Today is International Harm Reduction Day. It is a day that intends to honor the practice of harm reduction in our communities, and the people who champion for that cause. Downtown today, the Harm Reduction Action Center was busy, dispensing kits and patrolling Colfax for possible overdoses. Online, the conversation continues to get heated and everyone is asking, “What does harm reduction mean?”
Harm Reduction means simply that. It means to reduce the potential harm done, through evidence based tools and techniques. This does not simply apply to Substance Use Disorders. As a society, we have recognized the importance of harm reduction as a simple idea. We see it all the time, without even thinking about it.
- When you ride a bike, do you hear a helmet?
- When you get in your car, do you strap on your seat belt?
- When you go out in the sun, do you slather on the sunscreen?
- When you have sex, do you use a condom?
If you answered yes to any of the above, then congratulations! You have participated in some form of harm reduction.
But, what does it mean in relation to substance use? Why is such a logical idea a controversial issue when related to substance use? Well, let’s talk about what harm reduction even means in substance use.
When we talk about all the potential harms that substance use can cause, the list is both troublesome and daunting. Infectious diseases, overdoses, societal harms, legal
issues, loss of shelter, poor health, death- to name a notorious hand full. The aim of the conversation around harm reduction for people in recovery, is to hopefully mitigate some of those risks through evidence based practices. We are seeking to lessen the prevalence of these risks among people who use, so that we can move towards a more contributing and healthy society. The ways in which this is done, is often the most controversial elements of the conversation.
When someone is using, the first thing that we can do is engage in a sincere conversation around harm reduction. We can invite them to use in a way that is less risky, and benefits not just the person using, but society as well. This conversation does two things:
- It empowers the individual to make their own decisions, and safer choices and
- It removes the judgement around substance use and creates a safe place for that individual to express legitimate concerns in the recovery process
So, how are we encouraging people in substance use recovery to participate in harm reduction? Is harm reduction really even beneficial, and how?
- Medication Assisted Treatment- The use of pharmaceuticals such as Methadone, Suboxone and Vivitrol assist people in recovery in multiple ways. The premise of Methadone, was introduced as a way to mitigate illegal behavior in people suffering from substance use disorders through the dispensing of Methadone. The idea: People in recovery won’t engage in illegal activities in order to obtain their drug of choice if they aren’t suffering symptoms of withdrawal. MAT is a component of harm reduction because it mitigates the societal harms of substance use.
- Needle Exchanges/Clean Needle Kits- The Harm Reduction Action Center in Denver provides this service to people every day. Getting old, dull and dirty needles off of the street is a necessary step in keeping rates of infectious diseases down. Needle kits also help to lower risk of preventable diseases that can occur from reusing needles.
- Safer Routes of Use- Becoming an advocate for safer routes of use is also an easy way to reduce potential harms. For example, encouraging a needle user to switch to smoking or snorting, can lessen the opportunity for overdoses.
- Naloxone- Naloxone is a life saving pharmaceutical that has the potential to reverse an overdose. It has already saved lives, and continues to every day.
Okay, so all of that said and done here is the controversial topic:
Isn’t harm reduction just enabling?
The short answer here is, no. However, when you look a little deeper into the issue it’s easy to see that it isn’t so black and white. Yes, on a certain level you are consciously acknowledging that they are going to continue to use. Yes, you are engaging in conversation about how they are going to continue to use. And- Yes, you are supporting them through this process.
Harm Reduction is NOT:
- Encouraging that they continue to use substances as a means to coping
- Inviting people to use
- Condoning drug use
- Avoiding accountability
Harm Reduction is:
- Empowering people through education, tools and techniques to make smart decisions about their drug use
- Acknowledging that substance use exists, and causes detrimental damage and taking intentional action to try to mitigate that harm
- Dissolving social stigma around substance use so that meaningful conversation can occur
- Creating a safe space for healing to occur, free of judgment
- Reaching back into a vulnerable community to combat an epidemic
While we have come a long way as far as breaking down social stigma, we still have a long ways to go. The best way to combat it is to talk about it, put language to it and normalize the conversation. How will you contribute?
All pictures courtesy of Harm Reduction Coalition and Harm Reduction Action Center