Harm reduction seeks to maintain people’s safety and minimize death, disease and injury from high-risk behaviour. The reduction of harmful consequences can be associated with drug use or other risky health behaviours. Thus, harm reduction can be used to decrease harmful illicit drug use or prostitution. The main goals of harm reduction are supported by social justice and empowerment theory, as harm reduction allows people to make autonomous decisions, but it also addresses the inequalities and stigma that individuals who take part in risky behaviours experience in the community.
Harm reduction functions on a continuum with prevention and education on one side and enforcement on the other. The criminal justice apparatus cannot fix many health issues that result in risky behaviour; thus, harm reduction advocates for prevention, treatment and other healthcare services. However, critics of harm reduction often believe that tolerating these behaviours can represent an acceptance of these behaviours as acceptable in the community.
Drug Use
Harm reduction respects that people who use drugs will not always abstain from using drugs. Thus harm reduction strategies include needle and crack pipe distribution programs, supervised injection facilities, methadone replacement therapy, heroin maintenance programs and naloxone distribution. The primary function of needle and crack pipe distribution programs and supervised injection facilities is to provide clean needles to decrease the risk of abscesses, damage of veins, syringe sharing, HIV/HCV infections and fatal overdoses.
Methadone replacement therapy reduces harmful effects of opiates by substituting an opiate drug with an oral prescription, which eliminates the need to inject. In addition, if administered properly, individuals will not experience withdrawal symptoms and cravings. In heroin maintenance programs, people are provided with medical prescriptions for pharmaceutical heroin so that heroin-dependent individuals can use heroin in controlled environments.
Evidence has suggested that these programs can improve the health and social circumstances of participants, while also reducing costs incurred by criminalization, incarceration and health interventions. Naloxone distribution is used to counter overdose effects of opioids such as heroin or morphine overdose. The World Health Organization indicates that naloxone is one the most “essential medicines” and recommends its availability and usage. Harm reduction programs and practices help drug users develop awareness and education regarding safer drug use practices. Harm reduction programs also provide easy access to addiction counselling as drug addicts are often in contact with drug programs, social workers and healthcare staff, which can evidently lead to discontinuation of drug use as well.
Alcohol-Related Programs
The HAMS harm reduction network encourages goals for safer drinking, reduced drinking, moderate drinking and abstinence. Thus, harm reduction provides education to individuals on alcohol consumption, but allows individuals to make their own choices. In addition, the dangers of drinking and driving have also been analyzed and designated drivers or free taxi programs are used to reduce the occurrences of drunk driving accidents.
Tobacco
Harm reduction to reduce tobacco consumption takes action to lower the health risks associated with using tobacco, without engaging in abstinence from tobacco and nicotine. Such methods may include switching to lower tar cigarettes or using a non-tobacco nicotine delivery system. In addition, although discontinuing the usage of all tobacco products is encouraged, many individuals are unable or unwilling to be abstinent; thus, harm reduction can provide many benefits to these individuals.
Sex
Safe Sex
Many schools have committed to pre-teen and teen students who may be sexually active. Since teenagers may have sex, a harm reduction approach seeks to provide adolescents with the education to have safe sex such as use of birth control and condoms to prevent sexually transmitted diseases and unwanted pregnancy. These programs differ from abstinence-only education, which assumes that educating teenagers about sex will encourage them to engage in it.
Prostitution
Harm reduction provides education and advocacy for the human rights of both voluntary and coerced prostitution. Harm reduction strives to end the marginalization, isolation, powerlessness and oppression of sex works by promoting development of a critical and social consciousness. Since much disapproved behaviour from sex workers is often criminalized (ie. sex trafficking), the disproportionate amount of violence that they endure makes them increasingly vulnerable. Thus, sex workers are considered to be addicts, incompetent, diseased and desperate despite their likely circumstances of not having any other income options. Thus, instead of victimizing and infantilizing sex workers, harm reduction promotes the health, rights, and dignity of individuals impacted by sexual exchange and provides respectful and non-judgmental affirmation of power and control in society.
Photo Credit: Courtesy of Youth Rising
References
BC Centre for Disease Control. (2013). Harm Reduction. Retrieved March 24, 2014,from BC Centre for Disease Control : http://www.bccdc.ca/prevention/HarmReduction/default.htm
Canadian Harm Reduction Network. (2014). What is harm reduction? Retrieved March 24, 2014, from Canadian Harm Reduction : http://canadianharmreduction.com
Canadian Paediatric Society. (2014, Feb 1). Harm reduction: An approach to reducing risky health behaviours in adolescents. Retrieved March 24, 2014, from Canadian Paediatric Society: http://www.cps.ca/documents/position/harm-reduction-risky- health-behaviours
Harm Reduction Coalition. (2014). Sex workers without boarders. Retrieved March 24, 2014, from http://harmreduction.org/connect-locally/north-carolina/sex-workers-without-borders/
OHRDP. (2014). Harm Reduction. Retrieved March 24, 2014, from Ontario Harm Reduction Distribution Program : http://www.ohrdp.ca/about-us/harm-reduction/
Rhodes, T., Kimber, J., Small, W., Fitzgerald, J.,Kerr, T. et al. (2006). Public injecting and the need for ‘safer environment interventions’ in the reduction of drug-related harm. Society of the Study of Addiction, 1384-1393.
Wikepedia Encyclopedia. (2014). Harm reduction. Retrieved March 24, 2014 from http://en.wikipedia.org/wiki/Harm_reduction
