Harm reduction is a controversial range of public health policies aimed at lowering the risk of risky behaviours. In this article we will look at the history, the use, the effectiveness and the criticism of harm reduction.
Harm reduction is still a fairly new policy. One of the first forms of harm reduction were safe sex programs presented to children going through school. Being taught to use a condom is a form of harm reduction. Harm reduction based around heroin use is still quite new and is being given test runs in many countries. Some countries have been using heroin based harm reduction programs for a number of years now, such as Germany, Switzerland and the Netherlands to name a few.
Harm reduction policy is most commonly utilized around substance use and sex. Heroin has some of the most harm reduction programs built up around it, including: Naloxone distribution, safe injection sites, needle exchange programs and heroin maintenance programs. The drug Naloxone is an inverse agonist for heroin. Countries like the United States, as well as Canada, the United Kingdom, Russia and Spain have started programs where they hand out the drug to users, their family members and peers.
Safe injection sites are legally sanctioned rooms with professionals on hand to hand out clean supplies and monitor clients as they use heroin. They have tried these in Germany, Switzerland and even in Canada. Needle exchange programs are based around turning in used needles for clean ones. Generally, outreach workers are used to distribute the new needles and collect the used ones. This helps prevent the spread of blood based diseases such as Hepatitis C and HIV. Switzerland, Germany and the Netherlands will actually provide the heroin for users in their pharmacies. This is to make sure that professionals know what is in the heroin that the clients are using. It guarantees a level of safety as it is known that the heroin is not cut with a dangerous substance that can cause more harm than the heroin itself.
There is also harm reduction programs based around marijuana use. Some of these programs were created to help keep individuals from driving while under the influence and some are based around safer smoking, using vaporizers, taking the drug in pill form and foregoing the use of tobacco in order to promote lung health. Alcohol is another area where harm reduction has been introduced. In Toronto, Canada there is a wet shelter where clients are given one cup of wine every hour and are monitored by professionals. This draws out their consumption of the alcohol.
Sex is another area where harm reduction has been introduced. You probably don’t realize it but you have likely taken part in one of these programs if you attended public school in the mid-1980s or later. In schools across the country, safe sex programs promote the use of condoms to help stop the spread of sexually transmitted diseases and blood based diseases. There are also harm reduction policies targeted around a more specific group; street workers. Some countries, such as Germany and New Zealand have legalized prostitution.
One country that has fairly recently seen harm reduction work for it is Portugal. Portugal had a problem with one of the suburbs of its capital city of Lisbon. This area had become overrun with substance use which lead to high incidents of drug related crimes and deaths. The country decided to take action by decriminalizing certain amounts of drugs. A legal amount would be considered enough for a personal supply for the individual caught with it. If they were caught they would not be arrested rather they would be interviewed and assessed by a group of professionals, including doctors, psychiatrists and social workers and a plan would be developed in order to help them with their substance use issue. Portugal’s policy saw a marked decrease in crime and death in that area and major renovations have been done to that suburb making it a nicer place to live. The United States has actually shown interest in the program, sending members of the federal drug program over to investigate.
Some of the biggest criticism comes from right here in the United States, from the Drug Free America Foundation. They believe, as do many others, that permitting the use of illegal substances gives the public the notion that it is an acceptable behavior. And, so many people who would not have been introduced to the certain substance will now try it given the impression that no harm will come to them.