Olivia Nicastro | Embracing harm reduction for substance use at Penn

In a pilot study of Penn undergraduates, 39% of respondents reported using alcohol or other recreational drugs for the express purpose of combating stress. Penn’s primary substance use resource hub is the SUPER (Substance Use, Prevention, Education, and Recovery) program, which provides students with a list of recovery resources, including Alcoholics Anonymous, Narcotics Anonymous, and Al-Anon. The program also provides wellness workshops focused on harm reduction strategies, which is a scientifically-supported approach to substance use focused on directly engaging with individuals who use drugs to reduce the negative consequences associated with drug use. Although Penn has implemented progressive measures, additional steps are necessary to keep pace with evolving harm reduction strategies. 

One key harm reduction strategy not yet utilized by Penn is the implementation of syringe exchange programs. These programs provide places where substance users can get new, clean injecting equipment, receive advice for staying safe, and return any used equipment for safe disposal. The use of needles, particularly when they are unsterile or shared, significantly increases the risk of transmitting diseases such as hepatitis C and HIV. Nationwide, these programs are associated with an estimated 50% reduction in the incidence of both diseases.

Penn would also benefit from distributing harm reduction products to every incoming first year during New Student Orientation. One such product is testing strips, which can detect substances like fentanyl or xylazine. Fentanyl, a synthetic opioid, is significantly more potent than morphine and heroin and is a major drug threat in the Philadelphia area. It is commonly found in drugs used by college students, such as cocaine, methamphetamine, MDMA, and counterfeit Xanax. 

The rise in fentanyl overdoses is alarming, as seen in three recent deaths at the University of North Carolina at Chapel Hill. Additionally, xylazine, a veterinary tranquilizer, can dangerously depress breathing and heart rate and is often mixed with fentanyl. The drug has only recently appeared in the overdose crisis, so its nationwide impact on overdoses is still unclear. Narcan, an opioid antagonist that rapidly reverses overdoses, should also be regularly distributed by the University. In 2022 alone, 14,716 Americans died from opioid overdoses. Even if not every student uses these supplies, having them on hand is essential, given that nearly one-third of college students know someone who has overdosed.

Harm reduction extends beyond distributing safer use supplies — it also involves education. Penn could support organizations like The Everywhere Project, a nonprofit providing education and safer use supplies such as Narcan, safer injection kits, safer smoking kits, and testing strips, to operate with Penn students. Another potential partner organization is Prevention Point, a nonprofit public health organization offering harm reduction services in Philadelphia and the surrounding area. These organizations could provide incoming first years with essential safety information and demonstrations during NSO. This includes avoiding drinking on an empty stomach, pacing oneself rather than drinking rapidly, not mixing alcohol with other substances, testing drugs with strips before use, recognizing a drug overdose, administering Narcan, and never sharing needles.

Other universities across the country have adopted various harm reduction strategies, such as the Syringe Services Program at UNC Chapel Hill, the Alcohol Harm Reduction Plan at the University of Iowa, and the Safer Drug Use for College Students Initiative at San Francisco State University. Concurrently, the government has introduced legal measures that support harm reduction efforts on college campuses, including “Good Samaritan” laws. These provisions protect individuals who seek medical help or administer Narcan to someone experiencing a drug-related overdose, shielding them from arrest, charges, or prosecution for their own drug-related offenses. Similarly, Penn has a medical amnesty policy stating that no student seeking medical treatment for an alcohol or drug-related overdose, or helping an intoxicated student, will face University discipline for using or possessing alcohol or drugs. However, to further foster a non-judgmental campus environment, it is important to implement additional measures, such as guaranteed confidentiality, which have not yet been put into place. 

Central to the effectiveness of harm reduction is the creation of a non-judgmental and empathetic environment on college campuses. Drug use in its various forms is a reality for many students during their college years. By acknowledging this fact and focusing on understanding and mitigating the negative consequences, Penn can better support student safety and well-being. Through the distribution of safer use supplies, comprehensive education, and accessible support services, Penn can empower students to make safer choices and ultimately enhance their chances of successfully navigating their college experience.

OLIVIA NICASTRO is a rising College senior studying psychology from Lancaster, Pa. Her email is nolivia@sas.upenn.edu.