The unavoidable reality is that people use drugs, and substance use disorders directly affect far more people than we are willing to admit. More than 15 million Americans meet the National Institute on Alcohol Abuse and Alcoholism’s criteria for an alcohol use disorder, but the percentage of those people who would be willing to admit that they themselves struggle with substance use is unquestionably below 100%. These observations underscore the relevance and benefit of harm reduction.
There are many people who incorrectly purport that harm reduction models are simply ways to enable and even encourage drug use. This belief highlights a troubling lack of information as to what harm reduction entails.
What Is Harm Reduction Therapy?
Harm reduction provides education, resources, and avenues towards recovery for people who use substances. This approach benefits communities as well: Harm reduction reduces overall drug use, disease spread, violence/sexual assault (often directed at drug users) and public intoxication.
Harm Reduction Principles
The goal of harm reduction is to minimize the damage that drug use causes. Importantly, harm reduction takes a reality-based, non-judgmental approach that uses evidence and data rather than preconceived ideals set forth by people without a rudimentary understanding of addition.
The basic tenets of harm reduction serve both people with substance use disorders and the communities they live in. Drug users benefit by having access to education, rehab outreach and safe spaces that can intervene in the case of overdose and that keep intoxicated people off the street. Communities benefit by having healthier populations, reduced crime and improved community relations. Harm reduction also aims to restore basic human rights to addicts.
Goals of Harm Reduction Therapy
The most important goal of harm reduction therapy is providing help to drug addicts. This is accomplished by implementing overdose prevention strategies, providing drug awareness resources and offering assistance to people who are ready to quit drug or alcohol use.
Harm reduction therapy aims to provide basic decency to people who use drugs. For many people, this compassion is a crucial first step towards recovery. The sad fact is that drug users are often shunned by people who are unaware of the realities of drug use and addiction in America. Addicts are at increased risk for vicious attacks by malicious passersby and severe emotional trauma stemming from the dehumanization that accompanies serious addiction in the absence of wealth and social esteem.
Harm reduction also aims to mitigate the damage that substance use inflicts on entire communities. By providing people who use drugs with safe places to use drugs and programs that exchange needles, people who use drugs will have reduced risk of physical and psychological harm associated with drug use. This translates into improved health and social statistics by preventing the spread of disease and reducing arrest rates.
Harm Reduction Services
Examples of harm reduction strategies include:
- Needle Exchange Programs
These programs provide people who use intravenous drugs with a clean needle exchange, significantly reducing the risk of spreading disease.
- Safe Injection Sites
People who use intravenous drugs are at elevated risk of physical/sexual assault and serious, even deadly consequences of adverse reactions or overdose. Safe injection sites provide a supervised environment that reduces these risks and provides access to education and rehab opportunities.
- Opioid Replacement Therapy
Heroin and popular prescription opioids have recently become the focus of attention among upper-class Americans, who have suddenly been made aware of the fact that addiction is not a lack of moral fortitude that affects only certain groups of people. Opioid replacement therapy uses a scientifically valid approach that replaces highly addictive opioids like heroin and oxycodone with opioids that “trick” the brain into believing that the heroin/oxycodone is present without providing the self-reinforcing high that they deliver.
- Naloxone Distribution Program
Naloxone is a drug that is used to prevent opioid overdose deaths. According to the CDC, 37% of overdose deaths in 2013 involved opioids, many of which could have been prevented if a naloxone kit had been available. By providing naloxone kits and training to people who use or are exposed to opioid use regularly, opioid overdose deaths can be substantially reduced.
- Outreach Drug Rehab
Outreach drug rehab programs seek to connect people who are struggling with substance use disorders with rehab centers that can provide treatment.
Effectiveness of Harm Reduction
Any objective and scientifically valid measure of the benefits of harm reduction clearly identifies it as an incredibly valuable and worthwhile strategy to mitigate the damage that substance use causes to adolescents, adults, and communities. There are absolutely no reasons outside of blatant ignorance and prejudice to opposing harm reduction strategies.
Harm Reduction vs Abstinence
Abstinence is the “gold standard” of addiction recovery, but the reality is that demanding abstinence in order to be considered successful in recovery is as useful as demanding sexual abstinence from teenagers. Abstinence is an idealistic solution that is not reasonable or even obtainable for many people; harm reduction is a productive strategy to help people overcome devastating addictions that prevent them from living fulfilling and meaningful lives.
For example, opioids are among the most addictive chemicals known to man, and they have profound effects on short- and long-term chemical signaling in the brain. Harm reduction offers a way to manage and overcome these persistent physical changes. Abstinence, on the other hand, offers no solutions and implies that people who are unable to abstain are failures.
Disadvantages of Harm Reduction
Some groups claim that harm reduction “enables drug addicts.” This oppositional mentality is particularly prevalent among people who believe that addiction is a failure of willpower, and it highlights their unfamiliarity with addiction and their rudimentary understanding of human physiology. The reality of drug dependence is that it is a consequence of very real physical and chemical changes that occur in the brain and persist for months, even years after someone has achieved sobriety.
The deadly opioid and benzodiazepine epidemics that have swept upper-crust America have provided a devastating lesson in the realities of addiction for people who, until recently, were able to consider addiction “someone else’s problem.” Notably, the people who are dying from opioids and benzodiazepines are not stereotypical “users,” underscoring the importance of acknowledging addiction rather than hiding behind absurd non-sequiturs and pretending that it happens to “other people.”
When It’s Time to Treat Addiction
If you take a prescription or illicit drug and find that you are dependent on it in order to function at your ideal level, it is time to honestly assess whether you have a substance use disorder. Make an appointment with a medical professional who specializes in addiction to get recommendations and referrals.
Addiction treatment comes in many forms, but the first step is to make an evaluation appointment with an addiction expert. For people who struggle with overwhelming dependence, medical detox is likely to be the first phase of rehab, followed by residential and outpatient rehab programs. Most people who have successfully overcome addiction find that participation in aftercare programs is a valuable way to find inspiration and motivation later in recovery.
National Institute on Alcohol Abuse and Alcoholism. “Alcohol Facts and Statistics.” Updated August 2018. Accessed September 22, 2019.
Wheeler, Eliza; Jones, T. Stephen; Gilbert, Michael K; Davidson, Peter J. “Opioid Overdose Prevention Programs Providing Naloxone to Laypersons — United States, 2014.” Centers for Disease Control and Prevention Morbidity and Mortality Weekly, June 2015. Accessed September 22, 2019.
Leslie, Karen Mary. “Harm reduction: An approach to reducing risky health behaviours in adolescents.” Paediatrics & Child Health, January 2008. Accessed September 22, 2019.