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 the risks associated with substance use.
We are familiar with “Don’t drink and drive. Have a designated driver or use public transportation.” This recognizes that a person is going to drink, but reduces the risk of an accident. Similarly, to reduce the potential for opioid overdose, one shouldn’t use substances when they are alone. They can also reduce risk with an overdose plan and naloxone on hand. Furthermore, the use of clean needles and thoroughly cleaning bongs lowers the chance of infection and spreading diseases.
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.
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.