Harm Reduction in Substance Abuse

Harm Reduction in Substance Abuse

Harm reduction: Pros and (mostly) cons of harm reduction public policies directed at substance abusers

Harm reduction is a public health philosophy that seeks to mitigate the dangers that illicit drug abuse and drug use causes in society. "A basic tenet of harm reduction is that there has never been, is not now, and never will be a drug-free society" (Reducing harm: Treatment and beyond, 2010, DPA). A good example of a harm reduction policy would be providing clean needles to drug users. One of the harms of drug use is that users often share needles, which contributes to the spread of HIV and Hepatitis C in society.

In harm reduction strategies, the main emphasis is often on improving the overall public good rather than the health of drug users: the argument is that non-users benefit by a reduction in crime (when drugs are given through medical doctors, as in the case of 'registered' heroin users in some nations) and the reduced spread of blood-borne illnesses through the dissemination of clean needles. After all, often the unwitting sexual partners of drug users are infected even if they are not drug users themselves. Since the AIDS epidemic began, "34% of all reported cases in the United States have been among injection drug users and their sexual partners. Up to 75% of new AIDS cases among women and children are directly or indirectly a consequence of injection drug use" even when those afflicted were not drug users themselves (Sterile, 2010, DPA).

Providing clean needles does not necessarily reduce drug use overall, although advocates of the strategy hypothesize that presenting a benign picture of public health authorities might make a user more likely to seek treatment than he or she would otherwise. "Apart from needle/syringe exchange, oral substitution of drugs, medical care and education to prevent HIV / AIDS, a harm reduction program provides a psychological space to drug users that not only acts an emotional support but also enables them to reflect upon their life and risk behavior" (Priya 2005, p. 219).

Opponents of harm reduction programs argue that the policy merely serves to further normalize drug use. It suggests to current users that the government has accepted illegal drug use as part of society, rather than something to be opposed and eradicated. While in theory, harm reduction strategy may seem like a good idea, putting it into practice has proven difficult. Take the case of 'Needle Park' in Switzerland: "In the 1990s, Zurich experimented with what became known as Needle Park where addicts could openly purchase drugs and inject heroin without police intervention. Zurich became the mecca for drug addicts across Europe, who would travel to Needle Park. In 1992, when authorities decided to close Needle Park, the addicts moved to Letten railroad station until its closure in 1995" (Zurich, 2010, USDA). Innocent residents near the Park were plagued with the constant presence of drug addicts, and experienced a loss of quality of life as a result.