Harm reduction consists of certain policies and strategies devised to reduce the negative effects of substance abuse. The policies, which vary widely, are based on respect for human rights for all people, including those who are unready or unwilling to stop using drugs and alcohol.
Efforts at harm reduction have always been controversial, beginning in the 80s when needle-sharing programs were created to staunch the rapid spread of HIV/AIDS. The concept has very vocal opponents, and some people think that harm reduction places a stamp of approval on use of drugs and alcohol.
Compassion, Dignity and Quality of Life
Proponents of harm reduction recognize that use of drugs and alcohol is a reality and continuing use is inevitable. Problems associated with drug and alcohol, including crime, health problems and broken families, are fully acknowledged. However, harm reduction strategies attempt to minimize the consequences of drug and alcohol use, thus keeping more people safe and out of harm’s way.
Supporters of harm reduction also acknowledge that substance abuse is complex and may range from light, sporadic use where no treatment is needed, to severe abuse. While judgment-free treatment is offered and users are encouraged to cut down or stop, even people who are unwilling to begin drug and alcohol treatment or rehab are worthy of kindness and respect.
Harm reduction programs are never forced or coercive in nature, and users of drugs and alcohol have an important say in development of policies.
Examples of Harm Reduction Programs
Most harm reduction programs are simple and relatively inexpensive, such as needle sharing, designated driver programs, increased availability of taxicabs to reduce drunk driving, or programs that encourage safe sex instead of total abstinence for young people. Other programs are more complex, including:
- Providing police, prisons, emergency service workers and friends and families of drug users with naloxone, an inexpensive drug that saves lives by reversing symptoms of respiratory depression associated with opioid overdose. Naloxone, which takes effect very quickly, is already available in many countries and some areas of the United States.
- Creation of legal protections for people who call police or emergency services to report a drug overdose – a strategy often known as the Good Samaritan law. Many people are afraid to call for help when a friend is overdosing for fear of arrest and imprisonment.
- Drug replacement therapies in which heroin users are provided with milder, legal opiates such as methadone or buprenorphine. The drugs, administered under medical supervision, provide more stability and allow people to live more productive lives. Drug replacement programs are available in many countries and in some areas of the United States, where it has reduced costs associated with crime and emergency medical care.
- Creation of supervised injection facilities where drug users are provided with hygienic syringes and supplies for drug administration, access to medical care, and education on safe use of injection equipment. Supervised injection programs are already operating successfully in many countries around the world, and pilot programs are planned for San Francisco and New York.
- Recognition that there are no one-size-fits-all treatments for drug and alcohol addiction. Treatment, including 12-step programs that aren’t helpful for all people, are available but not required.