Substance use and destigmatization: SDG 3 and Me interview with Paige Lemen, PhD candidate
Published in Public Health
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What SDG3 target(s) is your work and the work of the organization most closely aligned with?
Among the targets listed, we are most aligned with the mission to “Strengthen the prevention and treatment of substance abuse,” however, we also focus on reducing the stigma of drug use as well. Not all of those who use drugs, including opioids, have a substance use disorder. Not all who use opioids outside of doctor’s orders are “abusing” the drug. Who determines what is considered abuse anyways?
Substance use disorder is a spectrum. It can range from healthy and responsible drug use to uncontrolled and chaotic drug use to a full disorder. Oftentimes, this depends on the individual’s quality of life. For example, someone who has all their needs met and can pay all of their bills is more likely to be able to control their drug use compared to someone who is experiencing homelessness, abuse and trauma, exploitation or some other issue that many of our most vulnerable people in our society experience.
Instead of policing drug use and taking a “punish and control” approach, we need to be focusing on the underlying causes that lead to people using drugs in a risky way in the first place.
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Do you feel there is something missing from the specific SDG 3 targets of the areas you are most interested in?
We want to show the importance of including the experiences and voices of those who use drugs. As our paper mentions, “Those with lived and living experience have unique insight into the complexities of overdose and the effectiveness of naloxone. They can provide valuable information on how a higher dose formulation may impact their ability to respond to an overdose. Additionally, they can offer insight into other factors that may contribute to overdose, such as polysubstance use or lack of access to harm reduction services. By listening to those with lived and living experience, we can gain a better understanding of the challenges and barriers faced by PWUD [people who use drugs] and make more informed decisions about how to address overdose in a way that is effective, equitable, and inclusive.”
Another important target for us is to bridge the gap between researchers and those working “on the ground,” as in directly with drug users and those with substance use disorder (SUD), or drug users themselves. From personal experience, I have worked with scientists who struggle to design studies that provide results that could be translated to treatment and prevention in humans, especially within our current society and policy landscape. This is because they lack the knowledge of how drug use and SUD occur in real life.
I’ve also worked with harm reductionists and drug users who could benefit, either in their work or personally, from understanding the science of drugs and SUD, or even how the scientific process itself, research, and funding works.
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Who (or what groups) would you like to work with, or would like to be in contact with, to push forward your ideas/projects?
As a PhD candidate, I’ll soon be Dr. Lemen and want to use my training in biomedical sciences to improve the lives of those who use drugs and those with SUD. However, I’m not sure in which way I’d like to go about that; scientific advisor, post-doc (continue doing the research I do now in academia), industry, or maybe even scientific journalism.
Academia needs SUD researchers with real world experience and have undergone the unlearning process of all the drug war propaganda that many scientists don’t even recognize they’ve fallen for as well. In that case, I’d love to work with like-minded researchers that have funding for post-docs.
I’m also interested in getting more involved with policy work or journalism in this same field. In that case, I’d love to connect with the Drug Policy Alliance and the Harm Reduction Coalition. However, it is possible to do both and one does compliment the other!
Paige M. Lemen is a PhD candidate at the University of Tennessee Health Science Center, studying the neurobiology and genetics of drug use and substance use disorder (SUD). She specializes in opioid use disorder (OUD) by using rats to model social determinants of health and adolescent adverse experiences, including social isolation, and how they play a role in drug use and the risk of developing OUD in adulthood. However, her research interests stem from years of experience being personally affected by OUD and the overdose crisis. Paige grew up in Cincinnati, Ohio, which has one of the highest overdose rates in the US. Here, she experienced a lot of stigma and misinformation about drug use and harm reduction which led to losing loved ones to overdose, incarceration, and harmful policies changes that involved treating drug users and harm reduction workers as the enemy. One example is the use, or lack of use, of naloxone. She is currently working on publishing another paper on naloxone that looks at genetic variation among the differences in response to morphine and naloxone-induced withdrawal. Paige hopes to bring the knowledge of people who use drugs and harm reduction workers to those actually studying and advocating for policy changes surrounding the proper use of naloxone, including the benefits and the risks.
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Harm Reduction Journal
This journal publishes research and commentary on approaches diminishing the harm of stigmatization, marginalization and criminalization of public health, human rights and social justice issues, as well as rebuking the de facto criminalization of marginalized and stigmatized communities.
Related Collections
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The Need for Intersectionality in Harm Reduction and Gender-Based Violence
This special collection of the Harm Reduction Journal focuses on the significance of intersectionality in advancing understandings of how to reduce gender-based violence and other harms in social issues such as alcohol use, gambling, tobacco, sex work, the internet, human enhancement drugs, psychoactive and addictive substances, incarceration, road trauma, youth justice issues, domestic and intimate partner violence, filicide, infanticide, parental exploitation, victims and perpetrators, and law enforcement.
Contributors are encouraged to explore diverse ways in which they have addressed these social issues, upholding human rights. This collection encourages contributors to think of intersectionality with specific emphasis on marginalised and vulnerable communities, such as people living with disability, gender and sexuality diversity, religious minorities, the young and the elderly and incarcerated individuals. Addressing intersectionality in the context of institutional responses, we encourage scholars, practitioners and academics from diverse disciplines to identify alternative ways of reducing harm through allied health professions such as occupational therapy, recreational therapy, and others, and people from criminal justice/criminology/law enforcement, social work, psychology/counselling, doctors, and nurses. We encourage submissions that speak to unconventional ways of addressing the issues either through co-designed research, methodological approaches, research findings etc.
This Collection supports and amplifies research related to SDG 3, Good Health and Well-Being, SDG 5, Gender Equality, SDG 10, Reduced Inequalities, and SDG 16, Peace, Justice and Strong Institutions.
All submissions in this collection undergo the journal’s standard peer review process. Similarly, all manuscripts authored by a Guest Editor(s) will be handled by the Editor-in-Chief. As an open access publication, this journal levies an article processing fee (details here). We recognize that many key stakeholders may not have access to such resources and are committed to supporting participation in this issue wherever resources are a barrier. For more information about what support may be available, please visit OA funding and support, or email OAfundingpolicy@springernature.com or the Editor-in-Chief.
Publishing Model: Open Access
Deadline: Aug 31, 2025
The Changing Face of Harm Reduction
Harm reduction has historically been thought of in relation to drug use and originally gained traction as a movement during the HIV/AIDS epidemic, where needle exchange programs were shown to reduce the transmission of the virus without necessarily reducing the level of injection drug use. Grassroots activism and an openness to the accounts of drug users caused the harm reduction movement to grow during the so-called “War on Drugs” and the opioid crisis in the US. Later, harm reductionists took aim at tobacco and alcohol. All these topics have been covered extensively by the Harm Reduction Journal since our founding in 2004.
It has become clear that the harm reduction philosophy should be applied to other types of public health issue where ineffective policies cause excessive harm to vulnerable populations. This collection seeks to compile Harm Reduction Journal’s best content on these new frontiers and encourage further discussion. All submissions will be reviewed by the Editor-in-Chief or Deputy Editor for their suitability to this collection and will then be assigned to the relevant Section Editor for review. Articles that do not fall into the sections outlined below are still encouraged and will be handled and included at the discretion of the Editor-in-Chief.
For more information on how articles on emerging topics will be handled by the journal, take a look at our Editorial Board or Contact Us for more information.
Edited by:
Professor Nick Crofts, AM, MB, MPH, FAFPHM, University of Melbourne, Australia, Editor-in-Chief
Public health is presented with a range of new challenges in emerging areas of importance and the success of the harm reductionist approach has encouraged research into other areas. As the sole public health journal that focuses exclusively on the harm reduction philosophy, Harm Reduction Journal is acutely aware of how the field is changing and is keen to encourage further growth. The internet, human enhancement, gambling, road trauma and sex work are all key areas where we hope to see more articles. Further to this, we are looking to elevate the voices of young people and AYAs, peers and people who use(d) drugs, those involved with the justice system, under-represented and vulnerable populations, and countries in the Global South (where harm reductionism has historically been less applied). Lastly, we are seeking broader perspectives on decriminalization and how this contributes to harm or harmful behaviours.
We have compiled some of the most impactful research from our open access archive to showcase these emerging themes and encourage further submissions. Our Section Editors are actively soliciting articles and would welcome any correspondence from potential authors looking to submit.
Following an initial assessment by the Editor-in-Chief or Deputy Editor, each manuscript will be assigned to the relevant Section Editor for review.
Section Editors for Drugs and the Internet
Angus Bancroft: University of Edinburgh, United Kingdom
Aleksey Lakhov: Humanitarian Action, Russia
Section Editor for Human Enhancement Drugs
James McVeigh: Manchester Metropolitan University, United Kingdom
Section Editor for Youth, Drugs and Harm Reduction
Danya Fast: University of British Columbia, Canada
Florian Scheibein: South East Technological University, Ireland
Section Editor for Gambling Harm Reduction
Michael Egerer University of Helsinki, Finland
Other suitable papers on emerging public health issues will be handled by the Editor-in-Chief or a relevant Associate Editor.
All submissions in this collection undergo the journal’s standard peer review process. Similarly, all manuscripts authored by a Guest Editor(s) will be handled by the Editor-in-Chief. As an open access publication, this journal levies an article processing fee (details here). We recognize that many key stakeholders may not have access to such resources and are committed to supporting participation in this issue wherever resources are a barrier. For more information about what support may be available, please visit OA funding and support, or email OAfundingpolicy@springernature.com or the Editor-in-Chief.
Publishing Model: Open Access
Deadline: Ongoing
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