The hottest Harm Reduction Substack posts right now

And their main takeaways
Category
Top Health & Wellness Topics

Why Fentanyl Deaths Are Falling

Common Sense with Bari Weiss • 459 implied HN points • 23 Jan 26
🏥 Health & Wellness Harm Reduction
  1. Fentanyl was mixed into the heroin supply starting around 2014, and many dealers and users didn’t even know they were getting it.
  2. Because fentanyl is about 50 times more potent than heroin, its effects hit faster and stronger, which accelerated addiction and initially increased overdoses.
  3. Big shifts in supply and demand, plus the toll of roughly a million deaths, have disrupted the fentanyl market and contributed to falling fentanyl-related deaths.

An Invitation to Think Differently About Addiction Treatment

Culture Study • 3347 implied HN points • 10 Aug 25
🏥 Health & Wellness Harm Reduction
  1. Harm reduction is essential for helping people with addiction. It means meeting people where they are and supporting their decisions rather than judging them.
  2. Many healthcare professionals don't learn enough about addiction treatment in medical school. This lack of education can lead to stigma and inadequate care for those struggling with addiction.
  3. Dr. Marie Nyswander made significant contributions to addiction medicine but is often overlooked. Her work on methadone showed that there are effective ways to treat addiction beyond just abstinence.

The Drug Turning Philadelphia into a Zombieland

Common Sense with Bari Weiss • 593 implied HN points • 09 Dec 25
🏥 Health & Wellness Harm Reduction
  1. Kensington Avenue is an open-air drug market that has shifted from heroin to fentanyl and then to animal tranquilizers, and now a new drug called medetomidine is appearing.
  2. Medetomidine is being mixed into fentanyl and other street drugs, intensifying harms and producing the extreme, 'zombifying' effects people describe.
  3. The area draws people chasing the strongest, cheapest highs, leaving families and the community grappling with a worsening public-health and safety crisis.

I Took 182 Drugs: But Which Was The Worst?

The Drug Users Bible • 59 implied HN points • 01 Oct 24
🏥 Health & Wellness Harm Reduction
  1. Research the drugs you take to stay safe. Some substances may seem harmless but can lead to very bad experiences.
  2. Pay attention to dosage and be careful with potent substances. Taking too much can result in panic and fear, which can be hard to handle.
  3. Alcohol can have serious negative effects, even if it's socially accepted. Recognizing its harmful aspects can help you make better choices.
Get a weekly roundup of the best Substack posts, by hacker news affinity:

It’s Time to Clear the Air on Juul

Common Sense with Bari Weiss • 217 implied HN points • 23 Jul 25
🏥 Health Politics Harm Reduction
  1. The FDA has authorized Juul's e-cigarettes for marketing after a long delay, and this decision has caused surprisingly little backlash.
  2. The once widespread concern about youth vaping has decreased significantly, with much fewer high school students using Juul compared to previous years.
  3. The debate around Juul seems to have shifted, as many health organizations have not raised strong objections following the FDA's recent decision.

If You Visit a Sex Worker, Consider Using Carrageenan Lube

Viruses Must Die • 26 implied HN points • 23 Dec 25
🏥 Health & Wellness Harm Reduction
  1. A lubricant made with carrageenan can reduce HPV infectivity, and a recent FDA‑supervised randomized trial found it safe and at least somewhat effective.
  2. Carrageenan is commonly used and generally regarded as safe in foods and cosmetics, but a product is treated as a drug only if it makes medical claims on its label.
  3. If you have sex outside a long-term relationship, it’s sensible to combine HPV vaccination, regular testing, and PrEP with using carrageenan lube as an extra layer of protection.

From Leaf to Life: The Conversation We Should Be Having Around Kratom 🌱

Tripsitter • 219 implied HN points • 08 Sep 23
🏥 Health & Wellness Harm Reduction
  1. Regulators have targeted kratom in attempts to ban it, but public backlash has prevented complete bans so far.
  2. Kratom is seen as a tool for harm reduction due to its potential as an alternative to prescription painkillers, but it carries risks and should be used carefully.
  3. Misinformation and misrepresentation of kratom-related deaths have fueled the stigma around the plant, highlighting the need for proper regulation and education rather than outright bans.

Does shutting down dark web markets kill people?

Aliveness Studies • 6 implied HN points • 20 Jan 26
🏥 Health Politics Harm Reduction
  1. Nationally, shutting down major darknet markets in mid‑2017 did not cause a spike in fentanyl deaths; instead the growth rate of synthetic opioid deaths slowed afterward, though it’s unclear if the shutdowns caused that change.
  2. The impact varied a lot by state: most states showed deceleration but several showed acceleration, and a few states (notably Ohio) drove much of the national pattern, suggesting local factors matter more than a single national event.
  3. Darknet market transactions plunged right after the shutdowns but recovered within about six months as users moved to other markets, so the disruption was short‑lived and shutdowns look like a temporary whack‑a‑mole fix.

Shades of Pink: The Rise of Colombian Tusi (Pink Cocaine)

Tripsitter • 139 implied HN points • 01 Dec 23
🏥 Health & Wellness Harm Reduction
  1. Colombian Tusi, also known as Pink Cocaine, is a highly variable mixture of substances like ketamine, MDMA, cocaine, and caffeine, often dyed pink.
  2. Tusi originated as a knockoff of the rare and expensive drug 2-CB in an effort to fill a market gap in South America.
  3. The drug Tusip is not to be confused with 2C-B, despite its phonetic similarity, and is created by mixing leftover drugs to produce a colorful and flavorful substance.

Designer Drug Exposé: Introduction To Research Chemicals 🧪

Tripsitter • 159 implied HN points • 28 Sep 23
🏥 Health & Wellness Harm Reduction
  1. Designer drugs are synthetic substances meant to simulate the effects of known psychoactive drugs but with modified chemical structures to avoid legal restrictions.
  2. Designer drugs pose inherent risks like dosing variability, impurities, unknown toxicity, and dangers from unscrupulous vendors, highlighting the importance of harm reduction practices.
  3. The history of designer drugs spans decades, evolving through different eras with the introduction of AI-driven drug discovery, increased regulatory challenges, and a growing market of novel psychoactive substances.

Toronto's toxic supply

City Hall Watcher • 137 implied HN points • 18 Sep 23
🏥 Health & Wellness Harm Reduction
  1. The number of fatal overdoses in Toronto remains high due to a toxic drug supply.
  2. During the pandemic, lack of access to injection sites and community-based programs contributed to rising overdoses.
  3. Pre-obtained drugs from the streets in Toronto have become more toxic, leading to a persisting crisis.

Compassion in Action: How Harm Reduction Saves Lives & Builds Healthier Communities

Tripsitter • 99 implied HN points • 27 Jul 23
🏥 Health & Wellness Harm Reduction
  1. Harm reduction focuses on compassion over punishment, preserving dignity for people who use drugs and creating healthier communities.
  2. Key principles of harm reduction include meeting individuals where they are at, using practical strategies for drug use, and respecting personal autonomy of drug users.
  3. Harm reduction strategies include education on safe practices, distribution of fentanyl test strips and Narcan, needle exchange programs, safe injection sites, medications for opioid use disorder, and safe sex education and supplies.

Free Speech To The Supreme Court — And Beyond!

Public • 234 implied HN points • 11 Aug 23
🇺🇸 U.S. Politics Harm Reduction
  1. The Fifth Circuit court heard oral arguments in the Missouri v. Biden case revealing government coercion of social media companies.
  2. US Attorney announced a crackdown on illegal supervised drug consumption sites in Harlem and San Francisco.
  3. Michael Shellenberger will be joining Ireland's free speech advocates in Dublin to fight against the hate censorship bill.

A Case for Drinking Alone

Anxiety Addiction & Ascension • 59 implied HN points • 31 Oct 22
🏥 Health & Wellness Harm Reduction
  1. The author challenges the idea that drinking alone is always problematic, especially for those looking to reduce harm caused by alcohol consumption.
  2. Having a group of 'drinking buddies' can provide a sense of camaraderie and protection from judgment when overindulging, but it can also reinforce unhealthy behaviors.
  3. Limiting social drinking and occasionally drinking alone may help reduce potential harm and avoid embarrassing situations that can arise from excessive alcohol consumption.

Death Is The Consequence of The Void

The Drug Users Bible • 19 implied HN points • 18 Feb 24
🏥 Health Politics Harm Reduction
  1. Governments should provide drug safety information because it can save lives. When they treat users as criminals, it creates a lack of important information.
  2. A project called the Drug Users Bible provides harm reduction information for drug users. This resource has been made available for free and has already been widely downloaded.
  3. Everyone can help by sharing safety information and resources within their communities. If officials won't help, we can step up and support each other.

On Sticking 2C-T-2 Up My Ass (29/30)

psychotechnology • 3 implied HN points • 30 Nov 25
🎭️ Culture Harm Reduction
  1. 2C-T-2 gives a powerful, mystical sense of connection to nature and awe, but it reliably causes severe nausea, dry-heaving, and whole-body tension during the come-up.
  2. Rectal administration raises bioavailability and speeds the come-up so you can use lower doses, but it can compress the experience and make nausea and body load worse rather than better.
  3. Nausea is likely driven by off-target serotonin receptors in the brain and gut (e.g., 5‑HT2B/2C), so changing the route of administration may not eliminate those side effects, and the imagined benefits of rectal dosing often don’t match the uncomfortable reality.