What is harm reduction?
Harm reduction includes policies, programs and practices that aim to keep people safe and minimize death, disease, and injury from high risk behaviour, especially psychoactive substance use. Harm reduction recognizes that the high risk behavior may continue despite the risks.
Harm reduction involves a range of support services and strategies to enhance the knowledge, skills, resources, and supports for individuals, families and communities to be safer and healthier.
A range of services is available to prevent harms from substance use. Some examples include:
- Needle distribution/recovery programs that distribute sterile needles and other harm reduction supplies, recover used needles and other supplies, and provide information and containers for their safe disposal.
- Substitution therapies that substitute illegal heroin with legal, non-injection methadone or other prescribed opioids.
- Take home naloxone program that provides an antidote to opioids to reverse an overdose thereby preventing brain injury, due to depressed breathing, and death.
- Supervised consumption facilities that help prevent overdose deaths and other harms by providing a safer, supervised environment for people using substances.
- Outreach and education services that make contact with people who use substances to encourage safer behavior.
- Peer support programs that are groups run and attended by people who use substances to improve their quality of life and to address gaps in services.
- Impaired driving prevention campaigns that create awareness of the risks of driving under the influence of alcohol and other legal or illegal substances.
What are the benefits of harm reduction related to substance use?
Harm reduction has many benefits for people who use substances, their families, and communities. Research shows harm reduction activities can:
- Reduce hepatitis and HIV.
- Reduce overdose deaths and other early deaths among people who use substances.
- Reduce injection substance use in public places, and reduce the number of used needles in public.
- Reduce the sharing of needles and other substance use equipment.
- Reduce crime and increase employment among people who use substances.
- Educate about safer injecting and smoking and reduce the frequency of use.
- Educate about safer sex and sexual health and increase condom use.
- Increase referrals to treatment programs and health and social services.
Harm reduction is a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use. It’s also a movement for social justice built on a belief in, and respect for, the rights of people who use drugs.
It incorporates a spectrum of strategies from safer use, to managed use to abstinence to meet drug users “where they’re at,” addressing conditions of use along with the use itself. Because harm reduction demands that interventions and policies designed to serve drug users reflect specific individual and community needs, there is no universal definition of or formula for implementing harm reduction.
However, HRC considers the following principles central to harm reduction practice.
- Accepts, for better and or worse, that licit and illicit drug use is part of our world and chooses to work to minimize its harmful effects rather than simply ignore or condemn them.
- Understands drug use as a complex, multi-faceted phenomenon that encompasses a continuum of behaviors from severe abuse to total abstinence, and acknowledges that some ways of using drugs are clearly safer than others.
- Establishes quality of individual and community life and well-being–not necessarily cessation of all drug use–as the criteria for successful interventions and policies.
- Calls for the non-judgmental, non-coercive provision of services and resources to people who use drugs and the communities in which they live in order to assist them in reducing attendant harm.
- Ensures that drug users and those with a history of drug use routinely have a real voice in the creation of programs and policies designed to serve them.
- Affirms drugs users themselves as the primary agents of reducing the harms of their drug use, and seeks to empower users to share information and support each other in strategies which meet their actual conditions of use.
- Recognizes that the realities of poverty, class, racism, social isolation, past trauma, sex-based discrimination and other social inequalities affect both people’s vulnerability to and capacity for effectively dealing with drug-related harm.
- Does not attempt to minimize or ignore the real and tragic harm and danger associated with licit and illicit drug use.
Should I have concerns about harm reduction?
Some people express concerns about harm reduction. Some of the more common concerns include the following questions:
- Makes it easier for people to use substances and stop them from quitting?
- People who are dependent on substances may not want or be able to quit, or they may continue to relapse into substance use. Harm reduction reduces the risks of substance use including the spread of infections like hepatitis and HIV. Harm reduction creates opportunities for people to lead healthier lives.
- Does it encourage people to use substances?
- Research shows that harm reduction activities do not encourage substance use.
- Does it drain funding from treatment programs for substance dependence?
- Treatment programs for substance dependence are part of harm reduction. Specific harm reduction activities are cost-effective, and prevent costly outcomes like hepatitis and HIV.
- Does it mean trying to legalize substances?
- Legalization is not part of harm reduction. Harm reduction applies to both legal and illegal substance use. A high school organizing safe rides home after graduation because parents realize their teenagers may be drinking, is an example of harm reduction.
What you should take from all of this is that there a lot of people and agencies working to make addiction treatment more accessible and more effective. Ultimately though, human will is at play here – if a person is not willing to enter treatment, no one can can change that. You may even check the person into a rehab only to discover he or she dropped out soon after. It takes a willing soul to have a change of heart.