Harm Reduction enables choices, possibilities, and opportunities without imposing change. 

Harm reduction is a set of practical public health strategies that reduce negative consequences of drug use and promote healthy individuals and communities by incorporating a spectrum of practices from safer use, to managed use, through abstinence. Harm reduction strategies meet drug users where they are, addressing conditions of use along with the use itself.

We consider the following principles central to harm reduction practice:

• Accept, for better and for worse, that licit and illicit drug use is part of our world and choose to work to minimize its harmful effects rather than simply ignore or condemn them.

• Understand drug use as a complex, multi-faceted phenomenon that encompasses a continuum of behaviors from severe abuse to total abstinence, and acknowledge that some ways of using drugs are clearly safer than others.

• Establish quality of individual and community life and well-being–not necessarily cessation of all drug use–as the criteria for successful interventions and policies.

• Call for the non-judgmental, non-coercive provision of services and resources to people who use drugs and the communities in which they live in order to assist them in reducing attendant harm.

• Ensure that drug users and those with a history of drug use routinely have a real voice in the creation of programs and policies designed to serve them.

• Affirm drugs users themselves as the primary agents of reducing the harms of their drug use, and seek to empower users to share information and support each other in strategies, which meet their actual conditions of use.

• Recognize that the realities of poverty, class, racism, social isolation, past trauma, sex-based discrimination and other social inequalities affect both people’s vulnerability to and capacity for effectively dealing with drug-related harm.

• Do not attempt to minimize or ignore the real and tragic harm and danger associated with licit and illicit drug use.

Harm Reduction is supporting any positive change.

Good public health policy reflects many things that are the core principles of harm reduction. Healthcare systems strive to meet people where they are, in hopes of bringing them to a healthier place. Doctors will often work with their patients’ substance use in incremental steps, realizing that drastic lifestyle change usually fails. Public health policy has begun to embrace holistic, person-centered care, which harm reduction has been practicing for years. Evidence-based practices are demanded of healthcare professionals. Public health reform and harm reduction use much of the same language and principles.  Harm reduction strategies are evidence-based, and most effective when adopted as a community-wide approach.

 Harm reduction gives basic human rights to the drug user, in a world where those are often denied. Harm reduction maximizes intervention options, recognizing that people benefit from a variety of approaches. No one method of treatment works for everyone, and harm reduction brings all the options to each participant’s table, so that they may be able to make a choice that is best suited for them. This philosophy reverberates throughout public health.

 The active participation of people who use drugs is at the heart of harm reduction.  People who use drugs are seen as the best source of information about their own drug use and are empowered to join with service providers to determine the best interventions to bring about change. Participating in one’s own treatment decisions, or volunteering in harm reduction helping others empowers drug users and motivates them to make positive change. Many healthcare providers take a similar approach with their patient’s health issues because no one is better equipped to find the best solution for one’s healthcare than the patient himself.

Every day, 42 Americans die from an opioid overdose. That is 2 an hour and 17,000 a year. 

In the last 15 years, heroin use has dramatically increased. But, that is only part of the story. 

Prescription opioids are at the heart of the problem. First, they fueled the opioid dependency.  When the government began to crack down on the vast over-prescribing of these medications, it did not stop the epidemic, but merely caused people to turn to heroin, as a cheaper and more available alternative. More Americans overdose on prescription opioids than on heroin, and overdose is the leading cause of accidental death in the country.

What exactly is an opioid overdose?

An overdose happens when a toxic amount of a drug, or combination of drugs, overwhelms the body. An opioid overdose happens when there are too many opioids or the combination of opioids and other drugs. The body becomes unresponsive and because the opioids also bind the receptors that control breathing, breathing is suppressed. Lack of oxygen can quickly cause brain damage and death, so it is important to administer rescue breaths in an overdose situation. Naloxone is an opiate antidote/antagonist with a very high affinity for the opioid receptor so it goes in and kicks off the opiates, and because it antagonizes (blocks) the receptor, rather than agonizing (activating) it, the overdose is reversed. 

PWID often have very limited access to medical services, but they are at-risk for a variety of diseases and conditions. Many times an injection drug user faces stigma in the healthcare industry, which keeps them from navigating the maze of services available in our community. Austin Harm Reduction Coalition is breaking down the barriers and increasing the access to healthcare services for PWID.  By providing wound care on a daily basis, many of our participants are not forced to go to the hospital for minor abscesses. Additionally, our nurse has a vast repertoire of referral providers, to assist with medical care, substance abuse treatment, mental health services, housing services, and food access programs. By providing HIV and HCV testing, we are increasing access to these tests, as well as increasing the number of at-risk people who are testing on a regular basis.

The real gem of our program is our HCV patient navigation component. With recent advancements in drug treatments for HCV, the medical community has begun to call HCV a curable disease. Previously, treatment was not very effective, combined harsh regimens of interferon and ribavirin and often people were only treated when their liver had serious damage. With these new medications, everyone is encouraged to try and treat the disease if they can. PWID are an exception to this rule, as they are often denied treatment because of the unproven fear that they will simply re-infect. Many times when PWID test positive for HCV, they are brushed aside because of their active drug use and are rarely referred to follow-up blood work, fibroscans, liver specialists, or even primary care. This is not good enough for us! When our participants test positive for HCV, they are given the opportunity to work with an outreach patient navigator to get all the follow-up blood work and liver imaging. This will empower them with education about liver disease and HCV, as well as give them more information about the state of their liver and the progression of their disease. Armed with this information, the participant can better weigh their options for care. We strive to get as many people treated as possible with increasing access to primary care and liver care. Everyone deserves to be treated for his or her illness, regardless of lifestyle choices. Studies show that PWID are just as compliant with treatment as some other groups, and many who have been treated for HCV are far more cautious to not re-infect. By providing harm reduction supplies to people who have been treated for HCV, we are not only decreasing their chances of re-infection but also empowering them with knowledge and options.

Changing the way the world views a drug user will break the stigma and increase access to treatment and healthcare.