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This study introduces HarmReduction, a new benchmark evaluating large language models on their ability to provide safe, evidence-based information for people who use drugs. The research reveals that current state-of-the-art LLMs often fail in this critical domain, presenting significant safety risks and inaccurate medical reasoning. This work establishes an essential evaluation framework to prevent negative health outcomes when deploying AI in sensitive public health contexts.
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HarmReduction: Benchmarking LLMs in Harm Reduction Information Provision to Support People Who Use Drugs

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arXiv:2507.21815v2 Announce Type: replace Abstract: 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.

Abstract: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.

Computation and Language (cs.CL); Computers and Society (cs.CY)

arXiv:2507.21815 [cs.CL]

(or arXiv:2507.21815v2 [cs.CL] for this version)

https://doi.org/10.48550/arXiv.2507.21815 Focus to learn more arXiv-issued DOI via DataCite

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