harm reduction and addiction

What is Harm Reduction in Addiction Treatment?

The harm reduction approach to substance abuse is designed for addicts who don’t respond to abstinence or traditional rehabilitation methods. Harm reduction limits the chance of a dangerous or undesired outcome in daily life.

People who abuse drugs or alcohol can also use harm reduction to improve their quality of life and prepare themselves for sobriety. Harm reduction consists of proactive methods you can use on your own or with friends and family, controlled use of medication, and safe use and disposal of syringes and needles.

Origins of Harm Reduction

Methadone centers for heroin addicts first opened in the early 1970s in large cities. Buprenorphine, a partial opioid agonist, is also used as replacement therapy for opioid addiction.

Methadone and buprenorphine are examples of medication-assisted treatment (MAT). MAT uses prescription medications as alternatives to opioids or other drugs. These drugs are administered by a medical professional to prevent overdoses and reduce the risk of hepatitis C and other diseases.

During the AIDS epidemic of the 1980s, harm reduction programs reduced blood-borne transmissions between heroin addicts due to contaminated needles. Syringe exchange programs began in the late 1980s in the U.S., which helped reduce the transmission of HIV.

Safe Consumption Spaces and Services

Legal, safe consumption spaces get addicts off the streets and into a controlled environment where they can access medical and mental health assistance. Onsite workers may check heroin for fentanyl or other signs of contamination. Users also have access to a crisis helpline and training on how to use medication-assisted treatment.

Supervised injection sites are associated with fewer ambulance calls, a decrease in HIV infections, and fewer overdose mortalities.

Safe Needle Disposal and Exchange

Needle exchange programs provide free, clean needles for heroin users. While heroin use is illegal, needle exchange services give addicts not yet committed to treatment contaminant-free needles, which helps them avoid contracting HIV or hepatitis. A needle disposal center is the first place many people receive counseling and treatment.

Contamination prevention programs offer safe sites for disposal of syringes and hypodermic needles, which reduces the amount of used injection equipment on the streets. Safe disposal sites protect users from possibly contracting hepatitis or other diseases from infected needles. Emergency medical personnel and the public at large are less likely to suffer from needle stick injuries or encounter syringes or needles on the ground in their neighborhoods when communities offer safe disposal and injection sites.

Opioids and Medication-Assisted Treatment (MAT)

safe disposal sitesReliance on prescription painkillers can be just as deadly as heroin addiction. Opioid dependence can be caused by excessive use of Vicodin, OxyContin, and fentanyl.

Naloxone, buprenorphine, and methadone, medications for opioid use disorder, may be used as part of a harm reduction program for prescription painkillers and heroin.

The opiate antagonist Naloxone reverses opioid overdoses. This medication can be administered as an injectable by medical professionals or as a nasal spray that can be used at home if approved by a doctor. This drug restores breathing by blocking opioid receptors.

Buprenorphine or Suboxone (naloxone combined with buprenorphine) is also used as medical assisted treatment for opioid addiction. These extended-release treatments are administered by a doctor or through an opioid treatment program (OTP).

Right Path Addiction Treatment Centers use MAT in conjunction with counseling and group therapy to help patients stay focused on repairing their mental and emotional health without worrying about physical withdrawals. Mental and emotional trauma are often the initial reasons for why the patient began abusing opioids. After initial detoxification, these medications can be used to prevent relapse so you can continue on your recovery.

Counseling and Support Groups

Traditional support groups and counseling are used along with harm reduction to provide recovering addicts with the psychological tools they’ll need to return to a normal life. Therapy and counseling are sometimes offered as part of an opioid treatment program (OTP).

Individual and group counseling help addicts explore the reasons behind their substance abuse. Through behavioral and talk therapy, addicts become aware of the psychological and environmental factors that lead to their addiction.

Alcohol Treatment

There are several harm reduction strategies used in treating alcoholism.

The patient and doctor work together to establish reduced drinking goals or maintain periods of abstinence. If you plan to go to a restaurant or other location where you may drink, arrange a ride in advance to avoid accidents, or give your keys to a sober companion. Log off social media before drinking to avoid posting anything you’ll regret later.

Through counseling and support groups, you’ll become aware of the triggers that cause you to drink. You’ll learn to reduce or avoid these triggers and how to deal with the underlying causes of your drinking. Harm reduction helps you realize how much you drink, when, and why you drink and allows you to track the number of drinks you have each day.

The opiate antagonist Naltrexone is helpful for some alcoholics because it may reduce cravings and the pleasurable feelings associated with drinking.

Pros and Cons of Harm Reduction

Counseling and Support Groups Research shows that harm reduction is cost-effective and yields better results than detention to improve the lives of people who misuse drugs or alcohol.

Individuals using harm reduction programs may receive referrals to medical and social service organizations, enroll in job training, or be offered employment through special programs. By reducing the chances of the worst happening, like overdose or disease transmission, addicted users can focus on getting their lives in order before undergoing physical withdrawals.

Opponents of harm reduction believe that it encourages substance abuse and makes it harder for people to abstain from drugs or alcohol. Some safe injection sites may be poorly managed, so it’s important to do your research before choosing one.

Consider Harm Reduction MAT

If you or someone you love has a substance abuse issue but won’t commit to traditional rehab, consider harm reduction addiction treatment. At Right Path Addiction Treatment Centers, we believe in progress, not perfection. We can use harm reduction MAT, combined with psychotherapy, to help you achieve your recovery goals.

Written by Sergey Zhitar, MD Medical Director

Native of Moldova, Dr. Zhitar is Board Certified in Addiction Medicine as well as Internal Medicine and completed his training at UPMC Shadyside, Pittsburgh, PA in 2000.