What is Harm Reduction and How Does it Work?

What is Harm Reduction and How Does it Work?

• Mandy Sandhu
• 30 Mar 2023

There is no one-size-fits-all approach to treating patients with addiction.

Addiction is a complicated, multi-faceted illness that can arise from several different causes. It can take many forms and manifest in various ways. Harm reduction addresses these issues by offering inclusive and flexible solutions.

By allowing people who use drugs (PWUD) to recover and thrive on their own terms, harm reduction can direct substance users toward treatment and recovery while also helping keep them and others safe.

So what is harm reduction as an addiction treatment? At its most basic, harm reduction is a way to cut down on the risks associated with drug use. However, it’s not an initiative solely for the substance user—everyone can participate in harm reduction.

What is Harm Reduction?

As a public health policy, harm reduction is an approach to lessening the negative consequences of different human behaviours without necessarily eradicating potentially problematic behaviours.

It encompasses legal and illegal activities, including both discretionary and mandatory legislation to keep the public safe. Harm reduction provides a means to reduce the implications of drug and stimulant use while prioritizing the welfare of the substance user when treating substance use disorder (SUD).

Compared to many addiction treatment options, the harm reduction approach to treating SUD may involve the use of potentially addictive substances or medications such as Suboxone (buprenorphine and naloxone compound) during treatment.

SUD harm reduction programs recognize positive changes at all stages, be it a slight reduction in usage or adopting total abstinence. It is a philosophy grounded on human rights that acknowledges both users and the public when extending services and providing facilities for treatment, information, and other kinds of support.

Harm reduction empowers people with SUD to choose how they manage their addiction instead of locking them into therapies.

What is the Harm Reduction Model?

While there is no absolute guideline for practicing harm reduction, the following are the core principles of harm reduction programs.

Humanism

Humanism refers to having genuine care and respect for patients. Providers try to understand the reasons why patients engage in harmful behaviours and use that information to extend services that are user-friendly, responsive, and non-judgmental.

Pragmatism

Achieving perfection in health and behaviour is impossible. Pragmatism gives room to explore ways to improve behaviours without pursuing unrealistic expectations. Supportive measures to reduce harm resulting from drug use are prioritized over abstinence.

Individualism

Available support must be flexible, and interventions and treatments should be tailored to each patient. Providers must assess each patient separately and recognize individual strengths, needs, and receptivity when recommending treatment options.

Autonomy

Patients make their own choices about their behaviours, so providers need to work with their patients during intervention and treatment. Promoting patient-driven care and collaborative decision-making in addition to education and physician suggestions can help patients make decisions appropriate for their current situation.

Incrementalism

Any small step toward positive change is seen as moving in the right direction. Recognizing and celebrating these changes helps motivate patients to continue their efforts and improve their health incrementally.

Accountability Without Termination

Providers must understand patients are responsible for their choices and are accountable for their decisions. However, patients should not be penalized for backward behaviour.

Examples of Harm Reduction Policies

Early concepts of harm reduction can be traced as far back as the 20s, but it wasn’t until the 80s after the discovery of AIDS that harm reduction became an important tool in preventing the spread of blood-borne diseases transmitted through recreational drug use.

Today, harm reduction programs include provisions for medically supervised injection sites. There, syringe exchange programs and drug injections are facilitated by medical staff to help prevent overdoses and reduce the risk of spreading blood-borne diseases.

Supervised injection sites also offer addiction education and treatment referrals. In some countries, they may also provide on-site counselling. In Canada, one can locate supervised injection sites through the official government website.

Harm reduction also involves educating the public about addiction to help eliminate the stigmas associated with drug use.

For example, by informing the public that addiction is a disease, patients are more likely to ask for treatment instead of shying away from help. Also, distributing test kits and overdose reversal medication to the public encourages them to do their part in reducing drug-related harms or death due to drug overdose.

Harm reduction encourages peer support and recovery services. It’s rooted in the belief that engaging with people with drug use experience can help in the development of programs that are relevant and acceptable.

For instance, asking peers, or persons with similar drug experience, can help providers determine if treatments are available, accessible, accommodating, affordable, and non-stigmatizing to those who seek and need them. This has helped push the decriminalization of drug use in some countries.

As of 2022, 105 countries support harm reduction policies offering different programs per state or country, which means despite adoption, not all of them offer opioid agonist therapies, drug consumption rooms, and syringe exchange programs.

Harm Reduction in Canada: Making Safety a Priority

So, what is harm reduction? In the simplest terms, it’s putting human beings first.

When we make the conversation around addiction more about the welfare of users and less about wanting to punish them, we help people live safer lives. Addiction is a disease and the importance of compassion cannot be overstated.

If you want to learn more about how you can help yourself or a loved one get free from the clutches of addiction, get in touch with us at Freedom from Addiction.

We’d love to answer any questions you may have.