Policy paper on preventing risks and reducing harm linked to the use of psychoactive substances. Harm reduction basics harm reduction hr is a philosophy and menu of services aimed at minimizing injury to self, others, and community by aod consumersfrom the most casual users to those with the most severe drug dependencies. Factors associated with harm reduction model use among. Harm reduction is an innovative approach to substance abuse treatment that focuses on reducing the harmful consequences of drug use. Harm reduction strategies often focus on avoiding overdose, the risk of infection or the development of new or stronger addictions. Harm reduction involves a range of support services and strategies to. The term harm reduction can be used to describe the philosophical beliefs that underlie strategies and programs, or it can be used to describe the. The history of harm reduction in the usa has led to the development of some of the most important methods for treating persons for drug use disorders, such as methadone and buprenorphine for opiate use disorder. Harm reduction is increasingly accepted among researchers and many clinicians as a legitimate approach to treating substance abuse.
Substance abuse and developments in harm reduction cmaj. The focus is on reducing the negative consequences and risky behaviors of substance use. The founding principle of harm reduction, a radical new paradigm in the treatment of alcohol and other drug problems, is to begin where the client is. The harm reduction model prioritizes reducing the negative consequences of a persons substance use over complete abstinence. Evaluating public order, pre and postspot first 12 weeks before opening spot, 91% of injection drug users reported willingness to use harm reduction programs, and those most likely to use such spaces were among those at. Targeted at risks and harms harm reduction is a targeted approach that focuses on specific risks and harms. Examples of harm reduction in substance abuse treatment. The community model follows an interpretation of harm reduction modified specifically to address treatment issues facing people with mental illness or dual diagnoses of mental illness and substance abuse. Harm reduction united nations office on drugs and crime. Harm reduction is any action that attempts to reduce the harm of substance or other behaviors harm reduction has a top down public health component and a grass roots user driven approach. Harm reduction is a broad term that applies to policies, programs, and practices that aim to minimize the health, social, and economic consequences of substance abuse. Harm reduction treatment is a controversial method of rehabilitation usually in regards to drug addiction and sex education. The difference between harm reduction and abstinence is in methods of treatment and the overall perception of modern substance abuse. Pdf this article provides information on harm reduction, a recent development in substance abuse services in response to the hivaids.
Oct 24, 2017 harm reduction refers to interventions aimed at reducing the negative effects of health behaviors without necessarily extinguishing the problematic health behaviors completely. Harm reduction keeps focus of attention is the damage done by the behavior and not the behavior itself. Factors associated with harm reduction model use among substance abuse counselors by tiffany madden ms, walden university, 2009 bs, ohio dominican university, 2006 dissertation submitted in partial fulfillment of the requirements for the degree of doctor of philosophy clinical psychology walden university february 2016. Harm reduction as a practice and prevention model for. Harm reduction benefits people who use drugs, their families and the community. At its core, harm reduction is a public health effort to save lives, and presents an alternative perspective between the disease model and the criminal. Historically, substance abuse treatment focused on reducing or eliminating drug use, neglecting the prevention of the adverse consequences of.
In this article it is argued that the harm reduction model, known primarily for its application in the area of substance abuse, reflects the most fundamental and cherished ideals of social work and provides an ideal framework for social work practice in a wide variety of settings. Harm reduction at the end of this section, you will be able to explain. Harm reduction is an oftencontroversial type of addiction treatment for iv drug use, such as heroin, cocaine, methamphetamine, opioid painkillers, and prescription stimulants. It combines public health principles and interventions, motivational interviewing, and psychiatric treatment with psychodynamic psychotherapy to create an integrated model of treating individuals with substance abuse and. It encourages people to build strengths and to gain a sense of con. Vicki lawton had to retrain her staff when the community action partnership of western nebraska shifted to a harm reduction model four years ago. The board of health shall collaborate with health care providers and other relevant partners to ensure access to, or provide based on local assessment, harm. The concept of harm reduction refers to a set of policies, programs, and practices that aim to reduce the health, social, and economic consequences of drug and alcohol abuse. A new perspective on substance abuse services article pdf available in social work 493. It reduces the sharing of needles or repeated use of dirty needles by intravenous drug users.
Examples of harm minimization public health policies could be the safe sex programs in schools, or the legalization of prostitution and sex work. Harm reduction is an evidencebased, clientcentred approach that seeks to reduce the health and social harms associated with addiction and substance use, without necessarily requiring people who use substances from abstaining or stopping. We encourage you to continue learning about harm reduction. Harm reduction treatment for heroin addiction alcoholism. Harm reduction interventions in substance abuse treatment. The pros and cons of harm reduction treatment drug rehab. My personal harm reduction safety plan continued knowledge is the best resource. It was a difficult shift because it required a fundamental culture change for our staff. Although the workshops were thorough, covering myriad harmreductionrelated topics that included outreach, overdose prevention, and engaging outoftreatment substance users, attendees also knew they were welcome to contact the hrc later for additional guidance and resources. In abstinencebased addiction recovery, people must refrain from the use of all mindaltering substances except for some emergencies where pain killers are used shortterm following a major surgery.
Without a doubt, reducing the spread of hiv is a national priority. Harm reduction refers to interventions aimed at reducing the negative effects of health behaviors without necessarily extinguishing the problematic health behaviors completely. Pdf this paper attempts to investigate the application of harm reduction model that is largely in practice, in the context of bangladesh. It is not a source book so it does not include a step by step guide to working with young people so as to minimise the harms associated with their drug use. Prevention, early intervention, harm reduction, and. On the one hand, we see addictions through the lens of disease. This publication has been archived on the ccsa website and was current when it was published. Whether your organisation agrees or not that the ultimate goal for substance abuse treatment should be total abstinence, drug use control, or both, harm reduction strategies are essential components of any modern treatment programme. Abstinence versus harm reduction valley recovery center. Harm reduction aims to reduce harmful consequences like. Definition for harm reduction everyday examples of harm reductions interventions. Jul 26, 2017 the history of harm reduction in the usa has led to the development of some of the most important methods for treating persons for drug use disorders, such as methadone and buprenorphine for opiate use disorder.
This resistance is rooted in historical demonization of particular. Harm reduction can help move a person from a state of chaos to a state of control. The individual is not considered to be responsible for the development of a problem, but is responsible for getting help. The guiding principles of harm reduction the history of harm reduction within vancouver and globally it is important to acknowledge that harm reduction is not a new concept. Substance use prevention and harm reduction guideline, 2018. It is available for reference or research purposes. Harm reduction accepts that some use of mindaltering substances is a common feature of human experience. The author describes his model of integrative harm reduction psychotherapy, an approach that integrates a strategic skillsbuilding focus with an exploration of the multiple meanings of substance use and the importance of the. The harm reduction coalition has a wealth of information and great opportunities to get involved locally. Harm reduction can be described as a strategy directed toward individuals or groups that aims to reduce the harms associated with certain behaviours. It focuses on reducing the harm of drug use to the user and society health, social, and economic consequences for people unable or unwilling to.
Principles of harm reduction harm reduction coalition. In this model, substance use disorders are viewed as biopsychosocial phenomena, treatment design, then, necessitates a sophisticated blend of research and clinical wisdom in many areas. Train your staff on harm reduction and trauma informed care. Defining principles of harm reduction harm reduction is practiced in a variety of ways by different providers. Harm reduction includes policies, programs and practices that aim to keep people safe and minimize death, disease, and injury from high risk behaviour, especially psychoactive substance use. Harm reduction models use a variety of strategies to reduce the harmful consequences associated with substance misuse. The late 1980s witnessed the emergence of the harm reduction approach, which represents a shift from the legal sanction debate to public health principles.
The core principles of harm reduction will, however, generally be the same, even if they are worded somewhat differently or provided in greater detail. Alcoholics and addicts are believed to have predispositions to the disease which is initiated upon the use of the substance. Most frequently associated with substance use, harm reduction also applies to any decisions that have negative consequences associated with them. The nature of this approach has been widely explored, and by now some international consensus on its basic characteristics has been reached. Hr service programs include promotion 1 personal communication with arthur c. Harm reduction strategies seek to reduce morbidity and mortality associated with substance misuse for those for whom abstinence is not an immediate andor feasible goal. These statements, however, illustrate the challenges facing public health and public safety regarding the issue of needle exchange programs. Harm reduction psychotherapy is the newest approach to engaging and working with substance users and abusers.
On the other hand, those who believe in the harm reduction model say. Harm reduction is a proactive approach to reducing the damage done by alcohol, drugs, and other addictive behaviors, as well as addressing broader health and social issues, such as hiv transmission. It has notand it shouldnt and probably never willsupplant the treatment of total abstinence, but, as with treatments for other disorders like depression, rage and even schizophrenia, the idea that there is a. When applied to substance abuse, harm reduction accepts that a continuing level of drug use both licit and illicit in society is inevitable and defines objectives as reducing adverse consequences.
The wisdom to know the difference harm reduction handout. In social work, some researchers have noted that the substance abuse field remains largely shaped by the disease model of addiction with little focus on harm reduction that may contribute to a. The paper presents harm reductions rationale, principles, treatment implications, and application to psychotherapy. The vast majority of the harm reduction literature focuses on the harms of drug use and on specific harm reduction strategies, such as syringe exchange, rather than on the harm reduction philosophy as a whole. Harm reduction groups, grounded in harm reduction principles and techniques, extend a lowthreshold welcome to people with unresolved substance abuse problems. Harm reduction is partly defined by a range of principles in which policies and programmes are grounded. The goal of harm reduction models is to reduce atrisk. Hrc held a followup training in kentucky in october. Harm reduction principles for healthcare settings harm. Harm reduction recognizes that the high risk behavior may continue despite the risks.
At its most basic, harm reduction aims to provide care, and in some cases rehabilitation, to active addicts. Harm reduction is a set of nonjudgmental policies and programs which aims to provide andor enhance skills, knowledge, resources and support that people need to live safer, healthier lives. Harm reduction models rhihub substance use disorder toolkit. The role of harm reduction in recoveryoriented systems of. However such broad definitions of harm reduction, allow drugs initiatives with many different aims and different methods to be included under the harm reduction umbrella. Hrc advocates for behavioral health substance abuse and. There are several concepts that support the general principles of harm reduction and form the foundation for clinical treatment of alcohol and drug disorders. As the quotation above suggests, it is an approach that is grounded. Principles the harm reduction approach to drugs is based on a strong commitment to public health and human rights. The canadian centre on substance abuse ccsa 1996 offers the following. This model recognizes that drug use is complex, and abstinence may not work for everyone. Mar 23, 2019 harm reduction sends out a message that illegal or risky practices are ok so long as they happen in a safe environment. Harm reduction is an umbrella term for interventions aiming to reduce the problematic effects of behaviors marlatt, 1998.