What is harm reduction?

Background

Harm reduction focuses on behavior and practices that jeopardize a person’s health and well-being. Such behaviors and practices include risky sexual practices, over-use of drugs and alcohol to the point of becoming unconscious or overdosing, using drugs alone and in seclusion, and sharing needles during intravenous drug use that can result in spreading diseases such Hepatitis C and HIV and drug abuse. Harm reduction is based in pragmatism, or realism, rather than in the idealism reflected in abstinence-only drug policies. Harm reduction methodology does not aim to stop a person from misusing drugs and alcohol but rather to reduce the individual's level of harm and risk often associated with such behavior.

Harm reduction practices are often controversial in that opponents view them as promoting an unhealthy, immoral, and sometimes illegal behavior. Advocates of harm reduction policies believe that prohibitionist drug policies can increase the risk and danger to users beyond those risks already associated with a drug. Focusing on reducing the levels of potential harm that results from drug and alcohol use while still maintaining a compassionate and nonjudgemental stance when working with individuals suffering from substance use disorder has been shown to have a greater impact on whether or not the afflicted choose to enter treatment and rehabilitation for their disease. Advocates believe that state and federal drug policies that are based on the prohibition of drugs will not eradicate drug use: people will still break laws and use drugs regardless of the laws in place. Drug policies, they argue, should seek to reduce the harm caused by drug use. Harm reduction policies regarding illegal substances are the most contentious in terms of public support.

Types of Programs

In the United States, harm reduction policies surrounding the use of heroin are among the most controversial yet the most prevalent as well. Canada and many European nations have embraced harm reduction policies. Needle exchange programs (also referred to as syringe services programs, or SSPs), in which addicts exchange a used needle for a clean one, are among the most disputed harm reduction programs. Controversy exists even though research consistently shows needle exchange programs minimize the risk of contracting blood-borne diseases such as those caused by the human immunodeficiency and hepatitis viruses.

The US Congress banned federal funding for needle exchange programs in the late 1980s but lifted the ban in 2009. Two years later, however, Congress reimposed the ban. Despite the ban on federal money being used to fund SSPs, such programs are not illegal in the United States. In the first quarter of 2013, there were over two hundred SSPs operating throughout thirty-four states, the District of Columbia, and the Commonwealth of Puerto Rico. Without the help of federal funds, however, these programs were only able to provide sterile syringes for approximately 3 percent of total number of injections that were estimated to occur that year.

Safe injection rooms, another form of harm reduction for intravenous drug users that exist in some European nations, provide medical personnel and sterile equipment and make referrals to treatment programs. Drug zones have also been implemented in some European cities to contain the spread of drug use into other areas. Additional harm reduction strategies include distributing condoms to prevent the spread of sexually transmitted diseases, providing methadone or naloxone to opiate addicts, promoting moderate and thoughtful drinking practices over abstinence for recovering alcoholics, and conducting responsible drinking campaigns on college campuses.

US Drug Policy

Despite a slight shift in thought and perception surrounding illicit drug use, substance use disorder, and opiate addiction in particular, the US drug policy continues to be shaped around punitive actions that promote zero-tolerance for drug use and heavy prison sentences for possession and distribution of drugs. The federal government continues to wage a war on drugs that seeks to eradicate drug use. US drug policy has created significant barriers to implementing harm reduction strategies.

Bibliography

"Federal Funding for Syringe Services Programs: Saving Money, Promoting Public Safety, and Improving Public Health." AMFAR: The Foundation for AIDS Research. amfAR, Mar. 2013. Web. 29 Oct. 2015. PDF file.

Hulse, Carl. "Surge in Cases of HIV Tests US Policy on Needle Exchanges.: New York Times. New York Times, 16 May 2015. Web. 29 Oct. 2015.

Inciardi, James, and Lana D. Harrison, eds. Harm Reduction: National and International Perspectives. Thousand Oaks, CA: Sage, 2000.

Marlatt, G. Alan, ed. Harm Reduction: Pragmatic Strategies for Managing High Risk Behavior. New York: Guilford, 1998.

McCann, Eugene, and Cristina Temenos. "Mobilizing Drug Consumption Rooms: Inter-place Networks and Harm Reduction Drug Policy." Health and Place 31 (2015): 216–23. Print.

Nadelmann, Ethan A. “Common Sense Drug Policy.” Foreign Affairs 77.1 (1998): 111–26. Print.