Harm Reduction and Substance Abuse

Paper Summary:

This paper examines how harm reduction is a theoretical model which has been proposed to address the harm which is caused by the behavior of an individual, not only to themselves, but also to the wider community. In particular, it looks at how the model has also provided a potential framework for dealing with substance abuse, and has been adopted in practice in many countries around the world. This paper examines the principals behind the theoretical model, and how these can be applied to successfully treat substance abusers. Specific applications of the model are also examined to determine how successful certain strategies have been in reducing harm, and how any limitations could be overcome to improve future implementations.

Outline:
Theoretical Model
Environmental Effects on the Individual
Time Orientation of Model
Applications of the Model
Strengths and Limitations
Harm Reduction Model and Substance Abuse
Basic Principles of Harm Reduction in Substance Abuse
Major Guidelines and Tools for Assessment
Syringe Exchange Program
Strengths and Limitations of Model
Conclusions

From the Paper:

"However there are certain principles to the theory of harm reduction which are generally agreed. Harm reduction is an approach or strategy rather than an actual goal, the aim of which is to reduce or eliminate the negative consequences of drug use rather than eliminate the actual drug use itself. There is an emphasis on the aim of reducing the adverse consequences among individuals who cannot be expected to cease their drug use at the present time for various reasons (Riley et al., 1999). The underlying philosophy to harm reduction is that the practitioner approaches the client in a nonjudgmental manner and works to help the client meet goals which have been established personally by the client (Bradley-Springer, 1996). In the harm reduction model, the rights of the individual are of prime importance, which include the client's rights to dignity and the right to make personal decisions. Harm reduction includes a holistic, incremental and multidimensional approach to decreasing risks for individuals and communities (Bradley-Springer, 1996). Although the model of harm reduction is contradictory to the traditional abstinence model, it may however be compatible with the eventual goal of abstinence. The model proposes that social support, health assistance, education and disease prevention measures should be maximized for all. "

Sample of Sources Used:

• Amato, L., Davoli, M.A., Perucci, C., Ferri, M., Faggiano, F.P. and Mattick, R. (2005) An overview of systematic reviews of the effectiveness of opiate maintenance therapies: Available evidence to inform clinical practice and research. Journal Substitutes Abuse Treatment, 28, 321-329.
• Bluthenthal, R.N., Kral, A.H., Erringer, E.A. and Edlin, B.R. (1998) Use of an illegal syringe exchange and injection-related risk behaviors among street-recruited injection drug users in Oakland, California, 1992 to 1995. Journal of Acquired Immune Deficiency Syndrome Human Retrovirology, 18, 505-511.
• Bradley-Springer, L. (1996) Patient education for behavior change: Help from the transtheoretical and harm reduction models. JANAC, 7(1), 23-33.
• Des Jarlais, D.C. (1995) Harm reduction: A framework for incorporating science into drug policy. American Journal of Public Health, 85, 10-12.
• Des Jarlais, D., Marmor, M., Paone, D. and Titus, S. (1996) HIV incidence among injecting drug users in New York City syringe-exchange programs. Lancet, 348, 987-991.

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