Harm reduction is an often-controversial type of addiction treatment for intravenous drug use, such as heroin, cocaine, methamphetamine, opioid painkillers, and prescription stimulants. At its most basic, harm reduction aims to provide care, and in some cases, rehabilitation, to active addicts. When considering the strength and weaknesses of harm reduction programs, it is vital to understand the complexity of the services available for addicts in active addiction.
What is Harm Reduction?
In a nutshell, harm reduction, also known as harm minimization, is a public health policy that helps reduce the negative social and physical consequences that link with addiction. Let’s explore some common types and analyze the strength and weaknesses of harm reduction programs.
Needle exchange programs are probably the most recognized form of harm reduction. Generally, these are places where an addict can go and trade dirty syringes for clean ones. Advocates say this reduces the spread of blood-borne diseases.
How does a needle exchange work? Typically, these exchanges provide access to unused syringes and properly dispose of used syringes. As a result, they reduce the harm of sharing needles. Additionally, they lower the risks of an unlucky person sticking themselves with an improperly discarded needle.
Some needle exchanges are buildings; others are nothing more than vans with a permit and clean needles.
Opponents of needle exchanges argue they perpetuate drug addiction. They say that illegal drugs are, well, illicit, and needle exchanges allow unlawful behavior to continue. However, a 2001 study done by harm reduction advocates reported needle exchanges reduced the spread of HIV in New York City by as much as 70%.
Another study in 2013 found that in neighborhoods with Syringe Exchange Programs (SEPs), break-ins and burglaries went down by 11 percent. Plus, they found that people who participate in SEPS are five times more likely to enroll in drug treatment than those who don’t.
Opioid Replacement Therapies (ORT)
Opioid Replacement Therapy is another popular form of harm reduction. It’s often called methadone maintenance. Generally, Opioid Replacement Therapy is when opioid addicts receive access to methadone or buprenorphine, to wean off street drugs.
Before we go any further, there are a few essential points to make regarding the strength and weaknesses of this harm reduction protocol. To be enrolled in an ORT, you must take drug tests. Taking regular drug tests ensures participants aren’t abusing heroin, or pain pills while receiving medication. Also, drug users go to an ORT clinic to receive the medication.
Sometimes, ORT clinics offer health and educational services, though this isn’t always the case. Advocates of Opioid Replacement Therapy say it’s a powerful, evidence-based way to wean addicts off of heroin and other illegal opioids.
Studies show 40% and 60% effectiveness of ORT’s, although this number is often debated. The study results are based on the success stories of individuals who stay in treatment for at least one year.
Opponents of ORT say it offers addicts a way to beat the system. They say rather than facing the consequences of their actions; addicts receive free drugs. Additionally, opponents say the biggest weakness of this harm reduction is that ORT’s are too lenient in enforcing drug screens.
According to the same research, treating opiate addiction with ORT has a superior treatment outcome than non-medication-based therapies. Increased retention means reduced mortality, better social function, and overall improved quality of life.
Naloxone is an “anti-overdose” drug. It’s a remarkably effective way to treat opioid overdoses. Naloxone can ultimately bring someone out of an overdose within two to eight minutes. Naloxone’s numerous benefits received recognition from the World Health Organization’s Essential Medicine List.
Trial programs have distributed Naloxone to active addicts, their loved ones, police, and social service agencies. This distribution sometimes takes place at needle exchanges and opioid replacement therapy clinics.
Advocates of Naloxone say it gives addicts, quite literally, a second chance at life. If addict overdoses on the street, their peers are more likely to provide them with Naloxone than take them to a hospital. If a police officer witnesses an overdose, either on the street or in jail, it’s quick and easy to give the overdosing individual the medication.
Opponents of Naloxone say that, once again, it’s too soft on addicts. They say addicts should be held responsible for their actions, should feel their consequences. They say if an addict overdoses, they should deal with the repercussions.
In the end, there’s no denying that Naloxone saves lives. In 2017, over 47,000 people died from an overdose. When first respondents and other health officials have Naloxone, many of these deaths can be prevented.
Safe Injection Sites
Safe injection sites are, without a doubt, the most controversial form of harm reduction. At their most basic, safe injection sites offer a legally sanctioned clinic for IV users to inject drugs.
Safe injection sites offer various services already mentioned. They provide access to clean syringes and Naloxone. Additionally, safe injection sites provide essential health care assistance and educational classes. They also have programs for addicts who’d like to receive drug treatment. They even have clothes and food for homeless addicts.
Advocates of safe injection sites argue that they offer an invaluable service to addicts. They provide a secure, government-sanctioned location to use IV drugs. They’re equipped to combat overdose, infection, abscesses, and other common medical problems. They offer education, medical services, and rehabilitation services. These types of programs can help save someone from contracting HIV and hepatitis, for example.
Opponents of safe injection sites argue this is simply too much. They say it’s not enough to have other options, but now addicts want a place to use illegal drugs with impunity. They say safe injection sites encourage and promote drug use.
It’s worth noting there are no safe injection sites in the US. So far, they’re in various European countries, Australia, and Canada.
Basic Healthcare Services
Essential healthcare services consist of physical exams, testing for HIV and various other infectious diseases, distribution of Naloxone, distribution of contraceptives, distribution of sterile injection supplies, and more.
Basic healthcare services are essential because many addicts don’t have access to doctors or other forms of primary healthcare. Advocates of harm reduction argue that essential healthcare services are a human right. Everyone, regardless of their addiction(s), should have access to healthcare.
There aren’t many opponents of basic healthcare services. Even among those who contest harm reduction strategies, few think that addicts shouldn’t receive access to healthcare.
So, Does Harm Reduction Help or Hurt Addicts?
Ultimately, this question can only be answered by the one asking it.
There are many benefits to harm reduction. Harm reduction provides addicts with safe injection supplies. It also offers many ways to escape the cycle of active addiction. Additionally, it gives addicts access to fundamental drug education and healthcare services.
In the case of Naloxone and safe injection sites, harm reduction even saves lives.
There are also some drawbacks. It can propagate addiction. Some addicts may find it easier to rely on harm reduction than to get sober.
When weighing the strength and weaknesses of harm reduction, it’s clear that overall the programs seem to be working. However, addiction is a complicated disease. What’s suitable for one may be harmful to another.
With harm reduction or not, seeking treatment for substance use disorder is always the best way to prevent death or relapse. If you or someone you know is struggling with drug abuse, contact us today to learn more about our treatment programs and discuss the strengths and weaknesses of harm reduction with our addiction specialists.