What is Harm Reduction?

Harm Reduction has been utilized in countless ways, including the many everyday items overlooked as being harm reduction. Examples include seatbelts, condoms, helmets, bandaids, child-proof locks, masks, ear protection, sunscreen, goggles, gloves, blood alcohol limits, exercise, nicotine gum, general hygiene, cigarette filters, gun locks, smoke detectors, traffic laws, recycling, life jackets, and age limits.

Harm Reduction is far more than a public health approach alone, although it is often narrowed to the field of substance use in the current discussion. According to Harm Reduction International, “[h]arm reduction refers to policies, programmes and practices that aim to minimise the negative health, social and legal impacts associated with drug use, drug policies and drug laws.”

The study linked below discusses that community based organization (CBO) SSPs that receive government funding are more effective than SSPs operated by health departments. “…CBOs with government funding had significantly higher syringe contacts, almost twice the naloxone contacts, and nine times higher odds of providing FTS and three times higher odds of providing buprenorphine than DPH SSPs” (p. 6).

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Critiques on Harm Reduction

Harm Reduction matters to everyone.

Substance use and public health are inextricably linked. HIV lifetime treatment costs are between $420,285-$1,079,999. One 12-week course of treatment for HCV can cost up to $84,000. The cost of a single syringe is less than 10 cents.

The Centers for Disease Control and Prevention explain that “[n]early 30 years of research has shown that comprehensive SSPs are safe, effective, and cost-saving, do not increase illegal drug use or crime, and play an important role in reducing the transmission of viral hepatitis, HIV and other infections. Research shows that new users of SSPs are five times more likely to enter drug treatment and about three times more likely to stop using drugs than those who don’t use the programs. SSPs that provide naloxone also help decrease opioid overdose deaths. SSPs protect the public and first responders by facilitating the safe disposal of used needles and syringes.”

In 2016 the World Health Organization set a global goal to eliminate Hepatitis B and C by 2030. Even still, HepC is common among people who inject drugs (PWID) and continues to become more of a public health concern. Injection drug use does not cause HepC transmission, the severe lack of access to safe injection supplies results in HepC transmission. HepC is transmitted when injection equipment that has presence of the virus is shared. A person who does not have HepC cannot contract it from themselves or reinvigorate a previous infection. However, when someone gets HepC, their body makes antibodies to fight it. Even after the virus is gone, these antibodies stay in the blood. So, if you had HepC before, you'll keep testing "positive" on rapid tests because of these antibodies. To know if the virus is still active, you need a blood test to check the amount of virus in your blood. Blood draws tell if the infection is still there or if it's been treated. Basically, a positive antibody test shows you had it before, but the viral load test tells if you still have it now.

Although HIV and HepC are common among people who use drugs, they are easily preventable with access to low barrier syringe service programs and safe consumption sites. SHRP provides additional care by offering education, vaccines, linkage to care, and transportation for COVID-19-related needs, as well as emerging public health issues that are especially impactful among vulnerable populations.

Accessibility is key.

Harm Reduction: Around the Globe