Harm Reduction Includes AbstinenceMadalyn McElwain
According to the Harm Reduction Coalition, harm reduction is a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use.
Harm reduction principles include:
- Accepts, for better and or worse, that licit and illicit drug use is part of our world and chooses to work to minimize its harmful effects rather than simply ignore or condemn them.
- Understands drug use as a complex, multi-faceted phenomenon that encompasses a continuum of behaviors from severe abuse to total abstinence, and acknowledges that some ways of using drugs are clearly safer than others.
- Establishes quality of individual and community life and well-being–not necessarily cessation of all drug use–as the criteria for successful interventions and policies.
- Calls for the non-judgmental, non-coercive provision of services and resources to people who use drugs and the communities in which they live in order to assist them in reducing attendant harm.
- Ensures that drug users and those with a history of drug use routinely have a real voice in the creation of programs and policies designed to serve them.
- Affirms drugs users themselves as the primary agents of reducing the harms of their drug use, and seeks to empower users to share information and support each other in strategies which meet their actual conditions of use.
- Recognizes that the realities of poverty, class, racism, social isolation, past trauma, sex-based discrimination and other social inequalities affect both people’s vulnerability to and capacity for effectively dealing with drug-related harm.
- Does not attempt to minimize or ignore the real and tragic harm and danger associated with licit and illicit drug use.
Opponents oftentimes believe harm reduction condones drug use, but that is not the case, as we discussed in this earlier blog. Along these same lines and logic, some people also wrongfully believe that harm reduction does not support abstinence–a myth DanceSafe intends to debunk.
In its barest sense, harm reduction is a pragmatic approach to dealing with the health problems in our society involving drug use. Harm reduction is based on the observation that whether or not it is possible to convince everybody to abstain from alcohol and other drugs, or to eliminate the supply altogether, people are using drugs right now and there is no indication this situation will change. While harm reduction does not promote nor condone drug use, it recognizes reducing associated harms is an exceedingly urgent and achievable goal over attempting to end all drug use.
That said, harm reduction and abstinence are not mutually exclusive. In other words, harm reduction involves setting up a hierarchy of goals, with the more immediate and realistic ones to be achieved first, in steps towards reduced-risk use, and then sometimes reaching abstinence if this is a goal (which, for some, it isn’t). It is therefore a pragmatic solution that balances costs and benefits, where the meaningful interests of the greater social fabric (beyond the immediate needs and interests of the drug users) are inherently included in this approach and aim to decrease significant barriers to a sensible and sustainable future.
Therefore, abstinence can be a form of harm reduction, as it aims to help people reduce the harms associated with drug use. Think of harm reduction as a spectrum–on one end, there is problematic drug use and on the other end, is abstinence. Harm reduction offers tools and information for people wherever they are on that spectrum. As they become more educated and have better access to effective harm reduction services, like needle exchanges, supervised injection facilities, and drug checking, they can begin to move along the spectrum to a position best suited for their needs, including eventually landing at abstinence, if that is the best option for them.
All in all, wherever someone is in their life, and whether that person has intentions to stop all drug use or not, harm reduction is the best means to promote health and safety in communities.