People who use drugs (PWUD) like heroin and morphine need safer ways to inject their drugs. Unfortunately, they will share or overdose if they cannot afford or find safer ways.
Sharing unsterilized needles increases these people’s risk of diseases and infections like hepatitis B, C, and HIV. In addition, when these people are infected, they can spread infections to the general population.
Therefore, harm reduction is a means of directly providing for the needs of the PWUD group to protect the larger population from diseases and drug-related harm.
Harm reduction is the policies and practices that minimize adverse health and social impacts of drug use. Its principles are grounded in justice and human rights. It answers one of the fundamental questions; how can we create a positive change with drug users without judgment and discrimination?
Harm reduction does not force people to stop using drugs before providing them with the support they need. Instead, it meets them at the point of their need. Some of the supports harm reduction strategies provide are education, safety, providing needles, providing a consumption house, providing alternative drugs that do not require the use of injections, and also providing legal/paralegal services.
The first time I heard about harm reduction was in my epidemiology class. It was interesting to find out that providing drug users with low-dead space needles can help prevent the spread of blood-borne diseases. There is decreased space between the needle and the plunger when fully pushed, making it safer for PWUD than traditional injections. Low-dead space needles are a good application of harm reduction.
In the same class, I learned we could provide IV drug users with oral alternatives that provide them the same agonist effect they seek. But, I had so many questions after the course, does harm reduction truly work? Doesn’t harm reduction encourage PWUD to use more drugs? This article aims at answering some of these questions.
Harm reduction works. It keeps drug users alive and reduces the spread of HIV and viral hepatitis within the population. It also plays a significant role in connecting drug users and integrating them into the general health system.
Over 100 countries already have harm reduction policies in place to help their citizens who are drug users. However, another question arises: Are harm reduction policies only targeted at drug users?
Health officials initially developed harm reduction to assist drug users who could not abstain. Today, it has extended to preventing teenage pregnancy, depression, alcohol use, etc.
Harm reduction is a public health strategy which means that the result is a benefit that can be extrapolated to the entire population and even globally. It entails educating drug users about safer ways to use the drugs, providing alternatives to intravenous (IV) drugs, and providing a safe location for supervised consumption sites that can help reduce overdose and needle-sharing cases.
Now let’s discuss the principles of harm reduction.
Harm reduction does not encourage people to use drugs. Instead, it meets these users at the point of their needs and addresses the conditions related to the use of illicit drugs. Harm reduction is not a universal formula. Instead, it is an individual or community-focused approach.
Harm reduction accepts that whether we like it or not, people will use IV drugs. It works on the notion that instead of covering the problem with a thick blanket, we should help these people. It reminds me of what our body does to tuberculosis in creating caseating granulomas. So it turns out that tuberculosis is a severe infection, so the body tries to cover it with a thick blanket that forms granulomas ( a collection of macrophages).
Harm reduction provides a way to solve the situation—giving the body six months of antituberculosis treatment to cure the disease.
Drug use is a continuum, from severe use to complete abstinence. Harm reduction understands the continuum and acknowledges that providing alternatives to IV drugs is safer. For example, giving drug users buprenorphine which can be taken as a patch or orally, is safer than using heroin intravenously. In addition, oral drug use has less incidence of viral hepatitis and HIV infections.
Harm reduction is also a powerful way of letting people who are drug users or ex-drug users routinely have a voice and help them in designing programs that will be helpful to their societies. Harm reduction educates people who use drugs (PWUD) that they are in charge of reducing the dangerous effects of drugs. It empowers them with health information and support.
Harm reduction affirms people who use drugs (PWUD) as the primary agents of reducing the harms of their drug use and seeks to empower PWUD to share information and support each other in strategies that meet their actual conditions of use.
Harm reduction is not blind to the fact that social inequalities like poverty, racism, discrimination and sexual trauma affect people’s capacity to handle drug-related harm effectively. Instead, it provides a hand to help these people too. But, most importantly, harm reduction does not deny the real danger related to illicit drugs.
In conclusion, harm reduction works; its main aim is to reduce the dangerous effects related to the use of illicit drugs. It does not promote the use of drugs but instead enables PWUD to be involved in health awareness. Therefore, we should apply harm reduction policies in every country. The only problem I can highlight is that harm reduction does not solve the root cause of drug abuse in society. But then, that’s a story for another day.
So then, let us not be like others, who are asleep, but let us be awake and sober. For those who sleep, sleep at night, and those who get drunk, get drunk at night. But since we belong to the day, let us be sober, putting on faith and love as a breastplate and the hope of salvation as a helmet. Thessalonians5:6-8.
Reference
MABS 