One of the directions of drug policy is the increasingly widespread model of harm reduction. Its main idea is to reduce the harm associated with drug use and reduce various costs both for society and for the drug users themselves. The definition of harm reduction refers to the policies and activities whose main purpose is to reduce the negative social, economic, and health consequences of drug use without necessarily ending overall drug use.
Recently, Biden’s administration announced a new approach to battling drug addiction in the country. Department of Health and Human Services 2022 Harm Reduction Program will focus, among other points, on providing safe drug use equipment to the affected population (The White House 2022). Along with is, there is a whole range of rehabilitation measures and approaches that help restore the physiological, psychological, and social well-being of addicts needed for reintegration into society. The harm reduction approach does not diminish the importance of trying to help people quit drugs altogether, but acknowledges and recognizes that for many drug users, this goal can take a very long time. Moreover, with unsafe and unmanaged drug use, the risk of HIV, hepatitis, and other infectious diseases remains high among addicts. Therefore, work with drug users should not be limited to the goal of complete cessation of use, but be aimed at safety-related problems and their minimization.
Indeed, having accepted the situation from a pragmatic point of view – the problem exists and is recognized by society regardless of laws or any morals – only realistic methods can minimize the risk associated with it. The harm reduction approach is based on the logical recognition that the use of narcotic substances has been and is currently occurring in every culture and social formation. Despite many years of efforts, no country, city, or community has so far been able to completely eradicate the use of psychoactive substances. Thus, society needs to work around that issue, minimizing its consequences in the long run.
Harm reduction interventions are complementary to the drug use prevention approach. They are based on the belief that many people around the world continue to use drugs despite all efforts to stop them. This assumption comes from the fact that many users are unwilling or unable to stop using drugs. For them, the availability of quality care is important, however, many do not have it at their disposal. Thus, drug users need adequate counseling and various services to help reduce the risks and harms associated with drug use. Harm reduction, like prevention in general, helps people adopt healthier lifestyles by providing continuous support and specific means that target the most relevant safety issues associated with drug addiction.
There are many forms of harm reduction services, each of which could provide help specifically to various groups of drug users. For example, there are services based at a fixed location center, known to the public as “needle exchange points,” where people who take injection drugs can obtain sterile syringes and needles. A harm reduction center is often a starting point for helping and counseling drug users, while for the latter, the center is the first point of contact with the health and social services system. People who visit harm reduction centers are much more likely to seek help and medical services compared to those who do not. Biden’s initiative mentions handing the population safe smoking kits and supplies to reduce the risks of pot or crack smoking which can be done at mobile centers.
However, none of these services can replace the other in the overall program. Different forms of harm reduction services need to be offered in parallel because different target groups and a larger number of those who need services can be reached in different ways. Perera et al. (2022) state that “hospitals can better serve individuals with substance use disorders by incorporating harm reduction education and equipment provided as essential addiction care” (1). For example, street work and mobile services are more effective for youth and high-risk drug users. Whereas harm reduction centers are usually visited by people who use drugs for a long time, with little risk in behavior.
All over the world, the creation of harm reduction centers is accompanied by conflicting opinions of the local population. Despite the scientifically proven effectiveness of these services, the opinion of residents, and often politicians, about harm reduction centers in most cases remains negative. The study conducted by Schlosser et al. (2022) reports a significant stigma around drug users in the U.S. The most recent case of such a reaction is the storm in the newspapers as they claimed that Biden would be giving free drugs to the people (Stolberg 2022). Other examples include cases where people believe that syringe exchange contributes to the prosperity of the drug market and the increase in the number of drug users. In many ways, this phenomenon is characterized by the following attitude: even if this service is necessary, it cannot be provided “near my house” (Not In My Back Yard, or NIMBY).
Studies have proven that closing harm reduction centers do not solve the problems that residents point out. The reason is that harm reduction centers are set up in places where people who inject drugs live or spend most of the day. Csák et al. (2021) add that “they serve a population that, due to stigma, discrimination and criminalization, faces barriers to accessing health and social services” (1). This means that drug use problems already existed in the area before the center was established and will not disappear with the closure of the center. However, the center can mitigate the existing problems and help make the environment safer for everyone, not just drug users.
Drug users should not be prejudiced in their rights, including the right to the highest attainable standard of health, social services, employment, protection from unauthorized detention, and freedom from ill-treatment or degrading treatment. Harm reduction opposes deliberate harm to drug users to control drug trafficking and prevent drug use. It calls for the use of drug response measures in the framework of respect for fundamental human rights.
Reducing harm can help a person move from a state of chaos to a state of control over their life and health. Harm reduction programs protect human rights and improve the quality of life by allowing consumers to remain integrated into society. This approach reduces healthcare costs by fighting drug overdoses, the transmission of infectious diseases, and other risks. Reduction of harm benefits society through a continuous decline in drug usage, control of discarded tools related to drug abuse, and lowering of the associated costs of health, law enforcement, and criminal law. It reduces the negative impact of the open drug environment on local trade and improves the climate for tourism and economic development. Suffice it to say that a harm reduction program is an efficient way to battle drug addiction problems in modern society.
Csák, Robert, et al. “Harm Reduction Must Be Recognised an Essential Public Health Intervention during Crises.” Harm Reduction Journal, vol. 18, no. 1, 2021, pp. 1–3. EBSCOhost, Web.
Perera, Rachel, et al. “Meeting People Where They Are: Implementing Hospital-Based Substance Use Harm Reduction.” Harm Reduction Journal, vol. 19, no. 1, 2022, pp. 1–7. EBSCOhost, Web.
Schlosser, Allison, et al. “Harm Reduction in the Heartland: Public Knowledge and Beliefs about Naloxone in Nebraska, USA.” Harm Reduction Journal, vol. 19, no. 1, 2022, pp. 1–7. EBSCOhost, Web.
Stolberg, S. G. (2022). Uproar over ‘Crack pipes’ puts Biden Drug Strategy At Risk. The New York Times. Web.
“White House Releases List of Actions Taken by the Biden-Harris Administration Since January 2021 to Address Addiction and the Overdose Epidemic.” The White House, 2022, Web.