Implementing Harm Reduction Strategies for Substance Use Disorders

Introduction:

Harm reduction approaches have proved beneficial in lowering morbidity and mortality rates in adults. This approach can be even applied in sexual health awareness programs to prevent sexually transmitted diseases (STDs), HIV (human immunodeficiency virus), and teen pregnancies. It can also help individuals to acquire alcohol abstinence. The strategies used will generally depend on the condition of the patient and the causative agent that has led the patient to such a state. It is imperative for healthcare professionals to adopt harm reduction strategies and get familiarized with the technique to avoid potential risks associated with treating agitated adults or teens and promote better outcomes.

What Is a Harm Reduction Strategy?

• Harm reduction is a strategy in which the victim or the patient suffering from substance abuse disorder is treated by lowering the social health risks associated with the substance use without making the people completely discontinue or stop the habit who have difficulty abstaining from it.

• It encourages individuals to choose the methods that cause less harm and act as a non-judgmental and non-compulsive approach to reducing substance use and harnessing moral values and awareness to live safe and healthy lives.

• The harm reduction strategy serves as an initiative for rendering social justice to individuals by showing respect and protecting the rights of the people suffering from substance abuse disorder.

What Are the Principles of Harm Reduction Strategy?

1. Believes that the lawful or unlawful practices of drug abuse form a part of the society. Hence, efforts should be made to minimize the harmful effects caused rather than forcing the individual to abstain from it or condemn it.

2. Substance use is a multifaceted, complex entity that may involve complex behaviors associated with severe drug abuse to total discontinuation. Understanding this complex phenomenon and encouraging the usage, which apparently seems to be safer than other drugs, should be encouraged.

3. Creating awareness about the better quality of life and community health among the affected and not stressing the fact that total abstinence is the only solution and is considered a successful intervention.

4. Being empathic towards these individuals and adopting non-judgmental and non-coercive methods to make them understand and reduce the harm from substance use.

5. Giving equal opportunity to substance use disorder patients with a history of drug use to participate in the programs entitled to cater to their needs.

6. Encourage people who use drugs to step forward in initiating the measures to reduce the harm caused by drug usage and make them empower each other in affirming each other to find ways that better meet their needs in a safer and healthier way.

7. When dealing with such patients, it is imperative to make them understand that the health care professionals understand the sad realities like poverty, racism, social isolation, past trauma, gender discrimination, and other social inequalities that would have contributed to such behaviors and their vulnerability.

8. At the same time, the harm associated with illicit drug use should not be neglected or ignored.

What Are the Advantages of Harm Reduction Strategies?

Many recent studies have revealed that harm reduction methods have created positive outcomes for people suffering from substance use disorder, their families, and their communities. The benefits include:

• Lowering the risks of getting contracted with HIV/AIDS (human immunodeficiency virus)/ (acquired immunodeficiency syndrome) and hepatitis infection.

• Lowering the death rates caused by drug overdose.

• Injection substance use in public has been reduced, and the number of used needles in public places has declined.

• Sharing of needles and other equipment used for substance use is reduced.

• The individuals are taught the safer injection methods and the benefits of reducing the frequency of the injection.

• Education on safe sex by encouraging condom use.

• Conducting sexual health awareness programs.

• Providing employment opportunities to substance use patients, thereby reducing the crime rates.

• Generating referrals for treatment programs and health and social services.

How Does Harm Reduction Strategies Function?

Harm reduction strategies include measures to help reduce the potential harms from substance use disorders, which include:

• Free syringe service workshops.

• Sites educating on harmful effects of drug overdoses.

• Fentanyl tests.

• Naloxone kits and training regarding the usage.

• Promoting the use of sterile injection or smoking equipment.

Harm reduction methods also involve de-addiction facilities, support groups, vaccination, and wound care centers, sex education programs, STI (sexually transmitted infections) tests, treatment plans, and pre-exposure prophylaxis (PrEP) and other harm reduction tools and access to these resources should be given through following modes:

• Community health clinics.

• Health departments.

• Churches.

• Public transportation places.

• Restaurants and hotels.

• Homeless shelters.

• Correction centers.

• Community centers.

• Social service offices.

• Mental healthcare facilities.

• Urgent care centers.

What Are the Harm Reduction Strategies Devised for Substance Use Disorder?

1. Discourage the Behavior: Forms a mode of primary prevention in young adolescents and preteens.

• The various programs charted to create awareness and primary invention depend on the individual.

• For preteens and young adolescents, discouraging the behavior as primary prevention works as the habit is not deep-rooted, and the patients respond well.

• Adolescents who have already established harmful behavior do not respond to the discouraging behavior or become impulsive if told to discontinue; hence, it should be managed carefully by advising them to reduce the behavior instead of having complete abstinence from the substance use.

2. Encourage the Teen to Reduce the Behavior: This is indicated in whom the behavior is already well established.

• If an adolescent is already involved in activities like risky sexual behavior, they should be encouraged to reduce the behavior and provide awareness on using condoms and safe sex practices.

• Also, they should be taught harms of sexual activity outside the marriage.

• Sex workers should be educated about using condoms, and awareness should be created about accessing the STI centers for screening of the STIs and emergency contraception.

3. Educating the Adolescents and Teens: Education about the harmful effects of substance use and the benefits of quitting the same plays a crucial role.

• Many studies reveal the success rates of both prevention and intervention of substance use behaviors in reducing the potential harm associated with the habit.

• Programs like the Alcohol Misuse Prevention Study (AMPS) and the School Health and Alcohol Harm Reduction Project are designed as part of harm reduction strategies.

• These programs are aimed at creating awareness about alcohol misuse and associated harms, and techniques of dealing with peer pressure among grade 5 and grade 6 students are taught.

• Evaluation of these programs has revealed the effectiveness of programs in making the children understand the potential risks associated with alcohol use and reduced consumption of alcohol among adolescents.

• Motivational interviewing is a form of harm reduction technique that aims to instill self-responsibility and tries to change or modify the individual’s behavior.

• Motivational interviewing of 35 to 40 minutes duration has encouraged many adults of around 17 to 20 years of age to reduce alcohol consumption, and hence, many potential risks associated with it have been warded off.

• Harm reduction methods are also used to avoid unwanted pregnancies in teens and young adults.

• Some more examples of harm reduction strategies include safe participation in sports and games like wearing bike helmets, wearing life vests for boating, and using visors for playing hockey, etc. All these form essential components of preventive care.

Conclusion:

Harm reduction strategies form an essential component of primary and secondary prevention of harmful behaviors associated with substance use disorder among the adolescent and teenage groups. Healthcare professionals' roles in educating and providing awareness about various harms associated with substance use are crucial and have turned out to be effective in reducing the substance use in many cases. Motivational interviewing has the advantage of giving the decision-making capacity about one’s health to individuals and has led to more successful outcomes.