Posted by: Tina M | 12 April , 2010

Harm Reduction for Dummies

While I’ve been working in health education and teaching Harm Reduction for the last 4 years, I recently learned a deeper level of it while training to be a member of a local syringe exchange program. The training lasted 4 weekends and covered such topics as Homelessness, Sex Work, Hepatitis, HIV, Overdose Prevention, Recovery Programs, mental health, the “war on drugs,” and more.

I was in heaven. I guess that sounds terrible since the topics are very serious and very saddening. I truly appreciate the process though because it gave me a chance to feel like I was focusing my energy on a real issue in my community. It’s being brave enough to look at the darker side of the status quo, reflect on the ways in which our own existence strengthens the structure of oppression, and be willing to humbly step up and help in whatever way you can.

Let me clarify. I don’t think I’m anywhere near reaching that enlightenment that I describe above, but it is the beginning of a lifelong journey that I committed to a long time ago. What I felt in my GirlScout heart, and promised in my college motto, is being put into practice in a real, political (even more so than being a sex educator!), and satisfying way.

I’ve been wanting to tell everyone around me about all that I’ve learned, but it’s hard to launch into a discussion about HR without understanding your audience’s values and understanding of drugs, morality, and justice. So I’ve decided to try to synthesize everything I learned into a few key points to think about when evaluating what misconceptions/perceptions and values you have about HR.

First, a definition:

Harm reduction is a set of practical strategies that reduce negative consequences of drug use, incorporating a spectrum of strategies from safer use, to managed use to abstinence. Harm reduction strategies meet drug users “where they’re at,” addressing conditions of use along with the use itself. According to The Harm Reduction Coalition

So, why attempt to reduce harm to people and communities without reducing the amount of drugs a person uses?

Isn’t abstinence the right answer?

The answer is that it’s not that simple. Look at it this way, in our economic times “Twenty-nine areas recorded jobless rates of at least 15.0 percent”, increased joblessness breeds increased homelessness and domestic violence. When folks are homeless or in a domestic violence situation (or often both) you become very isolated from the rest of the world, and when you are lonely, hungry, and have no safety or housing- drugs seem like a pretty good medicine.

I use the term medicine literally. As it turns out, most of our illicit drugs were once legal and often times encouraged. Whether it was Heroin during the Vietnam war to quiet the nightmares of PTSD that haunted many of the ground soldiers who had to witness horrific tragedies; speed to keep truck drivers or Wartime pilots awake and alert; or Morphine (prescription pills are often taken not in accordance with their prescription) for anesthetic. It turns out that many people that use illicit substances tend to choose drugs that address their pre-existing mental health conditions.

Self-Medication? Then why not just get them the right medicine?

If you’ve ever had to navigate social services, then you’ll understand the answer to this question. It’s not easy to get and maintain services. There is stigma surrounding drug use that prevents many people from seeking the help they may want or need. Even if you want to quit it’s often times not that easy. You not only have to address a possible physical addiction, psychological addiction, physical health, and mental  health, you also need to enter a new life, with new friends, community, schedule and often times you need to do it alone.

There was a really great video that my teacher showed us during training, from HBO’s Addiction series.

Watch the movie

Click here to watch the movie.

It is a harm reduction agency talking to young people about Drug Replacement Therapy, a Treatment that acknowledges the physical effects of substance use and replaces the drug with another substance that alleviates the physical withdrawal symptoms. What I didn’t realize, is that if you start using opiates (heroin, morphine, oxycontin, etc.) recreationally your brain will actually stop producing the natural opium-like neurotransmitter. That means when someone tries to quit, they feel crappier than most sober people do. That’s why it’s important to find alternative ways to meet the needs of folks in withdrawal (instead of expecting them to “just get over it”)

So, why do you give out clean needles?

Because, they’re hard to come by, and like condoms, they can significantly reduce the risk to the entire community for spreading viruses and other infections. Because statistics show that people will use clean needles when they are available to them.

Because everyone, no matter what decisions they make regarding their sexual or drug related behavior, deserves to be healthy and safe.

Because, we can’t ignore the people that have fallen through the cracks of dwindling social services.

But, won’t that increase violence, crime, etc?

No, the myth of homeless folks as being dangerous and crazy is similar to the myth of drug users being dangerous and crazy. These are Brothers, Fathers, Mothers, Sisters, Queer, Straight, Our Community.

If we give people the education and tools to healthy decisions about their lives, they will choose what is best for themselves. We have to trust each other to take care of ourselves.

We have to let go of our ideas of homeless/poor folks being “lazy,” “Stupid,” or “evil/bad.” and open our hearts to others instead of casting them as Other.

Syringe Exchange and Harm Reduction: If we don’t start checking our assumptions and our judgments, if we don’t stop trying to find a one-size-fits-all solution to a complex system of power and dominance, if we don’t start caring about each other in a genuine way. . . well, then what is this “civilization” we claim to be a part of?


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