Harm Reduction

Abstinence Not the Only Solution

“The beginning of wisdom is this: Get wisdom, and whatever else you get, get insight.” –Proverbs 4:7

Criminalization of drugs stands in the way of evidence-based policy. Science demands clarity, and criminalization of drugs only obscures the truth of how they operate in society.” –Michael Gilbert

The Journal of Clinical Psychology defines harm reduction as an “umbrella term for interventions aiming to reduce the problematic effects of behaviors. Interventions provide additional tools for clinicians working with clients who, for whatever reason, may not be ready, willing, or able to pursue full abstinence as a goal.”

Addiction is a disease that affects the brain. As with all chronic medical conditions, it affects every person differently. There is no one-size-fits-all solution to the problem. Not everyone needs treatment. While many successfully manage their condition, others don’t always have the resources, the support, or even the desire to seek treatment and enter recovery.

Abstinence is not always the only solution. In some cases the problem isn’t bad enough to require treatment, but bad enough for a person to want to change, and they just need some help. Harm reduction is an approach to mitigating the negative outcomes of addiction among the vast numbers of people whose addictive behaviors may not require treatment, but could simply use help and guidance to modify that behavior. With some help, guidance, and support people can reduce harm they may be causing themselves and those around them.

Harm reduction is a necessary element in a comprehensive strategy for addressing addiction in all its forms. By focusing on reducing the negative effects of addiction through education and resources, research shows core principles of harm reduction are effective at preventing large-scale infection transmissions and reducing drug user death rates.

The Following comes from the Harm Reduction Coalition (HRC)-  “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.”

However, the HRC considers the following principles central to harm reduction practice:

  • 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. 

The word “advocacy” means to call out for support. Our sacred texts insist upon advocacy:  Jews and Christians are told to “Let Justice roll down like waters, and righteousness like an overflowing stream,” (Amos 5:24).  The Koran calls upon Muslims to “Stand out firmly for justice, as witnesses to God, even as against yourselves or your parents, or your kin, and whether it be against rich or poor.” Qur’an 4:135

Separation between church and state is a bedrock principle of our nation.  But the First Amendment does not block religious advocacy.  It prohibits government from establishing particular religions and churches from engaging in partisan politics; it does not ban people from being guided by their faith as they raise moral issues in the public square.

Is there a connection between drug use and addiction, and advocacy? If so, what are advocates called to do?