How Harm Reduction Works in Substance Use

How Harm Reduction Works in Substance Use Addiction Drug Use Print How Harm Reduction Works With Substance Use By Elizabeth Hartney, BSc., MSc., MA, PhD Elizabeth Hartney, BSc, MSc, MA, PhD is a psychologist, professor, and Director of the Centre for Health Leadership and Research at Royal Roads University, Canada. Learn about our editorial policy Elizabeth Hartney, BSc., MSc., MA, PhD Medically reviewed by Medically reviewed by Steven Gans, MD on August 05, 2016 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Steven Gans, MD Updated on January 07, 2020 Sporrer/Rupp/Cultura/Getty Images More in Addiction Drug Use Cocaine Heroin Marijuana Meth Ecstasy/MDMA Hallucinogens Opioids Prescription Medications Alcohol Use Addictive Behaviors Nicotine Use Coping and Recovery Harm reduction is a proactive approach to reducing the damage done by alcohol, drugs, and other addictive behaviors, as well as addressing broader health and social issues, such as HIV transmission. The term harm reduction can be used to describe the philosophical beliefs that underlie strategies and programs, or it can be used to describe the strategies and programs on which it is based. Often, harm reduction strategies are used in conjunction with other approaches, which require abstinence. Does Harm Reduction Encourage Drug Use? A common misconception about harm reduction is that it condones or encourages drug use. Many advocates of harm reduction also support the goal of people working towards abstinence from alcohol, drugs, and addictive behaviors, but recognize that for many people, this process takes time. In the interim period, while the person is still drinking, using drugs, or engaging in other addictive behaviors, both they and the people around them are vulnerable to harm. Examples of harm reduction in action include the following. Drinking and Driving Laws While it is well known that even small amounts of alcohol can affect peoples ability to drive safely, driving and driving laws allow drivers to have a small amount of alcohol in their bloodstream. The focus is not on eliminating alcohol use from drivers completely but setting a limit over which the greatest risk of causing a serious accident is defined. Drinking and driving laws do not encourage drinking; they actually discourage it. But they accept the reality that many people will drink to some extent before driving, and that the overall harm to society is lessened by focusing attention on the worst offenders. The Dangers of Drinking and Driving Needle Exchange Services Injecting drugs such as heroin is illegal, yet harm reduction advocates for clean needles to be provided to drug users free of charge. This is because there is more harm caused to individual drug users, the health care system, and society as a whole if injection drug users pass HIV and hepatitis to each other through sharing needles. Needle exchange programs do not encourage drug use. In fact, they are usually the first point of contact for drug users to access addiction treatment services. These programs accept the fact that many people will inject drugs whether they have clean needles or not and prefer that they do not get ill and die as a result of infection. Safe Injection Facilities Safe injection sites go a step further than needle exchange services by providing a safe space in which people can inject drugs, clean needles and injection equipment, and supervision of the injection process by medical staff. In addition to the harm reduction goals of needle exchange services, i.e. reducing transmission of HIV, hepatitis, and other infections and damage caused by unclean equipment being used for injecting, safe injection rooms offer a safe space and immediate help if an overdose occurs. Safe injection facilities do not encourage drug useâ€"they provide a connection between the most vulnerable drug users and treatment services, such as detox. And they save lives that would otherwise be lost to drugs. Free Condoms Sex can be an addictive behavior, and it can lead to unplanned pregnancy, but the main reason that free condoms are sometimes provided as a harm reduction service is to reduce the transmission of STDs, specifically HIV. Condom Programs Promote Safe Sex Free condoms are not distributed to encourage people to have sex. Programs that distribute them recognize that people have unprotected sex for many different reasons and that factors such as embarrassment and poverty may get in the way of purchasing condoms. By providing free condoms, these services help prevent a lot of illnesses and problems associated with unprotected sex. How Sex Can Become an Addiction