Harm reduction made history recently when it was included in the steps the current White House Administration is taking to address our nation’s substance use problem.
Although harm reduction efforts have been around for almost five decades, it is safe to say that most Americans are relatively unfamiliar with it.
Even professionals in the mental health and medical community are frequently unaware of it, or more problematically many are opposed to it.
According to Harm Reduction International, “Harm reduction policies and practices are informed by a strong body of evidence that shows interventions to be practical, feasible, effective, safe and cost-effective in diverse social, cultural and economic settings.”
Despite this, there continues to be both stigma and misinformation surrounding both substance use and the practice of harm reduction. Over 93,000 people lost their lives to overdose in 2020, which according to Nora Volkow, Director of the National Institute on Drug Abuse is the highest number in recorded history.
Perhaps now is the time to give Harm Reduction the attention it deserves.
Understanding harm reduction
A tricky thing about harm reduction is that there is no universally accepted definition. This means that the principles may vary from organization to organization, but you will find that although they are different, they are complementary.
At its core, harm reduction is about meeting people where they are and working alongside them to minimize harm to themselves or others caused by substance use. Essentially, harm reduction is about safety. Harm reduction does not condone substance use, but rather understands that we live in a world in which it exists, and thus individual choice is respected.
Principles of harm reduction
Outlined below are the principles of harm reduction as outlined by Harm Reduction International.
1. Respecting the rights of people who use drugs. Harm reduction is rooted in the belief that people who use drugs are entitled to be treated with compassion, dignity, and respect. Having a substance use disorder should not be a forfeiture of human rights.
2. A commitment to evidence. Harm Reduction policies and programs are informed by strong bodies of evidence. Most harm reduction interventions are safe and cost effective in a wide range of cultural and economic settings.
3. A commitment to social justice and collaborating with networks of people who use drugs. Harm reduction is largely focused on addressing discrimination and removing unnecessary barriers to treatment.
4. The avoidance of stigma. People who practice harm reduction accept people as they are, without judgement.
The three goals of harm reduction
Although harm reduction is multi-faceted and ever growing with additional research, Harm Reduction International focuses on three primary goals.
1. Keep people alive and encourage positive change in their lives. Harm reduction believes that keeping someone alive is more important than keeping someone ‘compliant’. By accepting people as they are, it often creates a positive experience, thus increasing the likelihood of continuing to make positive changes to their lives.
2. Reduce the harms of drug laws and policy. Enough time has gone by to demonstrate that criminalizing substance use is neither an effective treatment nor deterrent. Harsh drug laws also disproportionately negatively impact people of lower socioeconomic status and/or persons of color.
3. Offer alternatives to approaches that seek to prevent or end drug use. Harm reduction is about choice and believes that forcing people into treatment or limiting available treatment options is insufficient to support people.
Harm reduction in action
As the movement and the need grows, so to do the array of harm reduction interventions and services. Below are some important examples of harm reduction, but by no means is this an exhaustive list.
1. Naloxone (Narcan) is an opioid overdose reversal medication. It has vast life saving potential with minimal risk. Find Narcan in your area.
2. Needle exchange programs. These programs provide access to clean needles which reduce individual and community spread of contagious disease. Unfortunately, these are not legal in every state, including Texas. Find a syringe program in your area.
3. Medication Assisted Treatment. For people struggling with opioid dependence, both methadone and buprenorphine are evidence-based treatments. Naltrexone is another option for both opioids and alcohol dependence.
4. Overdose prevention. Teaching people how to avoid overdose and to recognize the signs and symptoms of an overdose is a lifesaving intervention.
5. Harm Reduction Psychotherapy. A clinical application of the harm reduction principles, harm reduction psychotherapy is alternative therapy approach to abstinence only counseling programs.
There are no addicts
There are no addicts, only people. When talking about harm reduction, it can be helpful to remember we are talking about saving human lives. When we use terms like addict and alcoholic, we are talking about a concept rather than a person.
Harm reduction never attempts to minimize or ignore the real and potentially tragic harms associated with substance use. Rather, by connecting with people through compassion, pragmatism, and collaboration, it is possible to empower people to better care for themselves, and hopefully one day, be well.
Support if you need it
If you need support in managing drugs or alcohol, Substance Use Therapy is here. Contact us for a no charge consultation. If you aren’t sure, you want counseling, but you do need more harm reduction resources, visit our Safety-First page.
Whatever you are facing, you don’t have to face it alone.
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About the Author:
Kimberly May, LPC-S, LMFT is a therapist at Substance Use Therapy in Austin, TX. Kimberly works with individuals, couples and families whose lives have been affected by substance use. By utilizing a harm reduction framework, Kimberly works effectively with people in any stage of use. In addition to substance use, she works with other issues such as anger, burn-out, anxiety and grief. Contact today to schedule a no-charge, 30 minute, in-person consultation. *Note: telephone and telehealth sessions are currently available.