Addiction and Harm Reduction

As someone who has worked in the addiction and mental health field for over ten years, I have made a few key observations that I feel worthy of sharing with as wide an audience as possible.

Harm reduction can mean a lot of different things, but for the purpose of this discussion I will be focusing on different medical interventions that are commonly used to keep people alive or minimize the bodily harm that can result from drug use, particularly opioids such as fentanyl.

The drug Naloxone has been receiving a lot of press lately as a tool in fighting the opioid crisis. It has the ability to counteract the acute negative effects of an opioid overdose and save people's lives.

One of my first experiences with this harm reduction tool was when I was working at an emergency shelter. A young man emerged from his small room and asked me to call him an ambulance and then proceeded to vomit uncontrollably in the corner near the bathroom.

When the paramedics arrived I overheard one of them say something like, "This is the same guy we Narc'd this morning..." (Narcan being one of the brand names of Naloxone.)

I had to take a step back and realize how grim the situation had become for some people in terms of their drug abuse. I heard my coworkers describe similar situations where people were essentially saved from the brink of death multiple times a week or even per day.

This is a very poignant example of the double-edged sword of harm reduction because it essentially allows people to continue using certain harmful substances because other substances allow them to do so.

This is why this type of harm reduction alone will, at best, be grossly insufficient in truly helping people recover from substance abuse.

What kind of message is the young man I alluded to earlier receiving if he is allowed to use heroin or fentanyl to the brink of death only to be "Narc'd" whenever he overdoses? We could make the argument that his life has been saved many times by this type of medical intervention, but what kind of self destructive life is he being inadvertently enabled to live?

One could say that harm is being reduced to the body of the person, but what about their soul and the totality of their human potential? We need to develop and propagate much deeper intervention strategies in terms of people's addiction and mental health needs.

There is a therapeutic community called Woodwynn Farms close to where I live in British Columbia. I feel they are helping to fill the void mentioned above. They integrate a healthy lifestyle with an abstinence-based approach to addiction and endeavor to heal the mind, body, and soul of their participants rather than simply reducing harm to the body.

This will continue to be the key focus in my counseling work as well as many other organizations that deal with addiction and mental health recovery. Seeing people as more than just afflicted bundles of biology to be kept alive and realizing the value of getting to the root of their existential suffering is of paramount importance.

Addictions are acted out by individual people but reflect deeper systemic problems in society. Those who are on the margins are like a wake up call for the rest of us. What are the causes and conditions that have lead to so many falling into opioid addiction and other types of drug abuse?

Harm reduction is certainly one piece to this puzzle but we have to look much deeper and treat the heart and soul of the person along with the body. If we fail to do this we will unconsciously enable people to continue their destructive lifestyles and wonder why they aren't getting better.

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