Harm reduction is a set of policies that seek to minimize the harm associated with negative legal and illegal social behavior (Erickson, Riley, Cheung, & O'Hare, 2015). When advocating and implementing these policies, health workers do not focus on the legality of the behavior or the strategies adopted but rather on the overall reduction of the negative consequences associated with the behavior (Substance Abuse Mental Health Services Administration, 2014). In the USA, harm reduction strategies are widely applicable when dealing with drug and substance addiction. Report of the Global Commission on Drug Policy (2012) has identified various principles that govern the application of harm reduction strategies. Due to the subjectivity of the circumstances surrounding drug abuse and the confounding social aspects, most professionals in the field prefer to use people-oriented approaches rather than a standardized model (Peele, 2010). Nonetheless, the identified principles are flexible enough for application in either of the circumstances. These principles included neutrality, value addition, tolerance, use of drug users, non-judgmental attitudes, and reorganization of different vulnerability to drug use and addiction (Global Commission on Drug Policy, 2012).
According to Amundon, Zajicek, and Hunt (2014), the subjects of harm reduction become a marginalized majority in the society due to their failure to follow the accepted norms that mostly prohibit the use of illegal substances. Therefore, even before joining the harm reduction programs, these individuals feel alienated from the larger society. Haslam and Loughnan (2016) argue that the disconnection from the society, a trend that further threatens their social positions and worsens their recovery attempts. The principles of harm reduction attempt to adopt the victims of drug abuse and create stable social and psychological environments. For instance, in a training session, Wethington (2015) confesses that majority of the victims who recover have supportive family and friends who show deep interest in the victims lives.
In the past few years, I have engaged in effective programs of harm reduction in different communities. Despite the first-hand experience in dealing with the victims of drug addiction, the course reading materials increased my comprehension of the various strategies in harm reduction and their success rate in different communities. For instance, the review by Denning and Little (2011) helped to identify the role of biology in determining the success rate of harm reduction psychotherapy. Similarly, Drug Policy Alliance (2012) explained the need for supportive environments, trainers, and technical support to ensure partial or full recovery of the drug abuse victims. The fact considered in the reading materials indicate that harm reduction is a multi-aspect process and must take into account all the confounding aspects. Therefore, in my future occupation as a social worker, I will focus on the technical and personal predispositions that might affect outcomes of the programs. Moreover, the review by Engelberg, Moston, and Engelberg (2015) increased my awareness on the need for follow-up strategies after harm reduction programs. According to Farsalinos, Cibella, Caponnetto, Campagna, Morjaria, Battaglia and Polosa (2016), more than 45% of the impacts achieved by harm reduction methods are only temporary following the unsupportive environments. Other perspective gained from the reading materials includes the role of the society, the role of the victim, and health support structures that work in harmony for harm reduction in an identified population.
The Appeal of Harm Reduction
I find harm reduction a necessary social undertaking due to some reasons that make the victims an integrative part of the society. Firstly, as explained in Paloma Foundation Video (2017), most people become drug addicts due to the social environments that shape their socialization and cognitive development. Hence, it is the duty of the social health workers to step up and serve the victims, as they are an extension of the dynamic society. For instance, Engelberg, Moston, and Engelberg (2015) argued that drug addiction is determinant on economic, social, and religious aspects of the society. It is thus impartial to argue that the society contributes greatly to the drug addiction levels in some regions that other. The harm reduction programs aimed at identifying the marginalized societies and creating a sustainable solution. Moreover, if the social health workers ignore the drug addiction challenge facing members of the society, they risk increasing the victims through socialization. Paloma Foundation (2017) also observes that in the areas with effective harm reduction programs, the numbers of new addicts have reduced significantly over the years when compared to other regions. Therefore, it is the duty of social workers to design and implement the harm reduction programs despite the subjective predispositions of the victims.
Harm Reduction Strategies
As explained earlier, the applicability of the harm reduction models adopted in a society depends on the nature of the society. The factors to consider include the drug addiction level, types of drug, social systems that support the drug addiction, poverty levels, literacy levels, and the resources available. In the USA, the most applicable and easy to implement methods include peer education, referral to treatments, and vaccination and treatment for HIV and STDs. The USA society supports peer education due to the cohesive social and technology systems that allow free transfer of information (Van Amsterdam & Van den Brink, 2013). In the Implementation of the HIV and STDs, the majority of the drug addicts are likely to cooperate due to the direct impacts associated with the lack of treatments for these diseases. Moreover, a review by Anderson (1994) shows that majority of the harm reduction victims prefer to reduce the direct consequences of their behavior rather than focus on the drug addiction. Similarly, the
The Needle and Syringe Programs (NSPs) are the most challenging harm reduction approach. The program involves the provision of the equipment used during drug use (Iversen, Wand, Topp, Kaldor & Maher, 2014). In most cases, the drugs in consideration are mostly illegal thus making the adoption of the NSPs an ethical dilemma. The majority of the critics of the harm reduction argue that the use of NSPs might encourage other members of the society to use the drugs due to the low risk of contracting diseases and availability of support systems (Iversen, Wand, Topp, Kaldor & Maher, 2014). In the current USA society, such an adoption would lead to social conflicts between the interests of the taxpayers and the social workers.
Future of Harm Reduction
In the future, and following the proposed health amendments, the USA is likely to implement a higher number of harm reduction strategies. The health reforms will seek to increase the increase the funds decentralized to State health facilities (Engelberg, Moston, and Engelberg, 2015). Due to the different demographics that determine the applicability of the harm reduction models, the process is likely to be more effective with decentralized health care facilities that design treatment methods depending on the needs of the population.
While most of the critics follow the ethical debate that challenges harm reduction as a way of encouraging drug use. It is the ethical responsibility of the society to support the marginalized groups, who are mostly the victim of the social predispositions. As such despite the possible negative consequences of harm reduction processes, the stakeholders should attempt to reduce the negative outcomes without ignoring the needs of the drug addicts in the society.
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