Harm reduction: how to stay safer using drugs or alcohol
This section of our site brings together all our harm reduction information in one place. It links to individual pages covering different drugs, risks, and safer use advice, based on the same content in our printed leaflets, booklets and posters.
What is harm reduction?
Harm reduction is a public health approach that focuses on reducing the negative health, social and legal harms associated with drug and alcohol use. It recognises that people use substances for different reasons and provides practical advice to reduce risk, prevent injury and save lives.
Harm reduction does not require someone to stop using drugs or alcohol. Instead, it offers clear, evidence-based information so people can make safer decisions.
In the UK, harm reduction is used by drug and alcohol services, public health teams, outreach workers and peer networks. It includes simple, practical steps such as:
- Avoiding high-risk drug combinations
- Carrying naloxone where opioids are involved
- Using sterile injecting equipment
- Recognising early signs of overdose
- Pacing alcohol consumption
The aim is straightforward: reduce preventable harm and lower drug and alcohol related deaths.
Why harm reduction matters in the UK
Drug-related deaths in the UK remain at historically high levels, particularly those involving opioids. Alcohol-related hospital admissions also continue to place significant pressure on health services.
Several factors increase risk:
- Mixing substances such as opioids, benzodiazepines and alcohol
- Changes in drug supply strength
- Contamination with synthetic opioids such as fentanyl or nitazenes
- Using alone
- Reduced tolerance after periods of abstinence
Clear harm reduction advice helps people understand these risks and take practical steps to reduce them.
Whether someone is using heroin, crack cocaine, ketamine, benzodiazepines, gabapentinoids, GBL or alcohol, the principles remain consistent: understand how the drug affects the body, avoid high-risk combinations, and know when to seek medical help.
Explore harm reduction advice by substance
Below you’ll find detailed harm reduction guides covering specific drugs and alcohol. The copy reflects the wording in our printed drug and alcohol booklets and leaflets.
Each harm reduction guide explains:
- How the substance works
- Short and long-term risks
- Signs of overdose or toxicity
- Practical steps to reduce harm
- When to get help
Overdose prevention and contamination risks
Recognising overdose early can save lives.
Opioid overdose
Opioids slow breathing. When too much is taken, or when opioids are mixed with alcohol or benzodiazepines, breathing can slow or stop.
Common signs include:
- Slow, irregular or no breathing
- Gurgling or choking sounds
- Blue or grey lips and fingertips
- Unresponsiveness
In an emergency:
- Call emergency services immediately
- Administer naloxone if available
- Provide rescue breaths
- Place the person in the recovery position once breathing resumes
Synthetic opioids: fentanyl and nitazenes
Synthetic opioids such as fentanyl and nitazenes are far more potent than heroin. They have been detected in UK drug supplies, sometimes without the person’s knowledge. This increases overdose risk significantly.
Safer practice includes:
- Using a small test amount if supply changes
- Avoiding mixing with alcohol or benzodiazepines
- Carrying naloxone
- Staying informed about local drug alerts
Alcohol harm reduction
Alcohol is legal but can cause serious harm, particularly when consumed quickly or combined with other depressant drugs.
Reducing harm includes:
- Eating before and during drinking
- Pacing drinks and avoiding rapid consumption
- Alternating alcoholic and non-alcoholic drinks
- Avoiding drinking games
- Knowing the signs of alcohol poisoning
Mixing alcohol with opioids, benzodiazepines or GHB significantly increases the risk of breathing suppression and unconsciousness.
Polydrug use and mixing risks
Many serious drug-related harms occur when substances are combined.
High-risk combinations include:
- Opioids and benzodiazepines
- Opioids and alcohol
- GHB or GBL and alcohol
- Cocaine and alcohol
Understanding these interactions is a key part of harm reduction.
Harm reduction services in the UK
Harm reduction services aim to reduce risk, prevent infection and lower overdose deaths. These include:
- Needle and syringe programmes
- Naloxone distribution
- Drug and alcohol treatment services
- Outreach and peer support
- Drug checking where available
Accessing harm reduction support does not require someone to stop using drugs. The focus is safety, stability and reducing preventable harm.
Frequently asked questions
Is harm reduction the same as encouraging drug use?
No. Harm reduction recognises that drug and alcohol use occurs and focuses on reducing preventable harm. Evidence shows that interventions such as needle exchange and naloxone distribution reduce deaths and disease transmission without increasing drug use.
Who is harm reduction for?
Harm reduction advice is relevant to people who use drugs or alcohol, families, frontline workers, commissioners and public health teams.
