What is Harm Reduction?

What is Harm Reduction?

What is Harm Reduction?

This article examines the Philosophy of Harm Reduction and was written by East Kootenay Addiction Services' Executive Director, Dean Nicholson. The article below does not necessarily reflect the views and opinions of East Kootenay Addiction Services.

With all the talk about the Fentanyl crisis, the term Harm Reduction is often raised as an approach to deal with the problem.  Many people are unclear what Harm Reduction means and this article hopes to provide some clarification.  Harm Reduction refers to an approach to dealing with substance abuse, where the primary focus is to reduce the harms associated with using substances, rather than the focus being on stopping the use of substances.  This doesn’t mean that stopping or reducing use is not a goal, just that it is not the first goal. Often Harm Reduction is associated with programs like needle exchanges or safe-injection sites; programs in which people continue to use substances but are encouraged to do so in safer ways.  These are definitely Harm Reduction approaches but Harm Reduction casts a much wider net.  Too often in the past Harm Reduction approaches were contrasted with Abstinence approaches, with the two approaches being seen as polar opposites and opposed in principle.   From the Abstinence side, Harm Reduction was often characterized as supporting or encouraging substance use.   For some people on the Abstinence side, people on an Opioid Replacement Program like Suboxone or Methadone (which is one of the best ways to support people to get off Fentanyl) could be criticized for still being addicts because they were still using a drug.   In fact, Abstinence is also a Harm Reduction approach, as is responsible social drinking, as are needle exchanges. 

 

A problem with the debate around Harm Reduction is that historically society’s focus on drug and alcohol use as been on the behavior itself – on the using.  If using is the problem, then not using is the solution.  This is further entrenched by then making using illegal and with the consequence that users become criminals.  A Law and Order approach, or a War on Drugs approach, is the natural outcome.  In Canada, about 70% of all Federal dollars that go towards substance use problems, goes to the law enforcement side, including the RCMP, the courts and correctional services.  Only 30% goes to prevention, education, treatment and research.   Law and Order and Abstinence-only approaches limit the ways we can respond as a society.

 

Perhaps a good analogy is driving.  We all know that one of the major causes of death in Canada is motor vehicle accidents.   If we took a similar approach to driving deaths as we do to substance use, we would make all driving illegal, ban automobiles and motorbikes, and arrest and charge people caught using motor vehicles or involved in the production or sale of motor vehicles.  Clearly this is not an approach that anyone would support, even though we could all agree we would like to reduce motor vehicle deaths.  So what do we do?  We create a wide range of Harm Reduction programs to try and reduce the likelihood of motor vehicle accidents while allowing people to continue driving.  Programs like seat belt laws, graduated licensing systems for new drivers, standardized traffic rules, maximum speeds, improved car design etc. etc.  We don’t view driving as a criminal matter but as a public health concern and we create policies and programs accordingly.  At the same time, we take a Law and Order approach to certain behaviours associated with risky driving, such as speeding or driving while impaired, but we accept that people are going to drive.  Harm Reduction in the area of substance use is just the same.  If we accept that people are going to use substances (and in any given year over 80% of Canadians 15 or over will use a substance) then it makes more sense to develop programs and approaches that discourage unhealthy use, encourage responsible use, and provide means for people who have more serious problems to reduce negative consequences so that they can hopefully be in a place to make healthier choices.  At the same time, there is a role for a Law and Order approach in areas such as trafficking, unregulated drug production and inappropriate public use.

 

At East Kootenay Addiction Services, we view substance use, abuse and addiction as both a personal and a public health problem, rather than as a criminal problem.  Our aim is to provide services that reduce the harms that use can cause, whether that is by supporting someone to quit using altogether, to use in a more responsible and less harmful way, or to help them improve other areas of their life that their use may be impacting.  If we consider substance use as a personal and public health issue, then the goals for intervention can change, as can the types of interventions that are used.  This is what Harm Reduction means and research shows that programs coming from this approach are more effective in creating overall healthy change for people using and for communities as a whole.

 

 


Recent Posts

  • Cranbrook Drug Alert
  • Cranbrook Drug Alert

    Posted on: 16-Jun-2020

    Posted by EKASS | on 16-Jun-2020 Cranbrook Drug Alert

    CRANBROOK DRUG ALERT 

    Interior Heath has issued a Drug Alert for Cranbrook due to drug checking results through ANKORS that revealed highly toxic levels of fentanyl and benzodiazepines in a DARK PURPLE pebbly substance. People who use drugs are reporting passing out for extended periods of time after consuming this substance.  
    If you wish to share this alert with others – please note that this alert is localized to the community of CRANBROOK only. If you choose to display this poster, please remove by June 23rd, 2020 as per best practices.
    Thank you for your help in getting this important information out.  
    For your safety:
    ⭐️Buddy up when you are using, stay 2 meters (6 ft) from your buddy to remain physically distanced, but remember using with a buddy is safer than using alone!
    ⭐️Get your drugs checked - available at ANKORS and East Kootenay Addictions Services Society. More info: www.drugchecking.ca
    ⭐️Remember, smoking substances can still lead to overdose, take measures to prevent overdose.      
    ⭐️Avoid using different drugs at the same time or using drugs and alcohol together. 
    ⭐️Don’t use alone. Leave door unlocked. Tell someone to check on you.
    ⭐️If you feel you must use while alone, consider using the Lifeguard app which can connect you with emergency medical dispatchers in the event of an overdose. Download at the App Store or Google Play.  
    ⭐️Test by using a small amount, then go slow.
    ⭐️Carry a Naloxone kit and know how to use it.
    Know the signs of overdose and how to respond 
    🌟Recognize the signs of an OD: slow or no breathing, gurgling or gasping, lips/fingertips turning blue, difficult to rouse (awaken), non-responsive.
    🌟 Call 9-1-1 immediately It is still safe (and important) to use emergency services during the COVID -19 pandemic
    🌟Open airway and give rescue breaths using face mask
    🌟Give naloxone (Narcan) if you have it.
    Naloxone is available at:
    💫 ANKORS, EKASS, IH Public Health & Mental Health Substance Use Locations
    💫 Pharmacies located throughout Cranbrook
    Drug checking is available at:
    ✔️ANKORS #209 – 16th Ave North Cranbrook250-426-3383
    ✔️EKASS – 250-489-4344
    For more resources and links related to overdose and substance use, visit: https://www.interiorhealth.ca/AboutUs/Leadership/MHO/Pages/PHEmergency.aspx

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  • EKASS is now offering a virtual mindfulness group

    Posted on: 22-May-2020

    Posted by EKASS | on 22-May-2020 EKASS is now offering a virtual mindfulness group

    Mind full or Mindful?

    East Kootenay Addictions Services Society is offering a 4 week Mindfulness Skills Training Group (once a week, for 2 hours on Tuesdays) for anyone who would like to reduce their suffering and learn to live a happier, more peaceful life. For more information and to register for this free series, contact Kari or Eleine at 250-489-4344

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    Posted on: 03-Apr-2020

    Posted by Theresa Bartraw | on 03-Apr-2020 Cranbrook Food Resources

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Upcoming Events

  • New additions to the COVID-19 resource section

    Event Date: 31-Mar-2020

    Posted by Theresa Bartraw | on 31-Mar-2020 New additions to the COVID-19 resource section

    East Kootenay Addictions Services is building and adding to the COVID-19 Response Resources section of the website. Follow the link here COVID-19 Resources for more information

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  • Managing the Covid-19 Virus Update
    Event Date: 25-Mar-2020
  • Managing the Covid-19 Virus Update

    Event Date: 25-Mar-2020

    Posted by Theresa Bartraw | on 25-Mar-2020 Managing the Covid-19 Virus Update

    March 25, 2020

    Dear Clients:

    As part of our ongoing response to the Covid-19 pandemic, EKASS has followed the recommendations of the Federal and Provincial Governments, and has closed all our offices effective March 18, 2020.    

    To stay in line with the precautions suggested by the Federal Government of self-distancing, this office will be closed indefinitely.  Please check our website www.ekass.com for updated information and links to resources and supports.

    We are continuing to provide counselling services to our clients via phone or webbased options.  

    Clients on the OAT Program will be contacted by the doctors at the Interior Chemical Dependency Office in Kamloops to ensure that they continue to receive scripts.

    Harm Reduction supplies continue to be available as we continue to provide supplies to our community partners.

    We recognize that these are stressful times.  We are here to support you and want people to stay in touch as we navigate this situation together.  If you have questions or concerns, or to book an appointment, please call the Cranbrook office at 250-489-4344 for further information.  We will be checking the phones messages daily and responding as quickly as we can.

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  • Teen Empowerment and Mastery Program
    Event Date: 4-May-2020
  • Teen Empowerment and Mastery Program

    Event Date: 4-May-2020

    Posted by EKASS | on 14-Feb-2020 Teen Empowerment and Mastery Program

    Communities throughout the East Kootenay region will be holding the Teen Empowerment and Mastery (TEAM) Program in May and June of 2020. Click here to learn more about TEAM. If you are a young person interested in attending TEAM contact us at 1-877-489-4344 for more information.

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