Harm reduction

What is Harm Reduction?  I see it in articles about addiction and have been hearing the term a lot on the news.




Harm Reduction is, actually, a simple term when we don’t use it related to addiction and substance use disorder.  So, I will give you the definition and examples in its simplest form before we get into how the term is used related to drug addiction.

The definition: Harm reduction is the strategy, policy, and philosophy of reducing risk and thus the morbidity and mortality associated with an action or condition.

So, my favorite simple example of harm reduction is the use of seatbelts in a car.  We understand that while driving a car there is a possibility of an accident happening with that car.  It is a common occurrence and not unusual.  People often get hurt or die in car accidents.  We know that people are not going to stop driving to eliminate the possibility of having an accident.  This is where harm reduction comes in.  Putting seat belts in the car and also air bags has been found to greatly reduce death and major physical destruction in the event of a car accident.  This reduces harm to those in the car.  One major factor to keep in mind while we are discussing this is the fact that those in the car must use the seatbelts the way they are meant to be used in order for harm reduction to occur.  Simple.

Hard hats are another example of harm reduction.  Working in dangerous areas without protection can result in death or destruction to a person. People are not going to stop working in dangerous areas but using these hard hats can reduce the harm caused in an accident. 

The above examples are logical and not very controversial.  As we continue we will enter more controversial examples.

Sex education is schools is a form of harm reduction.  It is a common fact that a certain amount of teens will experiment with sex at an early age no matter how much education they have on this topic.  We know we can’t eliminate all teen sexual activity.  Handing out condoms (both for birth control and prevention from sexually transmitted disease) would be harm reduction practice.  Of course, this starts to get into the controversy.  If we hand out condoms for harm reduction doesn’t this just give the kids the permission to do this?  We get into what are our goals and priorities. Do we want to reduce the probability of pregnancy and sexually transmitted diseases or do we just hope the kids will abstain?  I would suggest there is no right or wrong answer.  Everyone has to consider this for their own situation. 

These days if you look up the term “harm reduction” most definitions will relate to Substance Use Disorder and the illegal use of drugs.  Sometimes it relates to alcohol.

Do we want to keep those suffering from Substance Use Disorders (SUD) alive or must they suffer from HIV (from dirty needles), experience overdoses and overdose deaths, do we offer tests for drugs to make sure they are safe and not tainted and deadly?  Needle exchange programs and safe injection sites are popping up all over the country including here in North Carolina. This has greatly reduced death, infections, diseases.   First Responders are using Naxalone (Narcan), a drug used to reverse overdose before someone dies.  Although overdose events still continue to rise everywhere including Surry County, overdose deaths are slowly declining due to this Harm Reduction method. 

Medication Assisted Treatments such as methadone treatment and use of Suboxone can lead to better lives, help those in treatment avoid the need to search for expensive prohibited drugs, achieve workplace functioning, and limits the mortality rate of the drug addicted population. 

As I mentioned with regards to seatbelts, Harm Reduction requires compliance to work.

This has just been an overview of harm reduction.  There are no conclusions here.  The more knowledge we have about what is available and what works in other places, the more educated decisions we can make here in Surry County and in our own homes with our own families.

I hope this has been helpful.


Denise Krochta

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