Draft Open for Public Comment

SAMHSA Harm Reduction Framework

The SAMHSA Harm Reduction Framework is the first document to comprehensively outline harm reduction and its role within the Department of Health and Human Services (HHS). The Framework will inform SAMHSA’s harm reduction activities moving forward, as well as related policies, programs, and practices. 

The Framework

  • Provides a roadmap of best practices, principles, and pillars that anyone can apply to their work.
  • Serves as a list of best practices and services, with descriptions and citations of evidence.
  • Gives a brief background on harm reduction in the U.S. and describes Community-Based Harm Reduction Programs (CHRP) and their mission-critical role in connecting with our communities’ most vulnerable individuals.


The Biden-Harris Administration has identified harm reduction as a federal drug policy priority, and it is one of the four strategic priorities of the U.S. Department of Health and Human Services (HHS) Overdose Prevention Strategy.

SAMHSA convened the first-ever federal Harm Reduction Summit, in partnership with the Centers for Disease Control and Prevention (CDC) and the White House Office of National Drug Control Policy (ONDCP), in December 2021. The Summit brought together over 100 experts representing prevention, treatment, recovery, harm reduction and (most importantly) those with lived and living experience with substance use — to help inform SAMHSA’s policies, programs, and practices.

The Framework was developed and written in partnership with a Steering Committee of harm reduction leaders from around the country. This group represents a broad array of backgrounds and experience, with most having lived or living experience of drug use. The Steering Committee synthesized findings from the Harm Reduction Summit. The Framework is adapted from the Committee’s final report.

How to Provide Comments on the Framework

Submit your comments on the Harm Reduction Framework via a webform no later than August 14, 2023 at 5 p.m. ET. Review these steps on how to provide comments, and then click the button below to go to the submission webform. 

1. Identify the Issues

In your comment, clearly identify which issues you are commenting on within the regulatory action. Provide the page number, column, and/or paragraph if you are commenting on a particular word, phrase, or sentence. You do not have to comment on every issue in a rule. You may select the issues on which you wish to comment.

2. Address Specific Agency Requests

The Department often requests comments on specific parts of proposed rules. This may be a helpful place to focus your comments.

3. Provide Detailed Comments

Constructive, detailed comments (whether positive or negative) are most helpful. If you agree with a proposed action, your comments are helpful to show that the public wants or needs the proposed action. If you disagree with a proposed action, suggest an alternative (including not regulating at all) and include an explanation of how the alternative might meet the same objective or be more effective. Evidence-based information is particularly helpful.

Submit Your Comments here