Expand Harm Reduction Practices

Introductory Paragraph

The term harm reduction has involved reducing all types of harm.  Preventing death through reversing overdose, preventing infection and disease transmission through needle exchange programs, preventing overdose through the use of testing strips, and supporting public awareness campaigns in support of harm reduction strategies are just some of the ways harm reduction is put into practice.

One important aspect of harm reduction is that it supports interventions aimed at reducing the negative effects of health behaviors without necessarily extinguishing the problematic health behaviors completely.  In a substance use disorder setting, harm reduction seeks to keep a person alive while minimizing negative health impacts that result from being active in addiction.  It is not the primary goal of harm reduction strategies to get someone into treatment and recovery.  It is rooted in the view that we need to meet people where they are - and many are not ready to accept the treatment of recovery.  That being said those involved in harm reduction are nearly always too ready to assist someone in getting connected to services if they express a desire to get help.

As many in the harm reduction community will say, a dead person cannot recover.

Definition

The Harm Reduction Journal defines harm reduction as 'policies and programs which aim to reduce the health, social, and economic costs of legal and illegal psychoactive drug use  without necessarily reducing drug consumption.  Exact definitions from other organizations vary slightly in their wording but are overall consistent.

 

Principles

Harm Reduction Principles set out by the National Harm Reduction Coalition include:

Accepts, for better 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

Ensures that people who use drugs 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 people who use drugs (PWUD) themselves as the primary agents of reducing the harms of their drug use and seeks to empower PWUD to share information and support each other in strategies that meet their actual conditions of use

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

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 that can be associated with illicit drug use

Understands drug use as a complex, multi-faceted phenomenon that encompasses a continuum of behaviors from severe use 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 

Available Tools and Resources

The resource pages under Harm Reduction explore many of the main strategies used in communities accross the country to achieve the outcomes sought by harm reduction advocates and practicioners.  Some of the most widely adopted include:

Naloxone Training and Distribution

Saving a life provides the opportunity to find recovery.  A wide variety of stakeholders are engaged in this strategy because there is no such thing as too many opportunities to get an use overdose reversal medication.  Efforts are often accompanied with public awareness campaigns that inform the public about where to get Naloxone and encourage active users not to use alone.

Expansion of Needle Exchange Programs

The use of "dirty" needles can lead to infection, spread disease, and creates a tremndous increase in health care related costs.  The investment of a few cents in a single clean needle that can be accessed by users can save thousands of dollars.  As with most harm reduction strategies, there is an element of stigma which needs to be overcome, both with the user and the public - many of whom in the latter group see these programs as enabling harmful behaviors.  Having people participate in needle exchange programs provides another opportunity to connect with others and be connected to services if willing.

Harm Reduction in Special Settings

The resources pages also fous on how to help those in specific situations, including those in the criminal justice system and women who are pregnant or who have recently given birth.  In both cases numerous strategies have been developed to improve harm reduction for all effected. 

 

Promising Practices

National Harm Reduction Coalition:

Harm Reduction Coalition

National Harm Reduction Journal:

https://harmreductionjournal.biomedcentral.com