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What is Harm Reduction? What is Recovery Oriented Care?

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The term "harm reduction" seems to be gaining more traction among those involved in the fight against opioid and alcohol addiction.

 

So, what is it exactly? Here’s the definition according to the International Harm Reduction Association:

 

“'Harm Reduction' refers to policies, programs and practices that aim primarily to reduce the adverse health, social and economic consequences of the use of legal and illegal psychoactive drugs without necessarily reducing drug consumption. Harm reduction benefits people who use drugs, their families and the community.”

 

Practically, it’s a pragmatic approach to Substance Use Disorder (SUD) that acknowledges the fact that the world is not drug free and if people are going to use drugs, then it’s better to use them in a safer environment in order to minimize the number of overdose deaths that occur. Harm reduction began as a grass-roots movement in the 1980’s during the HIV crisis. It began as providing needle exchange programs to ensure that if someone was injecting drugs, such as heroin, that they were doing it more safely and not spreading the disease. The first international Harm Reduction Conference was held in Europe in 1990.

 

Today, organized harm reduction groups still provide needle exchanges in communities as well as “safe injection sites.” These safe injection sites provide sterile materials, round-the-clock supervision and often coordinate with local drug treatment and mental health facilities. Additionally, harm reduction groups like IHRA and The Harm Reduction Coalition (HRC) in the U.S. advocate for decriminalization of drugs and the reduction of the stigma associated with drug use.They also distribute Naloxone, the anti-overdose drug, and provide education on its use. A large part of the work harm reduction groups do is in impoverished communities and with the homeless.

 

Harm reduction is somewhat controversial because some see it as a crutch, an easy way out of, or a barrier to entering a program and/ or adopting a lifestyle of recovery and abstinence. Harm reduction groups can support opioid and alcohol recovery groups and some evidence shows that it can be a bridge to recovery for those who initially are reluctant to go into recovery but ultimately decide they want to.

 

Symetria Recovery Program Director Casey Wegner, LCPC, CADC describes what is called a "Recovery Oriented System of Care":

"While we are not abstinence based only, we are not harm reduction, quite either. Treatment is not necessarily on a linear continuum with abstinence based and harm reduction on opposite ends.  The Symetria Method is unique, outpatient care provided by a team of doctors, PAs, nurses and counselors applying Medically Assisted Treatment (MAT) combined with individual and group therapies, all under one roof.  This team works to provide a customized treatment plan to fit the patient's unique needs - including comorbidities such as depression, anxiety and trauma such as PTSD.  Some of our patients might continue using, say marijuana, but heroin is not necessarily something we are trying to ultimately "reduce harm" with. It may take time to cease using, and in early stages we may be harm reduction in modality, however, the goal is to help the patient to ultimately stop as soon as possible in order to avoid harming their lives psychologically, physiologically, emotionally, socially, and so on.  We also don't ever just kick someone out of treatment for lapsing, even multiple times. Each patient's needs are unique in their road to recovery, and our team is able to move together to treat each patient with care and respect, on a case by case basis."

 

 

Dale Willenbrink
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