What Is Harm Reduction?
In the case of substance abuse, harm reduction is a proactive approach to making drug use—both legal and illegal—as safe as possible. These practices address broad social and health issues. Harm reduction is a concept that can be applied to any type of high-risk or behavior such as drinking or unsafe sexual activity.
The principles are founded on the rationale that an abstinence-only approach towards drugs leaves millions of people vulnerable to otherwise unmoderated high-risk behavior. Harm reduction does not seek to encourage drug users to avoid drugs or cease their drug use entirely. Instead, it simply aims to minimize the harmful effects of it for the sake of the user’s welfare.
Types of Harm Reduction Model
A harm reduction model is a strategy or implementation through which safe drug use is encouraged. They provide non-judgmental and—more importantly—non-punitive access to drug-related resources and care.
Needle Exchange Programs (NEPs) & Syringe Exchange Programs SEPs)
Needle-based drug use carries extra risk compared to other methods of drug use. The risk of HIV or hepatitis transmission is a very real consequence of using contaminated needles. There are a number of other complications that can occur at the site of the injection. These confidential programs provide access to clean materials as well as a means to safely dispose of used needles and syringes. This cuts down on litter and other biohazards, a benefit for both the individual and the community at large.
These types of programs can be found in 86 countries around the world. In the U.S. the North American Syringe Exchange Network has 430 locations with at least one in each state.
Safe Injection Sites
These are supervised spaces where drug users have access to clean equipment and medical staff. In addition to having a safe space to use drugs, trained medical professionals are present and can intervene in the case of an overdose or other deadly mishap. Safe injection sites often include other valuable services such as healthcare or counseling and significantly increases the likelihood of an individual seeking treatment or entering a detox program. These sites are a topic of controversy, but their benefits are notable for both the individual and the community.
Expansion Programs of Overdose-Reversal Drugs
As of July 2017, all 50 states in the U.S. have passed legislation to make naloxone, the life-saving medication that can reverse the side effects of an opioid overdose, more accessible. These expansion programs help to reduce the number of overdose deaths by making it more readily available and by educating people on how to use it.
Drug Checking
Also sometimes referred to as pill testing or adulterant screening, this useful service can determine whether a drug is laced with harmful additives. Drug checking can also tell if a drug is actually what it’s claimed to be. The process of testing is simple and fast but can literally be life-saving. In as little as 30 seconds, a test can identify methamphetamines, MDMA, opioids, LSD, and bath salts.
These programs are commonplace at nightlife and music festival scenes. They can save drug users from the harmful effects of toxic fillers or mixing different types of drugs. There are also inexpensive drug testing kits that are available to the public that can do the same thing.
Drug Courts
These are specialized courts that specialize in handling drug-related offenses for individuals with a substance abuse disorder. Instead of the standard punishment of jail time, these alternative judicial circuits provide consequences in the form of supervision, drug testing, and treatment. Drug courts have been shown to be quite effective in actually curbing drug use in individuals and encouraging them to seek treatment.
The Drawbacks of a Harm Reduction Model
While the importance of harm reduction models for the good of public health is clear, it’s important to emphasize that these models are more of a bandage rather than a long term solution for dealing with drug abuse or addiction. Further, these programs are controversial and may not be available everywhere—leaving those outside of its reach at the mercy of their compulsions.
For help dealing with an overdose or withdrawal, a local addiction treatment facility can provide similar benefits as harm reduction strategies. These specialized facilities have many of the same benefits as well as the means to get off drugs for good. Both entities are focused on the welfare of the drug user, but harm reduction models lack the same extent of support for helping drug users end the harmful cycle of addiction once and for all.
Laurel McGinnis
Brie Rodriguez
CORI BAIZA
JOHN GAU
MARK GUDIM
Jeffrey M. Bishop, D.O.
AMANDA MARINELLI, DNP, BBA, AG NP-BC, PMHNP-BC, CARN-AP
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