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The Case for Harm Reduction

A recent increase in the number of drug and alcohol programs employing the harm reduction policy indicates that the once-controversial measure is gaining ground.


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By Paul Gaita


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Harm reduction, a range of public health policies which seek to reduce the physical, social, and economic problems of addiction without reducing consumption of alcohol and substances, is not a new approach to recovery. Its best-known format, the needle exchange, has been in use since the 1980s, and has been cited by the Centers for Disease Control and the World Health Organization as an effective method for reducing the spread of HIV among intravenous drug users.

Heroin maintenance treatment, which allows medically supervised access to heroin, has been implemented on a global scale and received positive response from a 2012 Cochrane Review. News of “wet rooms,” which provides supervised alcohol to homeless addicts, and drug programs that offer crack pipes in vending machines, have also shown to be effective methods of treatment that circumvent the traditional method of total abstinence.

Though providing addicts with access to drugs or alcohol may seem like a counterintuitive measure, research has shown that harm reduction is beneficial in not only reducing the chances of overdose, but also in reducing consumption, preventing overdose, and even inspiring drug users to seek out further treatment.

A Swiss study noted that 40 percent of participants in a heroin maintenance program actually sought abstinence treatment as part of their recovery; by removing the constant search for the drug from their lives – as well as the inherent danger involved in that pursuit – addicts found it easier to shift their focus to abstinence and even gainful employment. Similarly, a report from the Journal of the American Medical Association found that Seattle’s wet house program, which offered both liquor and housing to alcoholics, reduced the participants’ intake and saved the city money by reducing both police and medical attention to these individuals.

Harm reduction still faces a number of hurdles in its path to widespread acceptance – the policy remains at odds with most politicians, and was openly opposed by both George W. Bush and Bill Clinton. But as the official stance on drugs continues to change, there is hope that approaches to treatment will follow suit.

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