Understanding Harm Reduction: Substance Use
What is harm reduction?
Harm reduction is a public health approach that aims to reduce harms related to substance use. Harm reduction includes many options and approaches. It may include abstinence, or not using substances at all. Stopping all substance use isn’t required before receiving care. It meets people wherever they are in their substance use journey. Evidence shows that harm reduction does not increase or encourage substance use.
Harm reduction strategies and services can lessen the consequences associated with substance use. The consequences include social, physical, emotional and/or spiritual concerns. It may include access to safer sex and safer substance use supplies and/or take home naloxone. It also involves outreach and support programs and referrals to health and support services. Harm reduction helps ensure services are non-judgmental and available to all.
Harm reduction treats people with respect. It helps people connect with others and develop healthy relationships. It involves working directly with people and their communities. The service helps individuals, families and friends learn harm reduction skills. People can learn about the resources and supports in their communities.
Some examples of services available to prevent harms from substance use include:
- Impaired driving prevention programs. The programs increase awareness of the risks of driving under the influence of substances
- Outreach and support programs
- Information and resources on safer ways to use substances. It covers opioid use, stimulants and other substances
- Supply distribution and needle recovery programs
- Options for opioid substitution (agonist) therapies such as methadone or suboxone
- Take home naloxone kits. The kits include medication to reverse an opioid overdose. This helps prevent brain injury and death
- Supervised consumption/injection services and overdose prevention services. These services help prevent overdose deaths. They can reduce other harms by providing a safer, supervised environment for people using substance
- Mental wellness and healing support programs and centres
- Peer support programs run and attended by people with experience using substances. The programs must receive enough funding for consistent service
What are the benefits of harm reduction related to substance use?
Harm reduction has many benefits for people who use substances. It also helps their families, friends and communities. Research shows harm reduction activities can:
- Increase referrals to support programs and health and social services
- Reduce stigma and increase access to health services
- Reduce sharing of substance use equipment
- Reduce hepatitis and HIV
- Reduce overdose deaths and other early deaths among people who use substances, including alcohol
- Increase knowledge around safer substance use
- Increase knowledge around safer sex and sexual health and increase condom use
What does harm reduction mean for people who use substances?
Harm reduction services are open to all people who use substances, at any stage of their substance use. Harm reduction recognizes that healing is different for everyone. The services are available for someone using substances who wants to move in a new direction. They may be connected to outreach, primary or other health care services and access substance use treatment.
Should I have concerns about harm reduction?
Some people express concerns about harm reduction. Some of the more common concerns include the following questions:
- Could harm reduction activities encourage people to use substances?
- Research shows that harm reduction activities do not encourage substance use. In fact, they can encourage people who use substances to start treatment.
- Is needle distribution better than needle exchange?
- From a public health perspective, the answer is yes. Needle distribution is evidence-based to prevent HIV and hepatitis. One-for-one needle exchange may lead to people re-using needles. It is recommended that people receive enough needles to use a new one for each injection.
- Does this mean there will be used needles in public spaces?
- People do not intend harm to others by discarding needles. They need an easy way to dispose of needles safely. Needle distribution programs should also provide safe needle disposal.
For More Information
For more information about harm reduction and naloxone, see the following:
- HealthLinkBC File #102b Harm Reduction for Families and Caregivers
- HealthLinkBC File #118 Naloxone: Treating Opioid Overdose
- Ministry of Health - Harm Reduction: A British Columbia Community Guide www.health.gov.bc.ca/library/publications/year/2005/hrcommunityguide.pdf.
For more information about overdose recognition, prevention and the THN program, visit:
- Toward the Heart https://towardtheheart.com/
- Toward the Heart, Harm Reduction Best Practices: Needle Distribution at https://towardtheheart.com/assets/uploads/1527610699wCmnRqriGptLjpB06OPS1tx0sBFAOKOxCpND7cM.pdf