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Harm reduction is a public health approach to managing high-risk behaviors, including drug and alcohol addiction. It focuses on reducing the negative consequences of the action. The harm reduction model values abstinence, but abstinence is not exclusively the goal.
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The main priorities of harm reduction are to keep people alive and reduce suffering. This type of treatment meets the needs of patients “where they’re at” in their journey and recognizes that some people may not be willing or able to stop the risky or illegal behavior.
Harm reduction focuses on providing judgment-free healthcare solutions that mitigate the health risks associated with these behaviors. Some of the methods used include safe access to drug paraphernalia, allowing drug intake in a controlled environment, and health education. The harm reduction model is gaining momentum worldwide, with over 200 syringe exchange programs operating in the United States.
According to the Harm Reduction Coalition, the principles of harm reduction are:
Some of the more common harm reduction strategies include:
Research shows that harm reduction has many positive outcomes. The main positives of harm reduction include:
Harm reduction is not without its critics. The primary criticisms of harm reduction are:
Contrary to the misconception, advocates for harm reduction do not seek the legalization of drugs. Harm reduction advocates for regulation, drug use de-stigmatization, and reduced legal penalties for drug use in certain circumstances.
Evidence shows that harm reduction does not encourage substance abuse, and harm reduction has shown great promise in treating patients. Patients who received therapy to control their drinking function better than patients who were treated with the goal of abstinence. Given its successes, harm reduction is the primary policy response to drug use in Europe. It is growing in popularity in the United States.
Harm reduction can be useful in treating alcohol and drug abuse. This treatment model recognizes that many drug users are either unable or unwilling to stop, do not need inpatient treatment, or are not ready for treatment. In these cases, harm reduction focuses on reducing harm due to dangerous drinking or drug use such as HIV transmission, viral hepatitis, and death from overdose.
Harm reduction helps individuals slowly cut back on their drug or alcohol with the ultimate (though not exclusive) goal of complete abstinence. Harm reduction strategies for addiction focus on education, overdose prevention, and disease control.
Because harm reduction is a relatively new form of therapy for addiction treatment, there is limited data on its effectiveness. However, The National Institute on Alcohol Abuse and Alcoholism does not recommend a singular approach to treat everyone. It encourages controlled drinking and other harm reduction strategies.
In 1988 the United States Secretary of Health and Human Services found that syringe exchange was “safe and effective.” Research shows that syringe and needle exchange programs lower HIV risk and hepatitis transmission, prevent overdose, and provide a gateway to drug users’ treatment.
While still in early research, other harm reduction strategies have shown promise, including heroin prescribing, depenalization, drug consumption rooms, and pill testing.
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