From Harm Reduction on the Streets to Research in the ED

By Brittany Salerno

Brittany Salerno, MPH, is project manager of Substance Use Research in Emergency Medicine at Penn Medicine’s Center for Addiction Medicine and Policy and recently earned a Master of Public Health from the University of Pennsylvania’s Perelman School of Medicine. Here, she shares how her passion for advocacy influenced her career path.

I have an undergraduate degree in journalism and previously worked as a documentary-style photographer. Photography is still a hobby, but my true calling is harm reduction and outreach on the streets of Philadelphia.

The philosophy of harm reduction involves engaging respectfully with people who use drugs and providing tools and information to help them avoid overdose, access health care, and stay safe. There are many organizations in Philly partnering in this work, but I prefer offering support on my own, whether that’s disposing of syringes, providing basic wound care, or handing out socks and harm reduction kits containing overdose-reversing medication, sterile syringes, and other lifesaving supplies. 

A Life-Changing Event 

This work is personal. I’ve lost friends and former classmates to opioid-related deaths, and I have a family member who has struggled with substance use. I’ve sat through family sessions at treatment centers that stigmatized drug use. There were no discussions on the importance of carrying naloxone—a nasal spray also sold under the brand name Narcan—that can reverse an opioid overdose and save a life. I didn’t learn about Narcan until after my family member overdosed in my car and I didn’t have it. He survived, thanks to the emergency medical technicians who gave him Narcan to bring him back. After, we went to Penn Presbyterian Medical Center (PPMC). The experience motivated me to become a volunteer advocate for people struggling with substance use and their family members.

A New Career Path

Brittany Salerno stands outside holding a sign that says, "Substance use is not a moral failing. Your stigma kills thousands. Support OPS now."

A few years into my volunteer work, I was moderating a panel in South Philadelphia on harm reduction and supervised injection sites. A fellow advocate, who worked at Penn Medicine, told me about an opening there for a research associate who knew how to engage with this patient population. My personal and professional lives came full-circle, and I found my home at Penn Medicine.

In January 2020, I joined PPMC as a research coordinator for a study looking at the use of Suboxone (a combination of buprenorphine and naloxone) to treat patients with opioid use disorder in the Emergency Department (ED). 

I realized that without further education, I was limited in how far I could advance in my career and advocacy work. I wanted to be more articulate and get into higher-level conversations to support change in the areas of drug policy reform, harm reduction, and racial disparities in health care. Taking advantage of Penn Medicine’s tuition benefits, I earned my Master of Public Health degree last year from the Perelman School of Medicine. 

Harm Reduction is Health Care 

My graduate research project evaluated the feasibility of giving patients test strips in the ED for use, after discharge, to detect the presence of fentanyl, a synthetic opioid 50 times more lethal than heroin which is added to many drugs. People who use drugs who are not intentionally using opioids are often unaware of its presence, with stimulant users and Black Philadelphians being disproportionately impacted by fentanyl-related overdose death.

By giving someone a tool like a fentanyl test strip, you’re essentially telling them, “I don’t care what you do, I just want you to be safe and I don’t want you to die.” And that speaks volumes to people who have long been neglected.

The patient follow-up phase of my research confirmed what I’d been witnessing anecdotally for years: If you offer test strips and teach people how to use them, they will. We’re now putting them in all Penn Medicine EDs and primary care clinics, as well as some mobile clinics. 

I’m now the project coordinator of the Suboxone ED study I was originally hired for as a research coordinator. I also manage a team of advocates enrolling individuals outside the ED in the Suboxone study and a new post-overdose study, collecting information about patient drug use behaviors that led to their overdose, as well as their history of treatment and harm reduction access. A major focus of my work here and on the streets is reducing stigma around drug use. I tell every one of my patients, “You’re not a bad person because you use drugs,” and that they deserve care. It’s important to let patients know that somebody in the world is supporting them. I’m proud that PPMC is known across the city as a safe place to come for help. 

Brittany Salerno is one of many Penn Medicine employees tackling the opioid crisis from different angles. Philadelphia residents can order free fentanyl test strips and/or naloxone here. Narcan is also available without a prescription at any pharmacy in Pennsylvania (copay may apply). More first-person stories around substance use are available via the Penn Listening Lab, and several support and recovery programs in Philadelphia and across the region are highlighted on Penn Medicine’s Service in Action site.


Penn Medicine employees: Did you have an unconventional path to health care or within Penn Medicine? Email [email protected] and tell us about your career journey.

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