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As Rates of Fatal Overdose Soar, New Resources Feature Survival Strategies for People Who Use Drugs When They Are Alone

As Rates of Fatal Overdose Soar, New Resources Feature Survival Strategies for People Who Use Drugs When They Are Alone

November 12, Philadelphia –The overdose crisis has touched millions of people in the United States, with nearly 500,000 lives lost over the last decade alone. COVID-19 has exacerbated the overdose crisis with 93,000 lives lost due to overdose in 2020 alone, the highest number ever recorded in one year.   

Using drugs alone is a leading risk for overdose death, as there is no one around who can administer naloxone, the life-saving opioid overdose reversal drug, or call 911 for help. Harm reduction and public health experts encourage people who use drugs never to use drugs alone, but shame, stigma and the threat of punishment drive many people to use drugs alone. Evidence-driven harm reduction recognizes that offering information to meet people where they are at with their drug use – such as encouraging people to take incremental steps for greater safety if they use alone – can save lives.   

Project SAFE, a Philadelphia-based mutual aid harm reduction organization for women, queer, and transgender people who use drugs and do sex work, in partnership with public health organization Vital Strategies, has created two new resources to address this complex problem of solo drug use: one offering guidance for people who use drugs on how to be safer if they use alone, and a second for organizations who serve people who use drugs.  

“The adulteration with fentanyl and other psychoactive contaminants in the unregulated drug supply has heightened the need to think pragmatically and proactively about safety skills when using drugs alone,’ said Jen Bowles, Board Member of Project Safe. “It is shortsighted to think that people who use drugs always have a ‘safe’ person present to use drugs with. And so, we turned to our community for guidance on this difficult subject, and, as further evidenced by these documents, their expertise is unparalleled.”  

The “Do You Ever Use Drugs Alone?” guide for people who use drugs by people who use drugs shares how to use drugs as safely as possible, and what strategies to use to prevent overdose, when using drugs alone. Information and suggestions in the pamphlet include “learn about the day’s drug supply,” “plan before using,” and “lessons from sex workers who use drugs on navigating client and provider use.”   

“I hear people talking about the guide. I hear people using the statements that are in the guide, even the men are bringing it and taking in information,” said O, a Project Safe participant. “It’s very helpful and it’s keeping people more alert and more aware. We are addicts but we don’t have to be dead addicts. The guide was the best thing I have seen in a long time and I’m glad to put it out there and make people more aware. Not only addicts, but people who aren’t addicts too.”  

The second guide, “Survival Strategies While Using Drugs Alone from People Who Use Drugs,” focuses on groups that provide services to people who use drugs with suggestions for improvements to harm reduction and public health messaging to never use drugs alone. Also sourced through knowledge and experiences gathered directly from people who use drugs, the guide addresses why solo drug- use commonly occurs, and shares safety strategies for survivorship.   

“To save lives, harm reductions organizations and service providers need to tap into and respect the knowledge and experience of people who use drugs,” said Tracy Pugh, Senior Technical Advisor for Vital Strategies. “These new resources – built through listening and learning – share risk reduction methods that those who have used drugs while alone are taking to protect themselves and their peers, and may empower people to take steps that lessen the chance of a fatal overdose if they use alone.”  

About Project SAFE 
Project Safe is a volunteer-run mutual aid-based collective providing harm reduction supplies and related efforts for women and queer people involved in the street economies of Philadelphia. We have existed for more than 15 years, led and informed by the expertise of community members who use drugs and do sex work. 

To find out more, please visit social platforms (Twitter, Instagram, Facebook) @safephila and at We can be contacted at

About Vital Strategies 
Vital Strategies is a global health organization that believes every person should be protected by a strong public health system. We work with governments and civil society in 73 countries to design and implement evidence-based strategies that tackle their most pressing public health problems. Our goal is to see governments adopt promising interventions at scale as rapidly as possible.      

 To find out more, please visit or Twitter @VitalStrat.      

About Vital Strategies’ Overdose Prevention Program      

In November 2021, Bloomberg Philanthropies announced a five-year, $120 million investment to help combat the overdose crisis in the hard-hit states of Kentucky, New Jersey, New Mexico, North Carolina and Wisconsin. The initiative builds on work of the past three years in Michigan and Pennsylvania, launched in 2018 with $50 million and expands the work to promote improved federal policies. The partnership between Vital Strategies, Pew Charitable Trusts, Johns Hopkins University, CDC Foundation, and Global Health Advocacy Incubator is helping to strengthen and scale up evidence-based, data-driven policies and interventions to reduce overdose risks and save lives. 

To find out more, please visit or Twitter @VitalStrat.     

Media Contacts: 

Vital Strategies: Tony Newman:; 646-335-5384   
Project Safe: