What is the Harm Reduction Approach to Opioid Addiction?

harm reduction for opioid addiction treatment

Approximately 50,000 people in the United States alone died from drug overdoses related to opioids in 2019. The Centers for Disease Control currently describes the opioid situation as a national crisis. With tens of thousands of people dying annually, this is an apt term. In addition to the devastating loss of life, the crisis impacts the social, economic, and physical health of many people across the country and beyond. Both the problem and awareness of the problem continue to increase through media attention and drug education today.

Opioids include everything from prescription pain relievers and fentanyl to heroin and more. Prescription pain relievers are a direct cause of opioid dependence. Severe addiction often develops after a patient has been treated with a round of prescription opioids. Unfortunately, many of those individuals continue to experience chronic pain and misuse opioids to alleviate ongoing pain and to satisfy their addiction. However, prescription use is not the cause of all opioid addictions. Because there are different paths to addiction, there is not a clear-cut solution to deal with the problem.

There are two primary approaches to opioid treatment. These are the harm reduction approach and abstinence. The debate between harm eduction vs. abstinence rages on. Both solutions have their pros and cons. A closer look at these methodologies reveals that they also share some common ground.

Understanding the Harm Reduction Approach

The harm reduction approach is based on one important premise. This premise is that drug use is a part of the world we live in. Because of this, the approach states that it is beneficial to accept it and to minimize the effects of illicit and licit drug use. The harm reduction approach assumes the essential need for acceptance because it is not realistic to accept the alternatives. Alternatives include the full criminalization of the substance well as condemnation and ignoring the problem.

How Harm Reduction Works

Those who do not fully understand this harm reduction often believe that the technique condones drug abuse. However, this is not actually the case. Instead, harm reduction techniques provide some framework for safer use and even a path to non-use in some cases.

Often, this framework is in place with agreed-upon conditions for the use of the drugs in question. The goal is to make the use of the substance less harmful to the individual, to other people, and to society overall. Generally, harm reduction techniques rely on the insight of current or former drug abusers to create policies and programs. Services are provided in a non-judgmental, voluntary manner.

The Primary Principles of Harm Reduction

In clinical settings where harm reduction techniques are used, discrepancies related to its definition exist. For example, some care providers believe that harm reduction techniques are successful when they move toward full abstinence and sobriety. Others believe that anything that reduces harm or risk is successful. Because of the spectrum of fundamental beliefs in this area, there are no clear standards at this time related to harm reduction techniques.

Who Harm Reduction Applies To

Despite this general gray area, the harm reduction approach has been in practice in U.S. public health policy since the 1980s in various ways. In relation to opioids, it has applications across the full spectrum of users. This spectrum includes those who experiment with opioids or who use them recreationally. It also includes regular users and chaotic abusers. Essentially, harm reduction techniques require the care provider to step into the level that the user is at. The care provider connects with the user or abuser at that level, and the goal is to reduce the harmful outcome of his or her usage.

Deciding Between Harm Eduction vs. Abstinence

Harm reduction and abstinence are at odds on many points with solid discrepancies. However, there is a middle ground between harm reduction and abstinence as well. With this in mind, understanding the black, white, and gray areas between harm eduction vs. abstinence is essential. Through this understanding, you can more clearly see which approach is advantageous for a specific situation.

The Goal of Abstinence in the Drug Crisis

Abstinence involves complete restraint from the activity in question. There is no acceptance of moderation. Likewise, there is not a step-down approach to move toward sobriety. This approach generally assumes that all usage is bad. In addition, it assumes that an individual cannot safely use the substance. 

Proponents of abstinence to opioids believe that opioids should be completely banned. Essentially, they believe that these pain relief drugs cannot be safely prescribed for any type of beneficial intended purpose.

An Example of Harm Reduction Policy in Action

Now that you know what abstinence looks like in practice, you can dig deeper to understand the harm reduction approach. One example of how this approach has been used is with drunk driving laws. States generally have an acceptable legal limit for blood alcohol content. These drunk driving laws do not attempt to stop drinking and driving entirely. They simply set standards so that those who have been drinking heavily may be less likely to get in an accident and cause injury. 

The premise is that many people will drive after having at least one drink, so the law establishes what is deemed to be relatively safe and what is not.

The Impact of Drug Education on the Opioid Crisis

Everything from drug use prevention to treatment and even public policy hinge on drug education. Drug education continues to evolve through case studies, statistics, research and more. Drug use, treatment, and policy are complex and evolving matters. As a result, the matter of deepening our level of drug education continues to be highly relevant in the conversation about prevention and treatment.

The Role of Drug Education on the Opioid Crisis

Drug education has played a crucial role in the management of the opioid crisis to date. Prescription opioids were not widely prescribed for pain management prior to 1990. In fact, their primary use for pain management was largely limited to cancer patients. However, by the end of that decade, approximately 86 percent of opioid prescriptions were written to non-cancer patients. By 2015, more than 6.5 million teens and adults used opioids for non-prescribed purposes.

You can see that the escalation of the opioid crisis was dramatic. In fact, approximately 20,000 deaths in 2016 are associated with fentanyl alone. At that time, the CDC established comprehensive guidelines on the proper usage of opioids for medical purposes. By 2018, more educational materials were provided to physicians to curb the unnecessary prescription of opioids. As a result of drug education, the opioid crisis has received proper attention, and physicians are now taking action.

The Best Approach to Managing the Opioid Crisis

The opioid crisis is an undeniably serious and growing problem. Despite more extensive drug education and physicians’ increased awareness of their role in the crisis, people continue to develop addictions and die of overdoses. With this in mind, what is the best approach to take to deal with the opioid crisis?

Focusing on How Opioid Addiction Starts

One of the reasons why the debate between harm eduction vs. abstinence continues is because there are many paths to addiction. For example, opioids are often an effective form of pain relief for severe situations. They may be preferred by patients who do not want to seek a surgical or invasive treatment option or when other treatments are more expensive. 

On the other hand, opioids may not be the only prescription pain reliever available. Other pills could be available that are less addictive and habit-forming. However, the matter of using any type of pain relief medication long-term should be reviewed.

Of course, some people start using opioids experimentally or recreationally. They are not seeking pain relief. Instead, they may be seeking pleasure, numbness from feelings, or other effects. Currently, opioid use in this manner is criminalized. Therefore, abstinence is the accepted approach when the medication has not been prescribed by a doctor.

Choosing the Best Approach

Opioids serve an important role in pain management. Prior to the 1990s when opioids were prescribed more frequently, they were an important part of some cancer patients’ pain management plans. However, as that role has increased beyond use by cancer patients, misuse and abuse have become increasingly problematic. This is directly related to the addictive properties of opioids.

Does opioid use continue to have a place in doctor-managed pain management? A policy of abstinence requires a legal mandate. Therefore, drug education will continue to play an important role in curbing the opioid crisis until or unless laws are revised.

Contact Us Today to Learn More About Harm Reduction

The debate between harm eduction vs. abstinence continues. Many experts draw on various experiences and research to support their positions. However, addiction is a serious and complex matter. There is not a single approach that is best suited for all individuals. With this in mind, education on effective harm reduction techniques and a clearer understanding of how they work are essential. Ultimately, your understanding will help you to determine the best treatment option for you or your loved one.

Contact BRC Healthcare today to learn more about opioid addiction and how our team of addiction treatment professionals can help you or a loved one. 

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