Breaking Silos, Saving Lives

Harm Reduction Collaboratory

In North Carolina, South Carolina and nationally, addiction to opioids has exploded in recent decades, rising to epidemic levels. This trend has been especially problematic in rural areas where treatments for addictions may be inaccessible.

“Since around 2013, synthetic opioids, primarily illicit fentanyl, have made the number of opioid overdose deaths spike dramatically in a way that’s pretty scary,” says Dr. Dana Clifton, assistant professor in medicine and pediatrics at Duke University and co-chair of a program called Caring for Patients with Opioid Misuse through Evidence-Based Treatment (COMET).

More than 36,000 North Carolinians have died from overdose since 2000, according to the N.C. Division of Health and Human Services.

In response, the Harm Reduction Collaboratory was established through a $5 million grant to Duke University School of Medicine’s Department of Population Health Sciences. Originally focused on the opioid crisis, the Collaboratory today deals with a spectrum of substance use issues, and serves as a hub for research, evaluation, knowledge sharing, training and community engagement.

“The Collaboratory is comprised of many, many organizations. The real importance of having all of those voices is that opiod overdose and health outcomes related to drug use is a really complex problem.”

Asheley Skinner, Ph.D., Principal Investigator, Harm Reduction Research Collaboratory

TDE 100 Harm Reduction Collaboratory Ashley

“Harm reduction is a perspective on health where the goal is to reduce the harm that may come from either [the patient’s] health behavior or other experiences that they have,” says Dr. Asheley Skinner, Ph.D., principal investigator at the Harm Reduction Research Collaboratory.

Harm reduction approaches seek to minimize overdoses and other negative consequences of substance use while avoiding incarceration or other punitive measures for patients. These harm reduction approaches include strategies such as “safer use, managed use, abstinence, meeting people who use drugs ‘where they’re at,’ and addressing conditions of use along with the use itself,” according to the National Harm Reduction Coalition.

Embedded in the Harm Reduction Collaboratory is a strategic, systems-based approach that brings together researchers, health care professionals, policymakers and community stakeholders to develop innovative strategies for harm reduction. Embrace of this collective approach highlights how the Endowment honors founder James B. Duke’s vision of health as an enduring priority, even as it also evolves to meet current needs with new evidence-based and evidence-informed strategies.

Just as Mr. Duke intended, people and communities across North Carolina and South Carolina remain the guiding focus of all involved in the Harm Reduction Collaboratory. “Because there is drug use involved, there’s a tendency to not see them [patients] as people,” says Skinner. “Instead, they experience their health behavior as being attributed solely to their own moral failings. I don’t believe that. I believe all people deserve the best we can give to them.”

Learn more about the Harm Reduction Collaboratory.

00 Harm Reduction Collaboratory participants