By Dr. Lauren Prest, Director of Mental Health and Recovery Services at Moab Regional Hospital
Harm reduction has entered the Zeitgeist! Even though this term has been around since the 1980s, it is finally becoming a concept more and more people are familiar with. Those involved in caring for and treating people who engage in habitual, high-risk behaviors of substance use and addiction, know there’s no amount of negotiating, begging, pleading, or threatening that will change a person’s end action. From this basic truth, harm reduction was born.
Harm reduction means meeting someone where they are and helping negotiate the inevitable outcomes of their decisions. It means increased acceptance toward risky behaviors and finding strategic ways to reduce the associated damages through the core principles of realism, flexibility, pragmatism, and social justice.
Classically, harm reduction interventions have focused on substance using populations due the inherent harms involved. IV drug use, for example, is associated with many infectious diseases because needles may be shared or re-used. Safe needle exchanges, a type of harm reduction program, were created to give individuals who use IV drugs access to sterile needles. These programs also reduce the risk that needles will be shared, reused, or left in unsafe places. As a result, morbidity and death associated with infectious diseases like Hepatitis C and HIV and the cost of treating them have dropped significantly for health systems and communities using needle exchange programs.
Harm reduction philosophy can be applied to non-substance using people as well. We all engage in activities that have the potential for some threat. As an example, many of us wear seatbelts when driving. Wearing a seatbelt doesn’t stop us from getting into accidents, but it does reduce the threat of physical injury.
Of course, some activities go against social norms and as a result, carry more stigma. With this in mind, harm reduction has been growing as a mainstay of addiction care because it also helps fight stigma by allowing people to make their own decisions without judgement. It provides an access point for care and an intervention point for healthcare providers to introduce treatment. Harm reduction keeps people who might avoid treatment engaged in care by allowing them to participate more openly and find aspects of care that work for them.
Allowing those struggling with ambivalence about their behaviors to make their own decisions and empowering them to do so more safely can provide essential and lifesaving time for them. Addiction is not a moral failing – it is a biological and behavioral disease that responds to treatment just like diabetes and high blood pressure. Moreover, hope exists for healing as long as a person can be kept alive.
Nevertheless, because of social stigma, many people may misunderstand what harm reduction is intended to do. It should be understood that harm reduction does not advocate for drug use. In fact, in communities using harm reduction methods, drug use and crime rates both decline. The economic and legal benefits for communities that embrace harm reduction are well established and easily evidenced. And, programs that enhance education and emphasize social interaction are more effective.
As our new Recovery Center opens in June 2022, Moab Regional Hospital will engage in general harm reductionist philosophy to ensure an unbiased access point for care. The new Recovery Center will have strong, evidenced based standards, which include harm reduction as both a clinic culture and a form of treatment.
If you or your loved ones need support, education, or resources for substance use and addiction, please contact us at 435-719-3970. The Recovery Center will have Narcan and harm reduction kits available for anyone who asks.