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Drug Addiction: Understanding Harm Reduction

Dr. Gerardo Sison

Medically reviewed by

Dr. Gerardo Sison

April 1, 2019

The current system criminalizes and treats those who are currently in recovery like they are undeserving of medications for chronic pain or pain relating to surgery as a result of their past use. Harm reduction seeks to bridge gaps that exist in current policy by addressing the core issues that result in these attitudes and improving the treatment of those suffering from addiction-related issues.

What Is The Harm Reduction Model?

The Harm Reduction Model addresses some of these issues directly, and others indirectly in its underlying call for a non-judgmental and humane approach to working with people who suffer from drug addiction. The Harm Reduction Model applies a series of principles toward creating better policies and improving the treatment of those coping with addiction-related issues.

Principles that make up the Harm Reduction Model include a general acceptance of the realities that people who use drugs face, as well as meeting these individuals where they are, rather than asking more of them than is reasonable. It also suggests a level of involvement by these individuals in the development of programs designed to reduce harm in drug-using populations and communities.

Harm Reduction Principles:

  • Acceptance that drug use is a part of society and works to minimize the impact, rather than criminalize the people involved;
  • Understands the complexity of drug abuse and the spectrum of associated behaviors;
  • Focuses on improving quality of life, rather than focusing on complete cessation of drug use;
  • Takes a non-judgemental approach in offering a wide range of resources to those in need in order to reduce overall harm to communities and the individual from drug use;
  • Gives those who have used drugs a voice in the co-creation of programs to serve individuals in need;
  • Empowers users to design and seek out strategies to best support an ultimate goal toward a reduction in harm to self and their community;
  • Addresses the vulnerability and needs of individuals based on factors that perpetuate drug use including socioeconomic, environmental, and trauma-related issues;
  • Acknowledges the real harm associated with drug use

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Why Apply Harm Reduction Model?

In communities where drug use is rampant, criminalization does little to deter use, address related socioeconomic factors, or improve health outcomes for those who abuse drugs. Needle sharing among drug users accounts for the spread of several blood-borne pathogens including HIV, hepatitis B and C, botulism, tetanus, and other bacterial infections. These infections can spread within a community. They also put health care workers and those closest to drug-using individuals at risk.

The harm reduction model employs use of clinics that disperse clean needles and dispose of used needles safely, to reduce the incidence and spread of bloodborne pathogens. Studies have shown these programs are effective at limiting the spread of illness among communities in which drug-use is a significant problem.

Other programs seek to replace one harmful drug with one that causes less harm, as is the case with methadone or suboxone therapies in reducing the use of opioid drugs. Though these drugs carry their own risks, a person who is able to substitute methadone or suboxone for heroin is more likely to return to more appropriate behaviors and actions toward achieving stability in work, relationships, and other aspects of their lives.

Other programs relating to the harm reduction model include clinics that offer drug users a safe place to use. The rationale behind these facilities is to reduce overall public exposure to drug use, including unsafe disposal of needles or other paraphernalia, and reduction of overdose-related deaths with medical monitoring. These programs also offer needle exchanges to reduce exposure to bloodborne pathogens, and provide an avenue for treatment.

Benefits Of Harm Reduction Model On Individuals And Communities

Programs guided by the harm reduction model have a positive impact on the overall health of individuals struggling with drug addiction by reducing harm associated with the spread of bloodborne pathogens, overdose, and vulnerability on the street. They also provide a non-judgemental access to treatment for individuals who are ready to discontinue drug use.

These impacts are felt community-wide and benefit also from reduction in the spread of disease, as well as less public exposure to drug use or crime associated with drug use. In some cases, harm reduction programs restores individuals who formerly abused heroin to a productive status within their community.

Studies also indicate that harm reduction programs more effectively reduce risky behaviors associated with teenage use of alcohol and marijuana, than abstinence only programs like the Drug Abuse Resistance Education (DARE).

Harm Reduction Therapy In Treating Drug Addiction

Harm reduction therapy relies on an individualized approach to treating drug addiction. A person is not required to quit using altogether immediately, but works similarly through cognitive behavioral therapy to address the issues leading to the compulsion toward drug use. Rather than working to stop the addiction abruptly, the therapist works with a drug-addicted individual to address the frequency of use, ways to limit harm or use more safely, and setting goals toward a gradual reduction in use.

Treatment programs integrating the harm reduction model are thought to reach a broader audience than the traditional abstinence-based programs alone. Harm reduction involves meeting the drug-addicted individual where they are, and helping them move forward gradually. This allows someone who is not yet ready to quit drinking or using drugs achieve a more functional status until they are ready to commit to treatment.

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