Actions have consequences. For example, driving a car too fast can cause accidents. This is why speed limits are established and why laws exist to punish people who drive over the speed limit. In life, people will make mistakes. Unfortunately, these mistakes can cause great harm to individuals or other people around them—both strangers and family/friends alike. This is where a harm reduction approach comes in.
It is not always possible to stop people from making bad choices. Equally, it is impossible to completely prevent accidents from happening. However, harm reduction techniques can lessen the negative consequences of substance abuse or (in some cases) work to prevent substance abuse overall.
What are Harm Reduction Approaches?
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Harm reduction approaches are based on harm reduction techniques, which are designed to reduce the harms associated with certain behaviors. For instance, harm reduction approaches are used to prevent or reduce the harm that can be caused by dangerous behavior, such as engaging in unprotected sex, driving under the influence of drugs or alcohol, and other high-risk activities.
Harm reduction approaches can also help decrease accidents resulting from substance abuse. Broadly, substance abuse harm reduction refers to policies, programs, and practices that seek to lessen the negative consequences of drug or alcohol abuse. These consequences can be social, legal, or health-related.
Programs and practices work to protect those who engage in substance abuse or the people around them. Often, these approaches are social services that aim to help individuals without judgment. Harm reduction approaches for substance abuse can include the following programs and services:
- Drug consumption rooms
- Needle and syringe exchange programs
- Non-abstinence-based housing and employment initiatives
- Overdose prevention and reversal
- Drug testing (such as testing substances for fentanyl)
- Psychosocial support
- Information on safer drug use
Harm Reduction vs Abstinence in Addiction Treatment
In addiction treatment, harm reduction and abstinence are the two main philosophies employed. These two approaches differ greatly and the effectiveness of each depends on the needs of an individual with an addiction or substance use disorder (SUD).
The abstinence approach focuses on abstinence and avoiding triggers, and treatment is often 12-step oriented. This is the more popular approach and begins with an individual with a substance use disorder detoxing from their drug of choice before entering treatment completely sober.
Harm reduction seeks the lessening of harm for both the substance abuser and society at large with a nonjudgmental approach. In harm reduction, recovery from drug or alcohol addiction can be achieved through reducing the negative impact of drug abuse on oneself and others—such as engaging in less harm through using a clean needle and not driving.
The Principles Behind a Harm Reduction Approach
Harm reduction approaches hinge on the idea that people should not be required to stop using drugs completely to be deserving of support. Instead, harm reduction seeks to aid people who are abusing substances without them having to stop abusing drugs. Moreover, a harm reduction approach is based on four main principles:
- Respecting the rights of people even if they use drugs
- A commitment to evidence-based practices
- The avoidance of stigma
- A commitment to social justice and collaboration
High-quality care and treatment programs can still aid with the cessation of drug use for individuals with a SUD. Using a harm reduction approach, individuals are treated for drug addiction if it is of their own volition. Additionally, the reasons a person may be using drugs are addressed to keep a person from feeling as though they need drugs to cope. For example, if a person is abusing drugs to cope with homelessness, providing housing can remove the need to use drugs to deal with the struggles of living on the streets.
Common Harm Reduction Techniques for Substance Abuse
Harm reduction for substance abuse is an alternative to abstinence-only addiction treatment. For some people, stopping their drug use is extremely difficult. This can be due to a lack of housing or the absence of a support system. Therefore, abstinence may not be feasible for several reasons.
When abstinence isn’t possible or realistic to achieve, harm reduction can still help people who are abusing substances. No matter how small the change, harm reduction approaches aim to have a positive impact on the life of a person who is using drugs.
Several harm reduction techniques exist to help those who engage in substance abuse. Many of these are policies, laws, and programs were created to prevent harm to the substance user and the people around them. Here is a list of some common harm reduction techniques that you may or may not know about:
One way to combat drinking and driving is by using designated drivers; this allows people who want to drink alcohol to be able to do so without worrying about getting behind the wheel of a car.
Needle exchanges are another form of harm reduction. This harm-reduction technique provides safer drug injection for intravenous drug users. Harm reduction programs provide individuals with new needles and supplies. Individuals also get to learn about how to avoid blood-borne diseases such as HIV, AIDS, and hepatitis B through sharing needles that can harm the body if not used correctly.
Some harm reduction focuses more on reducing harm to other people. Smoking areas are designated areas for cigarette smokers. These areas reduce the exposure of non-smokers to dangerous secondhand smoke.
Safe Injection Sites
There are safe injection sites that provide a harm reduction approach to intravenous drug users. These are government-funded facilities where individuals have easy access to clean needles along with an area for them to inject drugs in order not to harm themselves or others.
Technically Alcoholics Anonymous is a type of harm reduction approach since harm reduction techniques don’t focus on abstinence. Alcoholics Anonymous is offered in an attempt to reduce harm brought about by alcoholism. But it does not claim that sobriety is the only goal of treatment.
Harm Reduction for Alcohol Abuse
Some harm reduction approaches are specific to certain types of addictions. When it comes to alcohol abuse, there are a few different harm reduction techniques for alcohol addiction and alcohol misuse.
Measures to Reduce Alcohol-Related Harm
Alcohol use disorder is the most common substance use disorder in the United States. Further, alcohol’s popularity has consequences that affect people who drink and, unfortunately, people around drinkers. Measures to reduce alcohol-related harm include the following:
- Free transportation services on holidays when drinking is common, such as New Year’s Eve
- Padded furniture in bars to reduce injury due to falls
- Compartmentalization of space in bar to reduce the risk of fights breaking out
- High prices for drinks with more alcohol to reduce consumption of alcohol
Server Training Programs
Server training programs are harm reduction programs that are designed to teach bartenders and servers in bars about how to recognize potentially dangerous situations when people might be intoxicated. Servers may be trained to recognize when someone should be recommended weaker drinks or non-alcoholic alternatives. Additionally, servers are trained to de-escalate situations where a patron has become unruly due to being refused alcohol.
Controlled Drinking Programs
Controlled drinking programs aim to train participants to learn to manage their drinking. These harm reduction programs attempt to teach people how to keep their intake of alcohol within safe levels by limiting the number of drinks per day or drinking only in certain situations.
Harm Reduction for Opioid Abuse
People who abuse opioids are also poised to benefit from a harm reduction approach. As the national rate of addiction to an overdose death from opioids surges, more harm reduction techniques are being used around the country. These range from preventing overdose through education to providing life-saving drugs that stop overdoses.
Intranasal Naloxone is a harm reduction therapy that is used for opioid overdoses. It’s currently being distributed by harm reduction organizations to drug users, their friends, family, and peers who are trained to use it.
First responders are also being given this drug to treat opioid overdose patients. Overall, this harm reduction technique is being implemented in many harm reduction organizations that are located throughout the country. This is due to the high rate of overdose death preventions it can contribute to. For example, some communities have seen a 46% reduction in opioid overdose deaths due to the availability of this harm reduction approach.
Opioid Risk Education
By educating people on the dangers of opioid abuse, harm reduction organizations are helping to reduce the harm caused by opioid use. This harm-reduction approach uses evidence-based education, before it occurs, to prevent harm. The goal of opioid risk education is to inform people of how dangerous these drugs can be.
Rather than trying to get people who are using opioids to stop, harm reduction recognizes that there is a certain level of drug use in every community. Education on opioids can include measures to inform people about lethal doses, adverse reactions due to mixing opioids with other drugs, and how to test for fentanyl.
Opioid Overdose Prevention and Response Protocols
In areas where opioid use is common, many different measures are being taken to prevent deaths from opioid abuse and overdose. These can include the following:
- Reverse motions detectors in public bathrooms to indicate if someone has potentially been rendered unconscious
- Education for business staff and first responders on overdose signs and next steps
- Intranasal Naloxone education and training
- CPR training
Addiction Treatment at Free by the Sea
If you are suffering from a substance use disorder and want to cease abusing drugs or alcohol, we can help. Here at Free by the Sea, we offer comprehensive addiction treatment to individuals who are ready to end the hold substance abuse has on their life.
Our programs include inpatient and outpatient addiction treatment programs for a range of substance abuse disorders that include opioid and alcohol use disorders. To speak to one of our admissions specialists and learn which program is best for you, contact us today. We can be your lifeboat in the sea of addiction.
Dr. Richard Crabbe joined our team in 2019 as our psychiatrist and medical director. He attended the University of Ghana Medical School where he became a Medical Doctor in 1977. From 1978 through 1984, he was a medical officer in the Ghana Navy and provided a variety of services from general medicine to surgeries. He received his Certificate in General Psychology from the American Board of Psychology and Neurology in 2002.