Harm Reduction

Harm Reduction 

Principles of Harm Reduction

Harm Reduction is a set of practical strategies with the goal of meeting drug users “where they’re at” to help them reduce any harm associated with their drug use. Because Harm Reduction demands that interventions and policies designed to serve drug users reflect specific individual and community needs, there is no universal definition of, or formula for, implementing Harm Reduction. However, the Harm Reduction Coalition considers the principles central to harm reduction practices. 

Harm Reduction Practice

1. Accepts, for better and for worse that licit and illicit drug use is part of our world and chooses to work to minimize its harmful effects rather than simply ignore or condemn them.

2. Understands drug use as a complex, multi-faceted phenomenon that encompasses a continuum of behaviors from severe abuse to total abstinence, and acknowledges that some ways of using drugs are clearly safer than others.

3. Establishes quality of individual and community life and well-being--not necessarily cessation of all drug use--as the criteria for successful interventions and policies.

4. Calls for the non-judgmental, non-coercive provision of services and resources to people who use drugs and the communities in which they live in order to assist them in reducing attendant harm.

5. Ensures that drug users and those with a history of drug use routinely have a real voice in the creation of programs and policies designed to serve them.

6. Affirms drugs users themselves as the primary agents of reducing the harms of their drug use, and seeks to empower users to share information and support each other in strategies which meet their actual conditions of use.

7. Does not attempt to minimize or ignore the real and tragic harm and danger associated with licit and illicit drug use.

With American drug treatment and prevention policy rooted in criminal law enforcement and incarceration, most approaches to drug-related problems help only a tiny fraction of the people who use illicit drugs. We recognize that families and communities (especially communities of color) are frequently devastated not only by addiction, but also by arrest and incarceration, the lack of available drug treatment, infectious disease, poor housing, unemployment, etc. Drug related problems continue to baffle communities across the country, leaving them frustrated and hopeless in their inability to respond to the harms they experience. The harm reduction movement grows from the need for a conscientious response to drug use that is less damaging to the fabric of our nation's diverse communities. Harm reduction works to redress the following injustices, among others:

· There is a shocking lack of the basic services that help reduce drug-related harm. Most areas in the <?xml:namespace prefix = st1 />United States still have neither needle exchange programs, nor over-the-counter sale of syringes, as HIV prevention measures. Drug treatment is not available at all in some states, and there are no methadone maintenance treatment programs in nearly one-fifth of them. Where treatment is available, it is not funded to meet the level of demand.

· The lack of universal health care and the movement toward privatization and managed care threaten to reduce or eliminate some the few therapeutic services that currently exist for illicit drug users‹particularly drug treatment.

· While personal difficulty in maintaining housing, family, employment and health may be worsened by chronic drug abuse, the problems are equally worsened by policies that create obstacles to housing, family, employment and health care for drug users.

· Most therapeutic services for drug users, including drug treatment, are designed to serve the priorities of providers instead of the needs of consumers. Drug education and prevention campaigns are largely ineffective, attempting to scare people away from using drugs instead of equipping them with accurate information about drugs and drug use, including their adverse and harmful effects.

· Current drug control strategies criminalize a huge proportion of the country's population. Since 1980, the number of adults incarcerated in state and federal prisons, local jails, and on probation or parole has more than tripled, with one-third of this expansion due to an increase in the number of drug law violators put behind bars. Women, African-Americans, and Latino/as have been disproportionately affected.

· A struggle exists between law enforcement and medical providers to define drug users as either criminals or medical patients, with communities and families left out of the debate and unable to define users as community and family members. Effective community planning for drug treatment and post-incarceration support for drug users have no priority in the allocation of drug intervention funding.

· The HIV epidemic has killed hundreds of thousands of people in the United States and continues to rage on. Swift public policy changes and the implementation of critical services could have prevented an untold number of deaths and HIV infections among injection drug users, their sexual partners, and children. 

Harm Reduction

12 Step Suggested Program for Drug Users (a work in progress)

1. We admitted we used drugs and had reasons for doing so, while we struggled with a society whose practices made our lives unmanageable.

2. We rejected the notion that we are insane thereby taking responsibility for our lives and our behavior.

3. We made informed decisions—in regards to drug use—while committing to ourselves, and those we deemed appropriate, our intention to reduce or eliminate any harms our drug use caused.

4. We listed and examined those parts of our lives when the use of drugs allows or forced us to participate in acts which caused harm to ourselves, our families and our communities.

5. We talked with a trusted friend or ally about these matters.

6. We determined those negative parts of our behavior which were no longer useful to us, while outlining a plan for survival which did not immerse us in guilt and self hatred.

7. We made a serious and focused attempt to live a life worth living.

8. Now seeking a peaceful existence, we made amends to persons we had harmed, explaining to them to connection between our use of drugs and the actions we took to survive.

9. We practiced responsible drug use behavior wherever and whenever possible.

10. We continued to monitor, review and manage our drug use seeking guidance as needed while striving to continually reduce drug related harm.

11. We utilized holistic treatments, prayer and/or meditation as a mechanism for guidance and clarity, discipline and sound judgment.

12. We carried a message of hope to other users, supporting and encouraging their harm reduction efforts, informing them that by utilizing harm reduction practices they no longer have to risk their lives while using drugs.

The treatment, Harm Reduction Psychotherapy is based on the belief that substance abuse develops in each individual from a unique interaction of biological, psychological, and social factors.

Harm Reduction Psychotherapy is a non-judgmental approach to helping substance users reduce the negative impact of drugs and alcohol in their lives. It respects that people use drugs for reasons. It addresses the complex relationship that people develop with drugs and alcohol. Drug and alcohol issues are addressed simultaneously with social and occupational concerns and psychological and emotional issues.

Anyone is welcome in our treatment, regardless of the status of their drug use and regardless of their primary concerns or goals. A person's goals can range from complete abstinence to controlled or safer use based on a desire to improve health, relationships, or one's functioning in the world.

Harm Reduction Therapy is a motivational approach to increasing people's desire for greater health and well-being and increasing their motivation and their capacity to achieve a healthier life. Drug users with other problems (mental illness, HIV, and Hepatitis C, for example) are the majority. They especially need a therapeutic approach that joins them at any point in their struggle with drugs and alcohol. Harm Reduction Therapy starts where the client is, works from the principles of acceptance and empowerment, and moves people in the direction of better health and responsibility. Its goal is improved quality of life in the areas of mental health, homelessness, incarceration, employment, and disease transmission, all of which have been demonstrated to be achievable without demanding abstinence from drugs and alcohol as a condition of treatment or assistance.

Harm Reduction Therapy is the most innovative and sophisticated development in drug and alcohol treatment in many decades. It is a multidimensional approach to working with drug and alcohol users who are experiencing problems related to their substance use. It takes into consideration the biological, emotional, and social components of drug and alcohol use, the complex nature of a person's relationship with drugs or alcohol, and the difficulty of achieving total abstinence. 

Kris Trairatana