Harm Reduction: Reducing the Potential for Harm

    Any step to reduce use or to lower the risks when using substances is a step toward wellness. It might not be what you want for your child, but it’s movement in a healthier direction.

    Why harm reduction matters

    Every day, we engage in some form of harm reduction. We wash hands to minimize the risk of COVID-19, use seat belts when driving or wear helmets when playing sports. Similarly, there are steps one can take to reduce risks associated with substance use.

    We are familiar with the advice to have a designated sober driver or use public transportation when planning to drink alcohol. Similarly, to reduce the potential for overdose, one shouldn’t use substances alone. Risk can also be reduced with an emergency overdose plan that includes having naloxone on hand. Furthermore, the use of clean needles and other materials (such as bongs) lowers the chance of infection and the spread of diseases.

    Strategies to reduce use

    One may reduce alcohol intake by alternating drinks with a glass of water, and those who smoke may choose to skip a cigarette or a joint. Others join moderation management groups. These focus on using substances only on specific days or times, and in certain quantities.

    Instead of stopping altogether, some people respond better when asked if they are willing to cut back. Some may be willing to stop using one substance but not others. For instance, they stop misusing opioids but keep using marijuana. Individual counseling and treatment programs can “meet people where they are.” Treatment plans are developed based on one’s goal and what they want to change about their substance use.

    In abstinence challenges, one examines what the benefits and drawbacks are of using the substance(s) over the course of 30 or so days. If this “sobriety sampling” works, their goal changes from moderation to abstinence. This approach is in sharp contrast to abstinence-based treatment programs, where abstinence is the goal from the beginning. In fact, a positive urine screen can result in being discharged from the program.

    Moving your child toward wellness

    While not condoning substance use, family members can help their loved ones and learn ways to promote healthier behavior and reduce harm. Community Reinforcement and Family Training (CRAFT) is a way to improve communication around substance use and other difficult topics. This includes noticing and encouraging any positive changes, helping your child engage in healthy alternatives to substance use, setting boundaries, using consequences appropriately and self-care.

    While there is no one-size-fits-all solution, harm reduction strategies are a way to reduce the health and social risks associated with substance use. They may be a good first step for your loved one to take in the direction of wellness.


    May 2020