Umbrella Project : Harm Reduction

Section 3: Harm Reduction (Online Training sub-module)

In this section we will be exploring harm reduction strategies that students can use on an everyday basis to decrease negative consequences.

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Tips

Focus on the harms. The goal of harm reduction is to decrease the harm caused by substance use, whether that is through abstinence or a change in the frequency or method of use.
Abstinence isn’t for everyone.Not everyone will want or be able to stop using, but there are other ways to decrease the negative side effects of substance use that they experience.
Making harm reduction options available helps students.Providing information and options shows that student’s well being is valued and creates the opportunity for honest conversations about risks.
Make a harm reduction plan.A plan can help mitigate the harms of substance use through substitution, delay, decrease risk/use, and replacing the substance.

About Harm Reduction

Intro

Harm reduction is a form of secondary prevention. Primary prevention intends to prevent high-risk behaviors and disease, whereas secondary prevention focuses on early identification, decreasing the harms and the negative impacts, as well as slowing down the progression.

In this section, you're going to be able to define what harm reduction is, understand the main principles, and create a harm reduction plan.

Definition of Harm Reduction

Harm reduction is an umbrella term for policies and practices that are focused on reducing problematic effects of alcohol and other drug use. It can take place on the individual, community, or societal level.

Examples:

SMART serve for bartenders and wait staff, which decreases public drunkenness.
Needle exchange programs that reduce HIV transmission.
Rules around no-smoking zones to limit second-hand exposure to smoke.

Watch the video or read the text below to learn about the principles of harm reduction.

Principles of Harm Reduction Video Transcript - RTF

There are five principles of harm reduction:

Pragmatism Accepting that some level of drug use will occur in society and that trying to eliminate use altogether is unrealistic. Harm reduction focuses efforts on decreasing the more immediate harms in the present term vs efforts towards creating a drug-free society
Focus on Harms Prioritizing the decrease of negative consequences of drug use for the individuals, families, and communities. Harm reduction may include, but does not demand, abstinence. Reduction of the level of use or mode use may be more immediate, practical, and effective.
Priority of Immediate Goals Supporting the individual’s goals and focusing on their most pressing needs. Harm reduction recognizes the importance of small gains that can add up over time. Small successes can empower people to make greater changes.
Humanism Valuing that each individual has the right to respect and dignity regardless of level or mode of use. Harm reduction is non-judgemental and creates safer space where people who use drugs are more likely to connect with service providers for support and to make the changes they desire to make.
Evaluation Measuring the effectiveness of initiatives to reduce drug-related harms. The health and functioning of the individual and the impact in the community are used to determine the success of harm reduction policies, procedures, and practices.

Myths

Let’s bust some myths. Watch the video or read the table below to learn about some common misconceptions about harm reduction and the facts about what harm reduction really is.

Myth	Fact
Harm-reduction is opposed to abstinence and therefore conflicts with traditional substance abuse treatment.	Harm-reduction supports all options for safer and/or managed use, including abstinence. It supports people where they are, and with what their individual goals are.
Harm reduction encourages drug use.	Harm reduction is neither for nor against drug use. It focuses on supporting efforts to reduce the harms created by drug use that affect the individual, their families, and communities.
Harm reduction takes money away from other programs.	In Canada, the National Anti-Drug Strategy allocates the majority of the funds to enforcing current drug laws. Only 17% of those funds go towards any type of treatment and a fraction—less than 2%—goes towards harm reduction programs or services, despite the evidence that they work.
Making condoms, safer drug use equipment, and harm reduction information pamphlets available will undermine policies that state that students cannot have sex or use drugs on the premises.	Making harm reduction equipment and information available shows that students’ health and well-being are valued and creates opportunities to have open and honest conversations about varying levels of risks associated with those practices. There is no evidence that making these tools available leads to an increase in the level of these activities on or off the premises.
If a person doesn't abstain from all substances, use will lead to renewed problems and possibly addiction.	Different people have different relationships with different drugs. For some, the use of any substance can trigger intense drug use, while others find it possible to use some substances in moderation.
Abstinence-based models are the only way people will get well.	Abstinence-only models are useful for some but not all individuals. Abstinence cannot always be reached right away. Not every person can stop or wants to stop using. Having abstinence as the only determinant of success can set people up for ongoing failure, increasing a sufferer’s sense of hopelessness and helplessness. Harm-reduction provides opportunities for small successes to lead to greater successes as well as practical and immediate solutions that can be used to decrease short and long-term consequences.

Harm Reduction Plan

A harm reduction plan is a way to decrease the negative side effects of substance use. There are four main ways that the harms of substance use can be mitigated:

Substitute: use other, less harmful substances.
Delay: Space out your use, or put off use a little longer.
Decrease Risk/Use: Use smaller quantities, or use safer methods
Replace: Get the effects of the substance in other, healthier ways.

Example Harm Reduction Plan

Watch the video or read the text below for an example of how to create a harm reduction plan.

Creating a Harm Reduction Plan Video Transcript - RTF

Caffeine is the most widely used psychoactive substance in the world, but it can cause some negative side effects, such as being irritable, jittery, and unable to focus, as well as developing ‘gut-rot’, and struggling to sleep at night. If you are a heavy consumer of caffeine, you may know that if you wake up tomorrow and do not have any caffeine, you will have a very nasty headache and feel exhausted.

If you were experiencing side effects from caffeine that impacted your life, here are some ways you could try to decrease these side effects while continuing to use caffeine:

Substitute: Have decaf or switch to tea.
Delay: Space out caffeinated drinks or have a bottle of water in between.
Decrease Risk/Use: Use more dairy in your coffee, use a smaller cup, cut out the afternoon caffeine, learn deep-breathing techniques, and inform you colleagues you’re changing your caffeine use.
Replace: Drink more water, get better sleep, and increase exercise.