bu.edu\/sph\/files\/2026\/07\/CRP-hr-1024x683.jpg 1024w, https:\/\/www.bu.edu\/sph\/files\/2026\/07\/CRP-hr-768x512.jpg 768w, https:\/\/www.bu.edu\/sph\/files\/2026\/07\/CRP-hr-1536x1024.jpg 1536w, https:\/\/www.bu.edu\/sph\/files\/2026\/07\/CRP-hr-2048x1365.jpg 2048w, https:\/\/www.bu.edu\/sph\/files\/2026\/07\/CRP-hr-755x503.jpg 755w, https:\/\/www.bu.edu\/sph\/files\/2026\/07\/CRP-hr-1500x1000.jpg 1500w, https:\/\/www.bu.edu\/sph\/files\/2026\/07\/CRP-hr-900x600.jpg 900w, https:\/\/www.bu.edu\/sph\/files\/2026\/07\/CRP-hr-450x300.jpg 450w, https:\/\/www.bu.edu\/sph\/files\/2026\/07\/CRP-hr-600x400.jpg 600w, https:\/\/www.bu.edu\/sph\/files\/2026\/07\/CRP-hr-1920x1280.jpg 1920w, https:\/\/www.bu.edu\/sph\/files\/2026\/07\/CRP-hr-1200x800.jpg 1200w\" sizes=\"(max-width: 2121px) 100vw, 2121px\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\n\t\t\t\n\t\t\t\t<div class=\"container-words-outer\">\n\n\t\t\t\t\t\n\t\t\t\t\t<div class=\"container-words-inner has-opacity-80\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"wp-prepress-tag\">drugs<\/span>\n\t\t\t\t\t\t\t\t<h1 class=\"head\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tWhy Is Harm Reduction Misunderstood on College Campuses?\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/h1>\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t<h4 class=\"deck\">A new study found that students and staff involved with collegiate recovery programs held very different definitions and perceptions of harm reduction and its role in these programs, suggesting opportunities to reframe this public health approach in collegiate settings in a way that builds common ground and meets students\u2019 varying substance use needs and recovery goals.<\/h4>\n\t\t\t\t\t\t\n\t\t\t\t\t<\/div>\n\n\t\t\t\t<\/div>\n\n\t\t\t\n\t\t<\/div>\n\n\t\t\n\t<\/div>\n\n\t\n<div class=\"wp-prepress-component-metabar js-block-editorial-metabar sphnews-prepress-layout-metabar\">\n\t<div class=\"wp-prepress-component-metabar-wrapper\">\n\t\t\t\t\t<div class=\"wp-prepress-component-metabar-date\">July 10, 2026<\/div>\n\t\t\n\t\t\t\t<div class=\"wp-prepress-component-metabar-credits\">\n\t\t\t\t\t\t\t\t<ul data-credit-type=\"By\">\n\t\t\t\t\t\t<li><a href=\"https:\/\/www.bu.edu\/sph\/news\/authors\/jillian-mckoy\/\">Jillian McKoy<\/a><\/li>\n\t\t\t\t\t<\/ul>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"wp-prepress-component-metabar-share js-bu-prepress-share-tools\">\n\t\t\t<span class=\"icon-twitter\"><span>Twitter<\/span><\/span>\n\t\t\t<span class=\"icon-facebook\"><span>Facebook<\/span><\/span>\n\t\t\t<span class=\"icon-action\"><\/span>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\t\n\n\n<p>As collegiate recovery programs (CRPs) continue to <a href=\"https:\/\/www.bu.edu\/sph\/news\/articles\/2025\/inclusive-peer-support-groups-are-expanding-at-us-colleges-but-stable-funding-is-needed\/\">expand<\/a> on college campuses across the United States, so too does the opportunity to incorporate approaches supportive of harm reduction into these programs in order to provide vital, <a rel=\"noreferrer noopener\" href=\"https:\/\/www.routledge.com\/The-Harm-Reduction-Gap-Helping-Individuals-Left-Behind-by-Conventional-Drug-Prevention-and-Abstinence-only-Addiction-Treatment\/Vakharia\/p\/book\/9781032294735\" target=\"_blank\">evidence-based<\/a> support to students navigating diverse recovery journeys and goals. But a lack of understanding of what harm reduction actually means has led to differing perspectives about this approach and how\u2014or whether\u2014it should be integrated into CRPs, according to a new study led by School of Public Health researchers.&nbsp;<\/p>\n\n\n\n<p>As it relates to drug use, harm reduction is a public health approach that <a rel=\"noreferrer noopener\" href=\"https:\/\/hri.global\/what-is-harm-reduction\/\" target=\"_blank\">focuses<\/a> on keeping people who use drugs safe and alive even if they continue to use drugs. It largely <a rel=\"noreferrer noopener\" href=\"https:\/\/harmreduction.org\/movement\/evolution\/\" target=\"_blank\">gained traction<\/a> during the height of the HIV\/AIDS crisis in the US, in the form of services such as syringe needle exchange programs and bleach kits to combat the spread of HIV. Emphasizing the prevention of negative consequences associated with drug use rather than the prevention of substance use, harm reduction has <a rel=\"noreferrer noopener\" href=\"https:\/\/aidsunited.org\/about\/our-initiatives\/harm-reduction\/\" target=\"_blank\">expanded<\/a> over the years to include interventions such as naloxone distribution kits and fentanyl test strips, as well as broader ideological commitments to treat people who use drugs with compassion and respect, recognizing that not everyone is ready or able to quit.&nbsp;<\/p>\n\n\n\n<p>But more than 40 years later, there is still no universally accepted definition of this public health approach. <a rel=\"noreferrer noopener\" href=\"https:\/\/journals.sagepub.com\/doi\/10.1177\/21676968261456379\" target=\"_blank\">Published in the journal <em>Emerging Adulthood<\/em><\/a>, the new study found that this ambiguity led to five varying definitions of harm reduction among CRP program directors, administrators, staff, and students\u2014categorized as <em>traditional, alternative pathway<\/em>, <em>preventative<\/em>, <em>humanistic<\/em>, and <em>skeptical<\/em>\u2014and<em> <\/em>these varying conceptualizations shaped the participants\u2019 perspectives on the possibilities and challenges of integrating harm reduction into CRPs.&nbsp;<\/p>\n\n\n\n<p>\u201cHarm reduction has evolved from its origins in HIV prevention to encompass overdose prevention, behavioral change, public health, and social justice, so different groups emphasize different aspects,\u201d says study senior author <a href=\"https:\/\/www.bu.edu\/sph\/profile\/noel-vest\/\">Noel Vest<\/a>, assistant professor of community health sciences. \u201cOur study found that these differing definitions directly shaped whether stakeholders viewed harm reduction as compatible with CRPs. In many cases, disagreements were less about specific interventions and more about what people meant by the term \u2018harm reduction.\u2019\u201d<\/p>\n\n\n\n<p>While drug overdose deaths among young adults <a rel=\"noreferrer noopener\" href=\"https:\/\/www.tfah.org\/wp-content\/uploads\/2026\/06\/TFAH_PainInTheNation2026_Fnl.pdf\" target=\"_blank\">declined<\/a> significantly for the third consecutive year in 2025 (along with national rates), drug overdoses remain a <a rel=\"noreferrer noopener\" href=\"https:\/\/drugabusestatistics.org\/drug-overdose-deaths\/\" target=\"_blank\">leading<\/a> cause of death among young people, and data also <a rel=\"noreferrer noopener\" href=\"https:\/\/www.healthaffairs.org\/content\/forefront\/opioid-epidemic-needed-focus-adolescents-and-young-adults\" target=\"_blank\">suggest<\/a> that two-thirds of adults with opioid use disorder begin using drugs before age 25. Furthermore, the Trump administration\u2019s recent <a rel=\"noreferrer noopener\" href=\"https:\/\/rollcall.com\/2026\/07\/01\/syringe-services-in-limbo-under-trump-risking-hepatitis-c-progress\/\" target=\"_blank\">funding cuts<\/a> to clean needle programs threaten to stymie the progress that has been made. Alternative harm reduction services in collegiate settings could offset this loss among recovering students, and understanding how people involved with or influential over CRPs perceive these services can inform how CRPs can continue to evolve and expand to meet students\u2019 needs\u2014without increasing <a rel=\"noreferrer noopener\" href=\"https:\/\/hri.global\/wp-content\/uploads\/2024\/10\/GSR24_full-document_12.12.24_B.pdf\" target=\"_blank\">drug use<\/a> or <a rel=\"noreferrer noopener\" href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC8541900\/\" target=\"_blank\">crime<\/a>.<\/p>\n\n\n\n<p>\u201cThere is evidence to support the idea that harm reduction strategies, such as naloxone and fentanyl test strip distribution, are effective approaches to achieving intended public health outcomes,\u201d says corresponding author <a href=\"https:\/\/www.bu.edu\/sph\/profile\/isabel-redman\/\">Isabel Redman<\/a>, research project coordinator in the Department of Community Health Sciences and an incoming DrPH student, who co-lead the study with Erin Major, PhD student in health services research. \u201cBut different major organizations maintain their own official definitions of harm reduction, and these varying definitions among CRP staff and students reflect these broader perspectives.\u201d<\/p>\n\n\n\n<p>For the study, the SPH team examined perspectives on harm reduction in 60 interviews in fall 2023 with 8 program directors, 4 administrators, 33 students, and 15 staff members across 5 CRPs in the US.<\/p>\n\n\n\n<p>Among the definitions\/conceptualizations identified:<\/p>\n\n\n\n<ul><li>The<em> traditional <\/em>conceptualization was deeply rooted in harm reduction\u2019s early HIV\/AIDS advocacy and viewed it as a means for preventing overdoses, disease spread, and other negative population-level outcomes\u2014and as a separate path that could lead towards eventual recovery. This group also believed clean needle programs would present ethical concerns that would contradict the structure of CRPs, which tend to be focused on abstinence.&nbsp;<\/li><li>The <em>alternative pathway <\/em>conceptualization\u2014the most commonly held view among the participants\u2014viewed harm reduction as a way for people to reduce substance use, but not necessarily with the goal to quit, and believed that harm reduction services and spaces could be offered separately from abstinence-based recovery services.&nbsp;<\/li><li>The<em> preventative<\/em> conceptualization defined harm reduction as necessary changes to substance use culture and environment around individuals that would prevent people engaging in excessive drug use or prevent them from relapsing (such as educational outreach and coaching, or \u201csober-curious\u201d or substance-free spaces).<\/li><li>The <em>humanistic<\/em> conceptualization framed harm reduction as a human rights-based movement and ideology that promotes the belief that all people should be treated with dignity and respect\u2014and without stigma\u2014and emphasized that the voices of those with lived experience with drug use should help inform harm reduction strategies.&nbsp;<\/li><li>The <em>skeptical<\/em> conceptualization\u2014a view only held personally by two student participants\u2014believed that harm reduction would enable people to continue using while claiming to be in recovery and would be a barrier to abstinence-based recovery.<\/li><\/ul>\n\n\n\n<p>Several overlapping themes and considerations emerged from these five perspectives of harm reduction and its potential role in CRPs, including space on campuses for both abstinence-only and safe\/reduced drug use, as well as overdose prevention education and systems-level changes to promote compassionate treatment towards people who use drugs. These overlapping viewpoints signal potential opportunities to create a harm reduction approach that blends multiple perspectives and goals, and places harm reduction on a spectrum, says Redman.<\/p>\n\n\n\n<p>\u201cSome participants also held multiple viewpoints on harm reduction simultaneously, suggesting that these varying perspectives are not necessarily mutually exclusive,\u201d she says. \u201cSome participants also described that their views on harm reduction changed over time, indicating that beliefs on harm reduction are not stagnant.\u201d<\/p>\n\n\n\n<p>A reframing of harm reduction should emphasize education and awareness of this approach to students\u2014ideally in adolescence before they reach college, Vest says, or at least early in their college experience, such as in new student orientations.&nbsp;<\/p>\n\n\n\n<p>\u201cPublic health has long embraced harm reduction through evidence-based strategies like seat belts, sunscreen, and condoms\u2014interventions that reduce risk without requiring people to eliminate the underlying behavior,\u201d says Vest. \u201cBrief educational interventions that clarify what harm reduction is, and perhaps more importantly what it is not, could help reduce misconceptions and build common ground. Rather than focusing on narrow concepts, conversations should center on shared goals like reducing overdose, fostering peer support, supporting student well-being, and helping students move toward healthier lives.\u201d<\/p>\n\n\n\n<p>Future research should focus on developing and testing educational interventions that improve understanding of harm reduction among collegiate recovery stakeholders. Establishing a shared understanding of harm reduction may reduce misconceptions and support more informed decision-making about its role within collegiate recovery. The researchers also note that this study should be repeated among other populations, including the general public, to see if similar misconceptions about harm reduction arise.<\/p>\n\n\n\n<p>\u201cContinuing the conversation, with a focus on common purpose, will help us to better understand the different dimensions of harm reduction and how it may be operationalized to improve student health,\u201d Redman says.<\/p>\n\n\n\n<p>The study was coauthored by Jad\u00a0Alshamah (CAS&#8217;26) and Bashir\u00a0Khalil (ENG&#8217;26), BU alums and research assistants at SPH at the time of the study.<\/p>\n\n\n\t<aside class=\"wp-block-editorial-relatedstories is-style-card has-two sphnews-block-editorial-relatedstories\">\n\t\t<h3 class=\"wp-block-editorial-relatedstories-title\">Related<\/h3>\n\t\t<ul class=\"wp-block-editorial-relatedstories-list\">\n\t\t\t\t\t\t\t<li class=\"wp-block-editorial-relatedstories-list-item\">\n\t\t\t\t\t<article class=\"wp-block-editorial-relatedstories-article\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<figure class=\"wp-block-editorial-relatedstories-article-image\">\n\t\t\t\t\t\t\t\t\t<img width=\"600\" height=\"362\" src=\"\/sph\/files\/2025\/10\/CRP-students-600.jpeg\" class=\"attachment-post-thumbnail size-post-thumbnail wp-post-image\" alt=\"Portrait of two young women hugging in support group meeting, both smiling happily, copy space\" loading=\"lazy\" \/>\t\t\t\t\t\t\t\t<\/figure>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"wp-block-editorial-relatedstories-article-content\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<p class=\"wp-block-editorial-relatedstories-article-category\"><span>alcohol\/substance use<\/span><\/p>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<h4 class=\"wp-block-editorial-relatedstories-article-title\"><a href=\"https:\/\/www.bu.edu\/sph\/news\/articles\/2025\/naloxone-training-social-support-and-stigma-reduction-among-top-needs-of-college-students-in-recovery\/\" class=\"wp-block-editorial-relatedstories-article-title-link\">Naloxone Training, Social Support, and Stigma Reduction Among Top Needs of College Students in Recovery<\/a><\/h4>\n\t\t\t\t\t\t\t<p class=\"wp-block-editorial-relatedstories-article-date\">October 31, 2025<\/p>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t<\/article>\n\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"wp-block-editorial-relatedstories-list-item\">\n\t\t\t\t\t<article class=\"wp-block-editorial-relatedstories-article\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<figure class=\"wp-block-editorial-relatedstories-article-image\">\n\t\t\t\t\t\t\t\t\t<img width=\"600\" height=\"362\" src=\"\/sph\/files\/2025\/07\/college-lecture-600.jpg\" class=\"attachment-post-thumbnail size-post-thumbnail wp-post-image\" alt=\"Defocused Image Of People At Auditorium\" loading=\"lazy\" \/>\t\t\t\t\t\t\t\t<\/figure>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"wp-block-editorial-relatedstories-article-content\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<p class=\"wp-block-editorial-relatedstories-article-category\"><span>college student health<\/span><\/p>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<h4 class=\"wp-block-editorial-relatedstories-article-title\"><a href=\"https:\/\/www.bu.edu\/sph\/news\/articles\/2025\/college-shouldnt-be-a-relapse-risk-why-collegiate-recovery-programs-deserve-sustainable-funding\/\" class=\"wp-block-editorial-relatedstories-article-title-link\">College Shouldn\u2019t Be a Relapse Risk: Why Collegiate Recovery Programs Deserve Sustainable Funding<\/a><\/h4>\n\t\t\t\t\t\t\t<p class=\"wp-block-editorial-relatedstories-article-date\">July 28, 2025<\/p>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t<\/article>\n\t\t\t\t<\/li>\n\t\t\t\t\t\t<\/ul>\n\t<\/aside>\n\t","protected":false},"excerpt":{"rendered":"<p>As collegiate recovery programs (CRPs) continue to expand on college campuses across the United States, so too does the opportunity to incorporate approaches supportive of harm reduction into these programs in order to provide vital, evidence-based support to students navigating diverse recovery journeys and goals. But a lack of understanding of what harm reduction actually [&hellip;]<\/p>\n","protected":false},"author":15205,"featured_media":266264,"comment_status":"closed","ping_status":"closed","template":"","meta":{"bu_prepress_billboard":"","_bu_prepress_primary_term":"","_bu_prepress_primary_term_manual":""},"tags":[1736,5243,1789,1894,3649,5538],"bu-publication":[3516],"sphnews-article-category":[],"sphnews-topic":[],"bu_edition":[],"media_type":[],"profile_tax":[5277,4026],"_links":{"self":[{"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu-article\/266255"}],"collection":[{"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu-article"}],"about":[{"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/types\/bu-article"}],"author":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/users\/15205"}],"replies":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/comments?post=266255"}],"version-history":[{"count":21,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu-article\/266255\/revisions"}],"predecessor-version":[{"id":266373,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu-article\/266255\/revisions\/266373"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/media\/266264"}],"wp:attachment":[{"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/media?parent=266255"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/tags?post=266255"},{"taxonomy":"bu-publication","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu-publication?post=266255"},{"taxonomy":"sphnews-article-category","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/sphnews-article-category?post=266255"},{"taxonomy":"sphnews-topic","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/sphnews-topic?post=266255"},{"taxonomy":"bu_edition","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu_edition?post=266255"},{"taxonomy":"media_type","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/media_type?post=266255"},{"taxonomy":"profile_tax","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/profile_tax?post=266255"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}