What is Harm Reduction?

In Valley County, almost five percent of high school students have tried meth or heroin. Just over eight percent have tried cocaine, MDMA, or hallucinogens. Almost one-fifth have used a prescription medication other than as prescribed.

2021 American overdose deaths break record: over 107,000, or one death every five minutes.

The Substance Abuse & Mental Health Services Administration (SAMHSA) asserts that harm reduction “emphasizes direct engagement with people who use drugs to prevent overdose and infectious disease transmission, improve the holistic wellbeing of those served, and offer low-threshold options for accessing substance use disorder treatment and other health care services.” Evidence shows that harm reduction strategies do not encourage substance use and create more opportunities to seek help.

People with substance-use disorders struggle to control their drug use despite knowing drugs are bad for them. Harm reduction uses the disease model of addiction to address substance use disorders. Addiction is not a moral failure or sign of a “bad” person. Many factors (i.e., poverty, class, racism, social isolation, past trauma, etc.) affect both one’s vulnerability to and capacity for effectively dealing with drug-related struggles. This does not excuse or overlook someone’s personal responsibility for their actions. Instead, it acknowledges that the person also endures harm from their use. Harm reduction strategies aim to support the quality of life and well-being for both the individual and community.

Overdose deaths are soaring as the opioid epidemic reached devastating heights in 2021. Drugs, legal and illegal, are part of our world- regardless of personal beliefs about them. Banning firearms, or prohibiting alcohol, would not erase them from the environment. It would, however, incentivize backdoor methods for use or sale. Clearly that does not keep people from using or selling drugs, but rather makes the process more dangerous, hard to regulate, and criminalizes seeking help. Focusing on full cessation sobriety as the only right way to address drug use is comparable to abstinence-

only sex education. The states with the most conservative sexual education have the highest rates of teen pregnancy and STI transmission. Limiting access to knowledge and resources also limits people’s agency to do something about their own drug-use or drug-related harm.

Stigmatization of addiction and substance use has a heavy hand in over 100,000 lives lost. Stigma is disdain and discrimination based on beliefs about people with particular characteristics. These beliefs often aren’t correct and lead to widespread neglect of various groups seen as “undesirable.” People who use drugs are not inherently immoral. Stigma against people who use drugs could look like not wanting to give someone a couple dollars because “they’ll just buy drugs/booze.”

What can we do to undo stigma? Learn (and unlearn)! Some of the ways to do that within yourself is to ask how you were taught to think about people who use drugs, what you think that looks like, who you think that is. How do you feel about them? Think about things that contradict those assumptions and ideas. Are there people or situations in your life that you feel are exempt from these assertions? What makes them different? After each of those questions, ask why. Why do you think someone who looks

like [they do] uses drugs? Is there another possibility?

People who use drugs know the most about what services are needed, how they can be implemented better, and what has been ineffective in the past. That reinforces personal agency and does wonders for the movement. Specific harm reduction strategies and examples will be explored in the next issue.

If you’d like to share a story of resilience around behavioral health, including substance use, consider submitting an anonymous entry to Stories from the Strong at valleycarecoalition.com.