Harm Reduction addresses the reality that a certain proportion of the population will choose to use drugs. From chocolate to morphine (thank you, Andrew Weil), all of us typically crave some pleasure-giving substance. These pages offer avenues information about Harm Reduction, user-generated information about various substances, as well as new research on possible medical uses for some currently illicit drugs.
WHY HARM REDUCTION?
Harm reduction strategies are designed to reduce the negative consequences of active drug use. They may range from talking down bad LSD trips, through needle exchange to reduce infectious disease, to treatment programs such as meth maintenance.
Why have content about harm reduction and drug use in a website about the Haight Ashbury and free clinics? Because casual drug use of illicit drugs gained some degree of acceptance among middle-class young people during the late 1960s in the Haight, and media attention made that use visible to the nation and the world. Much of the Haight Ashbury Free Clinics’ work fell to helping people with drug issues find their way to recovery. The clinical staff and counselors, at the Detox program particularly, explored new ways to address the addictions carried by their patients.
Over 50 years, we’ve seen law enforcement and societal shifts lurch from “put them in jail” to “just say no” to “addiction is a chronic brain disease.” Harm reduction acknowledges another old adage, that “you can lead a horse to water, but you can’t make him drink.” Some people WILL use drugs and/or alcohol, and all the treatment opportunities in the world won’t/can’t/don’t keep them clean and sober.
Economics offers another reason to consider harm reduction. It’s usually cheaper to provide a safe place than incur repeated emergency room visits. More than one study has shown that every dollar spent on treatment saves $5-10 in medical, law enforcement, criminal justice and other societal costs. Providing a secure environment may provide opportunities for the addict to discuss treatment, and may reduce his/her consumption. Additionally, facets of harm reduction can reduce infectious disease transmission.
“Harm Reduction” refers to policies, programmes and practices that aim primarily to reduce the adverse health, social and economic consequences of the use of legal and illegal psychoactive drugs without necessarily reducing drug consumption. Harm reduction benefits people who use drugs, their families and the community, based on a strong commitment to public health and human rights.
Harm reduction is a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use. Harm Reduction is also a movement for social justice built on a belief in, and respect for, the rights of people who use drugs.
Harm reduction incorporates a spectrum of strategies from safer use, to managed use to abstinence to meet drug users “where they’re at,” addressing conditions of use along with the use itself. 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.
“Harm reduction: An approach to reducing risky health behaviours in adolescents.”Canadian Paediataric Society. Paediatric Child Health. Jan; 13(1): 53–56 provides background and a definition of Harm Reduction as a public health policy to aid those working with young people in reducing the risks of typical adolescents.
Needle exchanges are a public health response to the spread of infectious disease through contaminated syringes shared by intravenous drug users. Used syringes are exchanged for sterile syringes; often the exchange location will have outreach workers with information about drug treatment, medical care and social services.
Homeless Youth Alliance has posted an FAQ about the cost effectiveness of needle exchanges, why adhering to a strict one-for-one exchange can increase HIV transmission with no change in the number of discarded syringes, and a bibliography.
Naloxone accessibility (Narcan, Efzio)
The overprescribing of opioid painkillers in the early years of the 21st century has had severe consequences: addiction, transfer of usage to heroin, overdose.
Prescription Drug Monitoring Programs (PDMPs)
The majority of U.S. states now have databases to record prescriptions for controlled substances, allowing physicians to monitor their patients’ use (or misuse) of medications.
Safe Injection Sites
Controversial strategy to prevent injection-drug addicts using their drugs on the street by giving them safe, monitored places to do so.
Event and Street Services
San Francisco Community Awareness Treatment Services (SF CATS), in partnership with the San Francisco Department of Public Health, offers a sobering center and medical respite for medically frail individuals discharged from San Francisco General Hospital. The program was developed in response to the high costs and safety risks of using police, ambulance, and emergency services to handle intoxicated people picked up on the streets.