Harm Reduction Alternatives in Addiction Treatment

Harm reduction: describes the process of decreasing the health risks associated with various human behaviors. Addiction as described by The National Institute on Drug Abuse is “acute, recurring brain ailment” by the National Institute on Drug Abuse[1] . There is no mention of moral impairment or failure in this definition. Instead, the term suggests that addiction is a disability that requires care to recover harm reduction. Psychologists, social workers, therapists, and dependency professionals may assist individuals in solving their brain chemistry deficits so that their lives can be drug-free. Nonetheless, many addictions do not want to live a life of avoidance. The 2010 National Survey on Substance Use and Health, for instance, found that 30.1% of those who opted not to go to treatment indicated that they were not ready to stop using illicit substances[2]. Despite available treatment, these people refused to engage in harm reduction.

Although it is conceivable to disregard these individuals and encourage them to continue abusing drugs without restriction, research shows that substance addiction harms both the community and the drug consumer. Taking a look at prison statistics[3] illustrates this point: Jailing drug users costs money in accommodation, nutrition, Medicare, and harm reduction.

Abandoning Illegal Drug Users Untreated, on The Other Hand, Means Grappling with A Slew of Issues, Like:

• Increased criminal activity HIV/AIDS and other public health issues
• Children of addicted parents have a greater need for long-term foster care.
• Land prices in drug-affected areas have fallen.

Another option is to reduce the amount of harm done. The expectation is that individuals will choose to use illegal drugs to some extent, but that the community will reach in to offer help that will make drug use healthier and less dangerous for all involved. Harm reduction is a social policy technique that was first designed for people with substance abuse issues who couldn’t afford to abstain. In these adult demographics, harm management strategies have proven to be successful in lowering complications and death Harm reduction has been effectively extended to sexual health education in last few years in an effort to eliminate both adolescent pregnancy and sexually transmitted infections, such as HIV.

Harm reduction initiatives have also been effective in reducing harmful alcohol use. The basic approaches used are influenced by the target patient group and the scope in which harm management techniques are implemented. Harm reduction techniques directed at mitigating the possible hazards connected with conventional adolescent health habits should be acquainted to healthcare professionals (HCPs) who offer treatment to adolescents. Harm reduction is a technique aimed at people or communities with the goal of reducing the negative consequences of such behavior.

When it comes to substance abuse, harm reduction recognizes that a continued degree of substance abuse (both legal and illegal) is unavoidable in community and sets goals to reduce negative effects. It places a greater emphasis on measuring health, social, and economic outcomes rather than drug use. From its inception in the 1980s as an option to strictly avoidance based treatments for individuals with drug misuse problems, harm reduction has progressed over a period. It was taken into account that restraint was not a practical target for those suffering from addictions. Persons who wanted to cut down on their usage but not completely stop were also exempt from services that mandated restraint.

The adult literature indicates that harm reduction measures minimize incidence and death correlated with hazardous health behaviors substantially. When comparing regions that have implemented needle-exchange initiatives to regions that have not implemented needle-exchange initiatives, indicate annual reductions in HIV seroprevalence have been observed. Methadone management services are closely linked to lower death rates, both from organic affects and from overdoses, implying that these initiatives have an effect on general socio – medical health. Supervised injection services, that have since been efficiently introduced in Switzerland and the Netherlands, as well as more lately in Vancouver, British Columbia, are the most newest development to the harm reduction spectrum. Several of these harm reduction programs rely heavily on HCPs.

How should this harm reduction principle be extended to adolescents? The bulk of adolescent population would not need harm management measures such as those described above. A harm reduction strategy, on the other hand, is consistent with our understanding of adolescent growth and judgement.

According to several studies, there is a correlation between the potential for injury and the degree of harm reduction conducted for drug use. Education about potential dangers and ways to mitigate them can affect these behaviors. There must be a difference between interventions designed to prevent a particular behavior and those designed to prevent it in adolescents who have already acquired a behavior harm reduction. This necessitates the close evaluation of the approach’s desired sample population and the scope in which it is used.

The primary goal of harm reduction for teens or preteens is to avoid dangerous conduct. This can be accomplished by prohibiting the behavior (for instance, sexual behavior can be discouraged by promoting the avoidance of sexual activity onset). A street-involved young woman engaged in prostitution harm reduction may be convinced to stop harmful sexual behavior and given knowledge about contraception. She may also be exposed to STI testing and encouraged to stop using unsafe contraceptives. An increasing body of evidence supports the effectiveness of harm mitigation techniques in preventing and intervening with potentially harmful conduct. Marlatt and Witkiewitz (14) released a study of harm reduction strategies to alcohol use and a summary of the related studies on health advancement prevention and care.

They addressed data from the Drug Abuse Resistance Education (DARE) program, which centered on zero tolerance (the “just say no” concept) and was widely introduced in the United States. Several studies have shown that this program was ineffective in lowering drug abuse harm reduction (15,16). These preventive initiatives have not been efficient in modifying the behavior of teenagers who are already consuming excessively. The idea of learning to drink more responsibly relates to the fact that many teenagers consider drinking as natural. In addiction treatment programs that ask students to act out a specific harm reduction behavior, adolescents are less likely to participate. They may revolt against something they perceive to be judgmental.

Strategies that integrate motivational interviewing and consider the adolescent’s objectives are being established for use with adolescents. Motivational interviewing harm reduction utilizes guidelines for dealing with opposition and ambivalence or resistance to change. It stresses the importance of taking personal responsibility for altering or improving one’s behavior (20–22). These interventions have been shown to minimize alcohol-related issues in slightly older subjects (17 to 20 years old). Using the alcohol-related harm reduction model, Monti et al. described a brief intervention with 18- and 19-year-olds entering the ER.

Principles for Harm Reduction

Harm reduction is a series of practices that help lessen the negative consequences of particular drug-using behaviors. People who believe in this philosophy argue that substance use is unavoidable for certain people, and that rather than forcing them to endorse abstinence they won’t completely accept, it’s better to simply protect the community from the cumulative effects of addiction running amok.

Developing a needle-exchange network for people who inject drugs is one example of harm reduction concepts. This will encourage people to bring in their expired syringes and leave with a new collection to use to inject their illegal drugs. Individuals could use safe, pointed tools for each drug use harm reduction rather than sharing needles multiple times and potentially contracting bloodborne viruses, such as HIV.

Some communities consider establishing “shooting galleries” to take this concept even further. In England, one such initiative has been made,[4]Users of heroin and cocaine, for instance, may step into a drug consumption area and get clean syringes and sanitizing products, allowing them to use their substances safely without fear of being arrested. Free condoms should also be part of harm management measures, so individuals who use drugs and become expressive as a result aren’t tempted to have risky intercourse and cause infections. Instead, a harm reduction program could shield the population from some diseases that might infect it.

All of these values may affect societies all over the world, but some associations are solely focused on causing damage-medication-reduction strategies. According to these officials, providing the right type of drug may prevent individuals from abusing particular prescription medications to the point of addiction, thereby enabling these individuals to live with their addictions for a while and harm reduction.

Medications for Harm Reduction

 One of the most well-known harm reduction drugs is Methadone. To be exact, the medication acts on the same receptors as heroin, presenting patients with respite from cravings and symptoms of withdrawal without allowing them to feel an extreme high. This medication has been shown to be highly efficient in keeping heroin addicts alive as they attempt to heal from a life-threatening illness. In one sample, for instance, [5] “Harm reduction-based methadone therapy, in which the consumption of illegal drugs is permitted, is closely linked to reduced fatalities from natural causes and from overdoses,” researchers concluded in a 2001 report.

That’s a really good point, and it demonstrates how creative a methadone strategy can be in the recovery of an individual addicted to heavy medication harm reduction. Buprenorphine is identical to opiates like heroin in that it acts on the same receptors. However, it has a maximum capacity which suggests that individuals can’t take large doses to get high. They will use the medication to help with cravings and symptoms of withdrawal. However, there should not be any worry that it will always be used for harm reduction, even if it may sound like it is. The addition of naloxone, which kicks in at high doses and prevents patients from overdosing, can sometimes improve the drug’s abuse-resistance ability.

Buprenorphine-containing drugs are effective[6] in keeping substance use disorder patients willing to seek harm-reduction. They’re also thought to be an excellent long-run recovery option because doctors can administer them rather than a substance abuse specialist harm reduction. Individuals can also take these drugs at home instead of going to a doctor or pharmacy for a regular dose in some instances. 

However, some substance consumers are opposed to the thought of swapping a substance they enjoy with a prescribed medicine that alters their high. Entry to naltrexone could help these people. This medicine, which can be administered as an injection or as a nasal spray, can stop an overdose from occurring by knocking all active bits out of their receptors. It’s usually provided by a first aider, such as an ambulance driver. If the medication were readily accessible, drug users might help one another in the event of a drug overdose or even save thousands of lives through harm reduction.

These are only a handful of the drugs that can be used to treat addictions pharmaceutically. Others include Naltrexone and Antabuse, which function similarly and have similar benefits.

Harm Reduction Support by The Public

Individuals appear to be open to the fact that addictions are acute illnesses that individuals can and do heal. There are a growing number of businesses hiring recovering addicts,[8] showing that many people trust in second chances and harm reduction in the long run.

It’s rather difficult to predict how individuals will respond to the prospect of living with, working with, and engaging with individuals who use drugs in a more healthy or supervised way but never achieve sobriety in the long run. And business insiders don’t seem particularly excited about the design. One Canadian research, for instance, found that[9] Long-run methadone management was endorsed by just 61 percent of staff in drug recovery institutions. Correspondingly, a Canadian survey of doctors found that [10] Just 56% of respondents said they would be able to support addicts with long-run substitution treatment. According to research like this, addicted individuals will have to work extra vigorously to get the care they need to really gain from substantive harm reduction, as they may fail to find services prepared to help them.

However, several group members oppose harm reduction as a brain disorder that certain individuals can only handle. Clean Slate Addiction is a website dedicated to those who are addicted to clean slates,[11] On the flip side, addiction to drugs and alcohol is not necessarily a disorder, and to label it one, we must either ignore the big holes in the illness debate or fully reinterpret the word ‘illness.’”

Individuals who carry these views should feel that everyone will improve if they only work hard sufficiently. This may contribute to outright prejudice against individuals who engage in harm reduction.

A Change of View

Some groups advocate harm reduction among those suffering from addictions and those who take diabetes medications or heart medications. Should someone with a heroin-based addiction be branded as “addicted” to methadone if we wouldn’t call those with diabetes “addicted” to insulin? This change could be aided by the passage of the Affordable Care Act. Addiction therapies are still called “primary facilities” under this act, which means they must be covered by insurance. Four of the drugs mentioned above are used in those programs.[12] This could lead to more patients receiving these drugs and a greater understanding and appreciation of the benefits of replacement drugs. However, more must be seen harm reduction for the conclusions to be transparent.

In the meantime, we will continue to advocate for all individuals suffering from addictions to seek treatment and learn about the privilege of living a clean life. call today 615-490-9376 and Our admissions coordinators are standing by to assist you with any concerns you might have about how our recovery services about harm reduction will aid.

Citations

[1]”The science of addiction: Drugs, Brains, and Behavior.” (n.d.). National Institute on Drug Abuse. Accessed April 25, 2014.
[2]”Summary of National findings from the 2010 National Survey on Drug Use and Health..” (Sept. 2011). The Substance Abuse and National Health Services Administration. Accessed April 25, 2014.
[3]Dewey, W. (Oct. 2008). “Paper of Transition.” Friends of NIDA. Accessed April 25, 2014.
[4]Philby, C. (April 17, 2013). “Shooting Galleries: The Drug Scheme That Could Be Too Progressive Even for Brighton.” The Independent. Accessed April 25, 2014.
[5]Langendam, MW; Van Brussel, GH; Coutinho, RA & Van Ameijden, EJ. (May 2001). “The effects of injury-lessening-Based Methadone care on Mortality Among Heroin Users.” American Journal of Public Health. Accessed April 25, 2014.
[6]A. L. Krook, A.L.; Brørs, O.; Dahlberg, J.; Grouff, K.; Magnus, P.; Røysamb, E. & Waal, H. (April 25, 2002). “High Dose Buprenorphine in Opiates Addicts Anticipating Medication Assisted Rehabilitation in Oslo, Norway: A Placebo-Controlled Study.” Addiction. Accessed April 25, 2014.
[7]”Comprehending Naloxone.” (n.d.). Harm Reduction Coalition. Accessed April 25, 2014.
[8]”Recovering addicts and ex-offenders were encouraged to work on the website.” (April 28, 2005). The Partnership at DrugFree.org. Accessed April 25, 2014.
[9]Ogborne, A.C. & Burchmore-Timney, C. (March 1998). “Staff specialized addiction treatment in Ontario, Canada support harm reduction .” Drug and Alcohol Review. Accessed April 25, 2014.
[10]Dooley, J.; Asbridge, M.; Fraser, J.; Kirkland, S. (June 13, 2012). “Results of a Cross Sectional of Nova Scotia Primary Care Physicians on Physcians Attitudes Towards Office-Based Delivery of Methadone Maintenance Therapy.” Harm Reduction Journal. Accessed April 25, 2014.
[11]”Addiction is a choice and not a disease of the brain.” (n.d.). The Clean Slate Addiction Site. Accessed April 25, 2014.[12]Vimont, C. (Feb. 26, 2013). “Millions of new patients will recieve Substance abuse treatment thanks to the affordable care act.” The Partnership at Drugfree.org. Accessed April 25, 2014.