What's Harm Reduction?
As you are no doubt aware, “just say no” rarely works effectively.
When told to just say no to something they want to do, most people blunder ahead and do the thing and without knowing how to do it safely. Harm reduction opens the door to other ways of addressing choice; it gives us tools with which to make informed decisions. Harm reduction arms us with awareness of how to make better choices when facing virtually any decision.
Harm reduction is a set of strategies, but it is also a movement. There’s lowercase harm reduction - the strategies, and uppercase Harm Reduction - the movement.
The Harm Reduction movement is a peer-led, best-practices based approach which leads to folks implementing harm reduction strategies. Harm reduction - the strategies part - includes a wide range of tools and techniques that when implemented create a move toward less harm. In other words, you can still do the thing, but you can learn ways to do it without hurting yourself or others - or in cases where harm is unavoidable, you can learn ways to hurt yourself or others less. A harm reduction tool you are probably familiar with? The kind of sex education you get here at Scarleteen. And of course, condoms! Though there are many other examples too, and we will get into those a bit later.
The areas in which you’re probably familiar with harm reduction principles are birth control, safer sex and safer drug use, but we use harm reduction strategies, tools, and techniques in so many different areas in our daily lives. For instance, using sunscreen is harm reduction. Seatbelts, helmets, crosswalks, masks and social distancing, washing hands; implementing any of these measures is harm reduction.
Harm reduction is an essential part of making choices that may affect — and probably already has affected — your life in profound ways. It is a way to participate in decision making that allows you to make the best choices possible, regardless of what is going on in your life. Harm reduction is looking both ways before you cross the street, instead of just walking into traffic.
Some Principles of Harm Reduction
Meet People Where They Are is one of the mottos of harm reduction. It means not only physically showing up to people where they are at and offering education and tools, but the phrase can also be applied metaphorically - it means meeting someone at the mindset they are operating from, meeting them at where they are operating. It means working from an open perspective and showing up for folks without judgement.
Any Possible Positive Change means just that. If a person is engaging with activities that may be risky, like having unprotected sex, as a harm reductionist I will offer them education and supplies that may help them to make a different choice. I am not going to tell them what that choice needs to be; I am just going to offer the education about risks and about options to reduce risk, and leave it up to the person to make their own choices about what changes they may make. For example, using a condom some of the time, or with some people, is less risky than never using a condom.
Nothing About Us Without Us - Peer Leadership This phrase is held true and dear by many communities including disability rights, sex worker rights, and the Harm Reduction movement. What these communities have in common is that they hold peer leadership as a central value. What this means is that people with lived experience of drug use, sex work, and often unhoused life, for instance, are central to the movement. Legislation and organizational structure and movement values all inform the input and vantage points of folks with lived experience.
Harm Reduction, Safer Sex, and Relationships
So much has already been written here on Scarleteen about safer sex! Safer sex - condom use, dams for oral sex, gloves and finger cots, outercourse, mutual masturbation, regular STI testing, and more - is harm reduction! Having safer sex conversations is harm reduction. All safer sex strategies and tools are harm reduction.
Harm reduction can also be applied to relationships - not just to sex; having conversations about boundaries is harm reduction, maintaining close and loving relationships with friends is harm reduction, understanding how to avoid discrimination and harrassment is harm reduction - and finding creative and powerful ways to confront these things when they happen is also harm reduction. Abortion access is harm reduction. So is access to birth control. Knowing your rights and how to protect them is harm reduction. Building community is harm reduction. Mutual aid is harm reduction.
Harm Reduction and Drug Use
There are a few ways to make using drugs (alcohol or any other drug) more safe:
- Start Small. You can always add on, but you can’t take away from what you’ve already taken into your body. Whether smoking, eating, drinking, shooting, or booty bumping, starting with a low dose and only increasing slowly is harm reduction.
- Be Careful When Mixing. A little known fact is that many substances can make each other stronger. When in doubt, leave it out! Be careful about mixing drugs you are not used to taking. Be extra careful about mixing drugs that are dangerous together, like alcohol and narcotics. Do your research and stay safe(r).
- Test Your Supply. Even if you think it’s safe, testing your supply for fentanyl is smart. This is true for pressed pills as well as powders. Fentanyl is causing overdose rates to skyrocket. Don’t become a statistic; if you are going to use, make sure your substances are pure.
- Be Aware of Set and Setting. Be aware that your body’s response to any drug can vary based on your environment and many other factors. Set and setting can predict a more or less positive experience, or a more or less dangerous one. If you are using your substance of choice in a new setting, be aware that the outcome may be different from what you are used to.
- Never Use Alone. Always let someone know that you are going to be using your substance of choice. This is especially essential with anything that can make you feel unsafe in any way, and especially any substance that you can overdose on. This includes many pharmaceuticals, and especially narcotics. The need for this principle of use increases when you are using street narcotics, like heroin. Never shoot drugs alone. If you can’t find someone to sit with you, call Never Use Alone at 800-484-3731.
- Carry Narcan. Have those you love carry Narcan too. Get trained on how to use it. If you are using narcotics make sure your friends and family know how to use narcan too. Narcan saves lives.
Harm Reduction and COVID-19
What does harm reduction have to do with COVID-19? Wearing masks and practicing social distancing are harm reduction strategies. Washing your hands, limiting trips outside the home as possible, not socializing with people who live outside your home, and working to limit possible exposures in other ways are all harm reduction.
Harm reduction is the way we are going to get through this pandemic, by staying as safe as possible while also living life the way we must. Having a harm reduction frame will help you to make the best choices you can make, given the parameters of a global pandemic. Maybe you are an essential worker. If so, harm reduction is already your unrecognized bestie - every day you are relying on harm reduction strategies to lower your risk of exposure.
- What are three forms of harm reduction you have used in the past week?
- What are two kinds of harm reduction that matter most to you?
- What is one kind of harm reduction you want to learn more about?
Acceptable Levels of Risk
Any discussion of harm reduction would be incomplete, in my opinion, without a mention of acceptable levels of risk.
We all know that people get hurt and even die in car accidents, yet many of us still drive. Harm reduction is driving as safely as possible, and deciphering your acceptable levels of risk is knowing the stats and driving anyway - but as a harm reductionist, you will be wearing a seatbelt, obeying the speed limit, and making sure your tires are in good shape.
An acceptable level of risk is going to vary from person to person, and activity to activity. It will be reliant on your values, your gain or reward from a given activity, and your ideas regarding risk and reward in general. But having a concept of your acceptable levels of risk will allow you to have a more articulated internal, and interpersonal, process regarding your desires.
Harm Reduction is Key!
Harm reduction is a key to finding your way through internal and interpersonal processes around risk and reward. Learning a harm reduction vocabulary and frame is a great way to help you make more informed decisions in life. Harm reduction will help you to make the most resourceful choice you can, in most any setting.