Meet the ‘harm reduction influencers’ making safer drug habits go viral on social media

A small but dedicated group of online creators is using the power of the internet to share important information and help prevent overdose deaths.

NBC News; TikTok

When you're scrolling through TikTok or swiping through Instagram, you might see something unusual: Videos showing how to use naloxone, an opioid overdose treatment, posts about testing drugs and infographics about substance use proliferate on both platforms.

The social media messages just demonstrate how far the practice of harm reduction has come. The field, which is backed by decades of research and real-world application, has been practiced in the United States since the late 1980s, is seeing a surge of interest as overdose deaths rise. Online, harm reduction "influencers" are harnessing that newfound interest to educate and inform viewers.

Theo Krzywicki, the founder and CEO of End Overdose, a Los Angeles nonprofit that focuses on overdose reversal and rapid response training, said using TikTok and Instagram has been an effective way to reach younger audiences. Overdose death rates are highest among people aged 15 to 34, according to the Centers for Disease Control and Prevention.

"We use it really to just show people that the resources are there (and) where they can get it," said Krzywicki, who is 11 years sober. "(We also) give people an inside look at what we’re doing as an organization and then use it to debunk (misinformation)."

On TikTok, End Overdose's videos regularly receive thousands of views and hundreds of comments. Every so often, a video will go viral, skyrocketing in popularity and garnering hundreds of thousands of views. While it's hard to gauge just what will get that level of response, Krzywicki said that the key is mixing scientific information with whatever is trending on TikTok at the moment.

"We just do trends, really," Krzywicki said. "TikTok's algorithm favors whatever is trending ... So we answer basic questions, we'll do how-to videos. A big thing is they’re really simple. We don’t use them to be like training pieces, we use the videos to just garner attention and drive traffic to our online resource, or how people (take a course) with us in person."

Those online interactions have a real-world impact: Krzywicki said that he's seen a marked increase in the amount of inquiries End Overdose has received since the group began using social media in August 2021. They've shipped Narcan (a naloxone nasal spray) all over the country, and because they feature a mandatory online training, that means people are equipped with the tools and information to reverse an overdose.

According to the National Institutes for Health, in some states, you can get naloxone from pharmacies with or without a personal prescription or from community-based groups or local health departments. 

It's not just large organizations using social media to make an impact: Individual users are also spreading information on harm reduction and drug safety with their personal pages. Jessica L., the creator behind the TikTok account @partysaferwithJess, said that she found herself in the harm reduction space after getting more involved in the rave and festival community, which often deals with drug use and overdose. While practicing harm reduction at festivals can be difficult, the creator said that it's "much easier" to share the information and skills with the same community online.

"The reality is people have a short attention span ... TikTok and Instagram are definitely better platforms (because) you're able to get information across and you're able to hold people's attention," said Jessica, who asked to be identified only by her first name to protect her privacy and employment. "Because of the sort of viral nature of TikTok and now Instagram reels, it's able to reach a much broader audience."

Both Jessica and Krzywicki said that they struggle with content moderation on the platforms, though Jessica said that she has become part of TikTok's Instructive Accelerator Program. That program, formerly known as the Creative Learning Program, rewards creators who develop "quality instructive content" for the platform. TikTok confirmed that Jessica is part of the program.

"It was really nice to be recognized by TikTok, especially because of how taboo my content is," Jessica said.

Krzywicki said that he and others at End Overdose have had to come up with backup plans about what they'd do if their accounts were shut down by TikTok or Instagram (which is owned by Meta, the same parent company as Facebook).

"We're extremely dependent on social media, and with the way social media treats harm reduction in general, it can be kind of nerve-wracking (to worry about) if something gets a violation or banned," Krzywicki said.

A spokesperson for TikTok told TODAY that the app aims to "strike a balance between creativity, education, and safety" and their community guidelines note that some content that "would normally be removed ... may be in the public interest." However, the spokesperson said the app does not allow content "glorifying or promoting drug use." Meta did not respond to a request for comment clarifying their guidelines or content moderation practices.

In addition to connecting with a wide audience of viewers, social media lets those who practice harm reduction connect with peers.

"I realized that connecting with other harm reductionists in other parts of the country, in the world, would be really beneficial," said Claire Zagorski, a Texas harm reductionist and paramedic who found herself drawn to the field after seeing a patient whose overdose had been reversed by friends rather than needing to wait for EMS services. "Because harm reduction is pretty young as an organized academic field ... it's not as easy as just subscribing to a journal to stay on top of what's going on. It's very much rooted in word of mouth and shared collective knowledge."

Now, Zagorski is able to connect with people all over the world, share best practices and debunk misinformation about harm reduction and substance use. She even recently used her social media reach to find several rural harm reductionists and fund their travel to the National Harm Reduction Conference.

"I’ve been able to connect a lot of people to a lot of resources, teach a lot of people things, I’ve been able to lend my voice to legislative advocacy, to talking to doctors on behalf of their patients, and all kinds of really cool stuff," Zagorski said. "It keeps reinforcing that there’s power in just getting the information out there."

Krzywicki said that he sees the success of End Overdose's social media presence reflected in the impact the organization has. In June 2022, the organization had already given out around 50,000 fentanyl testing kits and almost 10,000 doses of naloxone. Bringing that access and information to social media is just a way of following one of harm reduction's central tenets: Meeting people where they are.

"Our mission is to make sure that you know anyone that wants to naloxone kit, they can have proper training and have it accessible and that it’s available and it’s not taboo," Krzywicki said.