Harm reduction consists of the steps we take to ensure our safety when we're put into a potentially dangerous situation. When we drive down the street, we wear a seatbelt. If we jump out of a plane, we'll use a parachute. When we ride a bike, we wear a helmet. These are the choices we make to reduce the harm that can come our way in day-to-day situations. In the context of alcohol or substance abuse, harm reduction can include medication that helps prevent relapse, support for more moderate use or abstinence, and addressing underlying mental health conditions that may be powering your substance abuse.

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If you are struggling with problematic drinking, are abusing opioids, or are abusing prescription medications, you may experience some part of you always or frequently thinking about or craving using. Harm reduction brings a practical approach to people struggling with substance abuse. The goal is to decrease the chance of relapse and overdose. Programs using a harm reduction philosophy have been shown to successfully lower risky alcohol use and reduce the effects of substance abuse.

So, what is harm reduction and how does it work?

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Harm reduction, abstinence, and moderation

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In its early years, harm reduction was conceived as an alternative to abstinence-only focused interventions (such as Alcoholics Anonymous) for adults with substance abuse disorders. For many people, abstinence is not a realistic goal, and many individuals are interested in reducing but not eliminating their alcohol consumption. The literature provides quite persuasive evidence that harm reduction approaches are effective in reducing risky behaviors.

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Medication that blocks the effects and feelings of alcohol, or that blocks the euphoric and sedative effects of opioids such as heroin, oxycodone, and morphine, are key tools in the harm reduction approach.

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Medication as a harm reduction approach for substance abuse – what are the benefits?

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The harm reduction toolbox includes a variety of different methods geared towards preventing relapse and dangerous behaviors. An important set of tools are medications for harm reduction. Medications such as buprenorphine, naltrexone, long-acting forms of naltrexone (Vivitrol), and others, can have significant beneficial effects for your recovery by preventing highs and reducing the possibility of overdose.

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Naltrexone, for example, binds to your endorphin receptors and can be effective for people struggling with alcohol abuse and opioid abuse. It blocks some of the effects and feelings of alcohol, reduces alcohol cravings, and reduces the amount of alcohol consumed. Naltrexone can help you maintain sobriety.

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For people who have been abusing opioids such as heroin, oxycodone, and morphine, naltrexone blocks the euphoric and sedative effects of opioids and suppresses opioid cravings.

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Medication is part of a comprehensive harm reduction treatment plan

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Naltrexone or other harm reduction medication should be one component of a comprehensive harm reduction treatment plan. Your treatment should start with a careful diagnosis and include psychotherapy to help you deal with any underlying or co-occurring mental health challenges.

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Medication-Assisted Treatment (MAT) combines the use of medications, counseling, and behavioral therapies, to provide an approach that treats you as a whole person with many dimensions. In planning your treatment your psychiatrist should consider the range of health conditions that you have, including possible mental health challenges and your physical health. For example, naltrexone is not a recommended option for people experiencing specific health conditions.

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Matching the harm reduction technique to where you are in your journey

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Substance abuse describes a very wide spectrum of behaviors. Your journey to healthy use of alcohol, or complete abstinence from drinking or opioids, may have many stations. You may be currently clean and sober, you may have relapsed, you may be cycling in and out of treatment, or you may not yet be in a place to stop. Harm reduction has the ability to help at all points in your journey.

 

Reach out now for private, confidential support for harm reduction

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Dr. Dhrymes offers at-home treatment for substance abuse. For more information, click here.

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If you need professional help with your substance abuse problem, you are not alone. Dr. Dhrymes is a psychiatrist based in New York and is ready to help you on your path to recovery. Reach out today.

 

Further reading about harm reduction 

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• Evidence for the Efficacy of Naltrexone in the Treatment of Alcohol Dependence (Alcoholism) - click here to read the full article.

• MAT Medications, Counseling, and Related Conditions on the website of The Substance Abuse and Mental Health Services Administration (SAMHSA) website - click here to read.