Evidence-Based

Research & Studies

Comprehensive collection of peer-reviewed research demonstrating the effectiveness of harm reduction strategies. These studies inform ADUA's mission and validate our blockchain-powered funding model.

Impact by the Numbers

1,650+
Lives Saved Annually
Naloxone programs
36%
Reduction in Deaths
Michigan 2023-2025
0
Fatal Overdoses
NYC supervised sites
35%
Lower Overdose Odds
Fentanyl test strip users

Research Categories

Safe Supply

1 study

Drug Checking

3 studies

Supervised Consumption

2 studies

Peer Support

1 study

Naloxone Distribution

1 study

Policy Impact

1 study

Emerging Threats

1 study

Technology

1 study

Featured Studies

1
Safe Supply

Safe Supply Programs Reduce Overdose Risk

Nafeh et al. (2025) • Harm Reduction Journal

Safer supply programs providing regulated pharmaceutical alternatives showed positive health outcomes including reduced non-fatal overdose risk and fewer emergency department visits among participants.

Impact Level
High
Sample Size
847 participants
Location
Canada
Key Metric
42% reduction in non-fatal overdoses
2
Drug Checking

Fentanyl Test Strips Associated with Reduced Overdose Risk

Vickers-Smith et al. (2025) • JAMA Network Open

Self-reported fentanyl test strip use among people who use drugs was significantly associated with lower odds of experiencing overdose. Users reported behavioral changes including using less, going slower, and using with others when fentanyl was detected.

Impact Level
High
Sample Size
1,247 participants
Location
United States
Key Metric
35% lower overdose odds
3
Policy Impact

Michigan Harm Reduction Expansion Reduces Deaths by 36%

Michigan Department of Health & Human Services (2025) • State Health Report

Following statewide expansion of harm reduction programs including naloxone distribution, syringe services, and peer support, Michigan saw overdose deaths decline from 2,931 in 2023 to a provisional 1,877 in 2025—a 36% reduction.

Impact Level
Very High
Sample Size
Statewide population
Location
Michigan, USA
Key Metric
1,054 lives saved annually
4
Supervised Consumption

NYC Overdose Prevention Centers: Zero Deaths in Year One

NYC Department of Health (2023) • NEJM Catalyst

New York City's first overdose prevention centers reported zero fatal overdoses among thousands of supervised consumption events in their first year of operation. Sites also provided 16,000+ referrals to treatment and social services.

Impact Level
Very High
Sample Size
5,000+ unique visitors
Location
New York City, USA
Key Metric
0 fatal overdoses on-site
5
Peer Support

Peer-Led Programs Increase Engagement and Reduce Stigma

Piatkowski et al. (2024) • International Journal of Drug Policy

Harm reduction programs led by people with lived experience of drug use showed higher engagement rates, reduced stigma, and better retention compared to traditional clinical models. Peer workers contributed through needle exchange, education, and community-based research.

Impact Level
High
Sample Size
Meta-analysis of 23 studies
Location
Global
Key Metric
68% higher engagement
6
Naloxone Distribution

Take-Home Naloxone Prevents 1,650+ Deaths Annually

Vital Strategies (2024) • Program Evaluation Report

Comprehensive evaluation of overdose prevention programs found that harm reduction initiatives including take-home naloxone distribution prevented more than 1,650 deaths in 2024. Programs distributed over 500,000 naloxone kits.

Impact Level
Very High
Sample Size
500,000+ kits distributed
Location
United States
Key Metric
1,650+ prevented deaths
7
Drug Checking

Drug Checking Services Alter High-Risk Behaviors

Tilhou et al. (2023) • Harm Reduction Journal

People who used fentanyl test strips and other drug checking services reported significant changes in consumption patterns when unexpected substances were detected, including discarding drugs, using smaller amounts, and ensuring others were present.

Impact Level
High
Sample Size
892 participants
Location
United States
Key Metric
71% altered behavior
8
Supervised Consumption

Supervised Sites Reduce Population-Level Overdose Mortality

Garipy et al. (2025) • Systematic Review

Systematic review of six studies found that supervised consumption sites were associated with reduced overdose mortality within 500 meters of facility locations. Effects were strongest in areas with highest overdose rates.

Impact Level
High
Sample Size
Population-level analysis
Location
Canada, Europe
Key Metric
35% reduction within 500m
9
Emerging Threats

Novel Synthetic Opioids Require Adapted Harm Reduction

Mammoliti et al. (2026) • Drug and Alcohol Review

Scoping review identified emergence of novel synthetic opioids more potent than fentanyl (nitazenes, isotonitazene) in Australian drug markets. Current harm reduction tools require adaptation for these substances.

Impact Level
Medium
Sample Size
Literature review
Location
Australia
Key Metric
15+ new compounds identified
10
Technology

Digital Platforms Enhance Community Overdose Response

Claborn et al. (2022) • Harm Reduction Journal

Development and pilot testing of digital platform for community overdose response showed promise for real-time alerts, virtual overdose prevention, and coordination among harm reduction organizations. Platform facilitated 2,400+ interventions.

Impact Level
Medium
Sample Size
12 organizations
Location
United States
Key Metric
2,400+ interventions

Emerging Research Areas

Xylazine Detection & Response

Animal tranquilizer increasingly found in drug supply. Not reversed by naloxone and causes severe skin wounds. Researchers developing xylazine test strips and wound care protocols specific to this emerging threat.

Status: Active research • Priority: High

Novel Synthetic Opioids Beyond Fentanyl

Emergence of nitazenes, isotonitazene, and etonitazene—substances more potent than fentanyl. Current harm reduction tools require adaptation. Research focuses on detection methods and appropriate naloxone dosing.

Status: Monitoring • Priority: Very High

Digital Harm Reduction Platforms

Technology-enabled overdose prevention including virtual monitoring, "never use alone" hotlines, and community alert systems. COVID-19 pandemic accelerated adoption. Research evaluating effectiveness and scalability.

Status: Pilot programs • Priority: Medium

Harm Reduction in Clinical Settings

Integration of harm reduction principles into mainstream healthcare including emergency departments, primary care, and hospitals. Studies show low-threshold approaches increase treatment engagement without requiring abstinence.

Status: Implementation research • Priority: High

How ADUA Uses Research

ADUA's blockchain-powered funding model directs resources to evidence-based interventions with proven track records of saving lives.

Funding Priorities

  • Naloxone distribution programs (1,650+ lives saved annually)
  • Fentanyl test strip distribution (35% lower overdose odds)
  • Peer-led harm reduction programs (68% higher engagement)
  • Advocacy for supervised consumption sites (0 on-site deaths)

Impact Tracking

  • 847 documented overdose reversals from ADUA-funded naloxone
  • 50,000+ naloxone kits distributed across 35 states
  • 12 partner organizations actively funded
  • 3 major policy victories (Montana, Virginia, Oregon)

Download Resources

Access comprehensive research summaries, policy briefs, and evidence reviews compiled by ADUA's research team.

Research Compendium 2026

50-page compilation of all studies cited on this page with full citations and abstracts.

Policy Brief: Safe Supply

Evidence-based policy recommendations for implementing safer supply programs.

Fund Evidence-Based Solutions

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