# HarmReduction: Benchmarking LLMs in Harm Reduction Information Provision to Support People Who Use Drugs

arXiv: https://arxiv.org/abs/2507.21815 · HTML: https://mlsanity.com/paper/2507.21815/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 14 of its 49 references that are in the map.
- First posted on arXiv 29 Jul 2025.

## Builds on (most cited first, 14 of 14)

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- [What Disease does this Patient Have? A Large-scale Open Domain Question Answering Dataset from Medical Exams](https://mlsanity.com/paper/2009.13081/) (2020)
- [PubMedQA: A Dataset for Biomedical Research Question Answering](https://mlsanity.com/paper/1909.06146/) (2019)
- [In-Context Retrieval-Augmented Language Models](https://mlsanity.com/paper/2302.00083/) (2023)
- [Benchmarking Retrieval-Augmented Generation for Medicine](https://mlsanity.com/paper/2402.13178/) (2024)
- [HuatuoGPT-o1, Towards Medical Complex Reasoning with LLMs](https://mlsanity.com/paper/2412.18925/) (2024)
- [Model Evaluation, Model Selection, and Algorithm Selection in Machine Learning](https://mlsanity.com/paper/1811.12808/) (2018)
- [Diagnostic Reasoning Prompts Reveal the Potential for Large Language Model Interpretability in Medicine](https://mlsanity.com/paper/2308.06834/) (2023)
- [Lived Experience Not Found: LLMs Struggle to Align with Experts on Addressing Adverse Drug Reactions from Psychiatric Medication Use](https://mlsanity.com/paper/2410.19155/) (2024)
- [Affective-ROPTester: Capability and Bias Analysis of LLMs in Predicting Retinopathy of Prematurity](https://mlsanity.com/paper/2507.05816/) (2025)
- [Positioning AI Tools to Support Online Harm Reduction Practice: Applications and Design Directions](https://mlsanity.com/paper/2506.22941/) (2025)

## Abstract (arXiv)

Millions of individuals' well-being are challenged by the harms of substance use. Harm reduction as a public health strategy provides non-judgemental, evidence-based information intended to improve health outcomes and reduce associated safety risks. Some large language models (LLMs) have demonstrated a high level of medical reasoning, promising to address the information needs of people who use drugs (PWUD). However, their performance in relevant tasks remains largely unexplored. We introduce HarmReduction, a benchmark designed to evaluate LLMs' accuracy and safety risks in harm reduction information provision. The benchmark dataset (HR-Basic) has 2,160 question-answer-evidence pairs. The scope covers three tasks: checking safety boundaries, providing quantitative values, and inferring polysubstance use risks. We build the Instruction and RAG schemes to evaluate model behaviours based on their inherent knowledge and the integration of domain knowledge. Our results indicate that state-of-the-art LLMs still struggle to provide accurate harm reduction information, and sometimes, present severe safety risks to PWUD. This work contributes an evaluation framework for LLMs to deliver harm reduction information to avoid introducing negative health outcomes through the use of LLMs.