Harm reduction is an umbrella term that encompasses several different methods used as public health measures to reduce the harm associated with substance abuse. These approaches focus on helping the people that need it most and emphasize a judgment free approach1.
The goal behind harm reduction is to educate, provide alternative and safer options for those struggling with substance abuse, and to lessen the consequences of substance abuse. By providing an environment of respect, understanding, and non-discrimination, harm reduction strategies encourage and allow people to receive help in situations where they normally would not.
Harm reduction strategies are important because they acknowledge the existence of pervasive issues in society and realize that it is virtually impossible to completely prevent substance abuse. Instead, harm reduction services aim to help people be healthier, safer, and promotes self-empowerment by providing resources, education, and tools to help people minimize their risk.
Harm reduction strategies do not focus on the complete cessation of drug use, as that is an unrealistic and largely unattainable goal that only pushes people away from seeking treatment. Instead, harm reduction centers validate people with substance abuse disorders by acknowledging all of the internal and societal factors that could have caused the substance abuse to begin2.
The Harm Reduction Coalition seeks to empower people to actively seek treatment and help for their substance abuse, and it does this by providing free and readily available options to the community. The goal of harm reduction services is to minimize the amount of people that are hurt, whether physically, mentally, or emotionally, or that are negatively impacted by substance abuse.
By providing community support, therapy services, supervised injection sites, take home naloxone kits, peer support groups, and more completely free of charge and widely available, harm reduction centers hope to positively impact their communities and provide aid to those who need it most.
At its core, the main goal of the Harm Reduction Coalition is to keep people alive. Additionally, the harm reduction model seeks to change government programs and laws that are problematic and excessively punishing to those who use substances. Many of these laws only worsen the existing problems and cause significant harm to the people and communities that are targeted3.
There has been significant research conducted on harm reduction strategies, their impact on substance abuse, and the communities where substance abuse is most prevalent. These studies have shown that harm reduction services do not increase the risk of substance abuse nor do they encourage people to consider using substances.
Rather, by providing an open and safe environment free of judgement, persecution, and consequences, harm reduction centers actively encourage those who are using substances to seek treatment and help. In addition, this acceptance and aid improves public safety by reducing the number of public injections and syringe disposals and reducing the cost of health care through prevention4.
The harm reduction model that was implemented in the 1980’s as a response to the AIDS epidemic has evolved significantly to where it is today. (5) The availability of methadone has significantly reduced annual death rates due to drug overdose, and methadone maintenance programs have reduced heroin use, crime associated with substance abuse, and risk behaviors associated with substance abuse.
The harm reduction model does not focus on a single strategy. Instead, it provides a wide number of available services that mitigate and prevent the damage done by substance abuse. Some of the most well-known harm reduction strategies are:
These services provide free and widely available locations for people who inject substances to bring their used needles in exchange for new ones. This exchange reduces the number of discarded syringes on the streets and in public areas and also helps prevent infections and diseases such as H.I.V that can occur from reusing contaminated needles.
Similar to needle exchange services, safe injection sites provide a monitored place where trained individuals can intervene to save a person’s life if they have a negative reaction to a drug or overdose on a substance. Being able to immediately help a person who is overdosing can prevent brain injuries, other debilitating conditions, and even death.
Additionally, it can create a safer community and ensure less public substance use by encouraging those who would use substances to go somewhere where they will be safe and protected.
These laws protect both those who use substances and the community around them from coming to harm. Most communities now have designated services that a person can call if they are inebriated and unable to drive themselves home. These services will pick a person up for free and ensure that they arrive home safely and that their car is taken care of, thereby preventing the urge to drink and drive.
As judgement can often be impaired as a result of substance abuse, it is imperative to mitigate and reduce the amount of potential harm that can come as a result of using substances. Providing free condoms at all clinics and harm reductions centers helps prevent many of the consequences of unsafe sex including STDS and unwanted pregnancies.
By providing harm reduction options for people who are struggling with opioid use disorder, it allows them to decide to seek help for themselves. There has been evidence that more people are likely to benefit from long-term success in seeking treatment for their opioid use when they choose it for themselves6.
As with any other decision, a person is more likely to seek help, treatment, and care when the choice is theirs. Forcing those who use substances into rehab centers, jails, prisons, or other forms of mandatory treatment is often unsustainable and unhelpful. In the majority of cases, these forms of treatment, when forced against a person’s will, result in more harm than good and create a lack of trust in authority and those who could potentially help them. Many people who are forced to go this route end up relapsing and using in more dangerous ways.
Methadone is incredibly effective at helping people break their substance use addictions. When utilized properly by qualified individuals at harm reduction centers, it can provide hope and treatment for those with opioid use disorder.
Within the past decade, vaping has become a form of harm reduction for people who smoke cigarettes. At first it was hailed as revolutionary method of helping prevent nicotine withdrawal and was touted as a completely safe alternative to combustible inhalation methods of smoking.
It has since been discovered that vaping is not entirely harmless, though most studies still find it to be significantly less harmful than traditional cigarettes. Unfortunately, e-cigarettes have not been around long enough to definitively say what the long-term effects of use may be.
That said, vaping is currently one of the most commonly touted methods of harm reduction when it comes to cigarette use, and it has thus far been extremely effective in helping people wean themselves off of cigarettes and, in some cases, stop smoking completely.
There are several that harm reduction is controversial to the general public, and the majority of the reasons stem from a lack of understanding. One of the most common complaints or arguments against harm reduction is that it condones drug use and encourages it.
However, this belief is not the case. Rather, harm reduction initiatives understand that, regardless of the steps that society takes to try to eliminate drug use, it will likely always be present in some shape or form. Instead of ignoring this fact or denying it, harm reduction accepts it and attempts to find ways to help those who use substances to be healthier, safer, and in a controlled environment.
It is important to note that harm reduction does not replace treatment or other methods of care. Instead, it offers an alternative to those who are unwilling or unable to attempt traditional methods of rehabilitation. By offering a judgement free and welcoming alternative, lives are being saved that would otherwise be lost and diseases are being prevented while simultaneously making communities safer.
There are many different types of treatment for substance use disorder, including:
Methadone can be used to help safely wean long-term users off substances. While it is possible to quit “cold turkey” and detox without aid, it is generally not recommended as the side-effects of withdrawal symptoms can be deadly. If possible, seek professional help with detox.
Many forms of therapy including cognitive behavioral therapy, talk therapy, and group therapy. All types help treat substance use disorder.
These programs include rehab centers that require patients to stay for an extended period to become sober.
These centers provide support and treatment to those who have completed inpatient programs or that choose to recover on their own.
Aftercare is a plan made to help a person in their early recovery and to prevent relapse. It helps them work toward their goals and cope with triggers, stress, and other forms of temptations.
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