Harm Reduction is anything that reduces the risk of injury whether or not the individual is able to abstain from the risky behavior. Inherently, it is a staged form of behavioral change, which is consistent with all the prevalent models of sexual and drug use behavior change and all the models of behavior change in these areas that have been shown to have some benefit.
--- David Ostrow, M.D., Ph.D.

Harm reduction philosophy in principle, aims to do exactly that: Reduce Harm. Although harm reduction practice can take many forms, all models accept that there are certain behaviors which people will always engage in for a variety of reasons. Harm Reduction interventions allow that these behaviors will take place and aim to minimize or in some cases eliminate the risks that these behaviors may pose to the individual, their loved ones, the community and society.

Harm Reduction truly meets the individual “Where they are at.” What many people don’t realize is that we ALL use Harm Reduction strategies in our daily lives. Have you arranged a designated driver, taxi or public transportation for a night out? Have you switched from whole milk to 2%? Have you limited yourself to one cookie after dinner instead of a whole box? Do you wear a helmet while biking? Congratulations, you’ve been practicing Harm Reduction.

The same logic that you have used when wearing a bicycle helmet is used by Harm Reduction-based Programs to provide services to individuals who use drugs, perform sex work or engage in other high risk behaviors. Riding a bicycle might be dangerous, but it is not realistic to expect people to stop riding them! By the same token, Harm Reduction recognizes that there are some individuals using drugs who are not ready, willing or able to stop using or to enter treatment. Appropriate substance abuse treatment is also not available to everyone who seeks it. When we consider Heroin use for example, Methadone Maintenance Treatment Programs which have proven to be effective have waiting lists of six months or more!

Syringe Exchange

So if we establish that there are people who are unable or unwilling to stop using for various reasons and that significant barriers exist for those who wish to obtain treatment, what are we to do? It is well known that individuals who inject drugs and those closest to them are at significantly higher risk than the general public for HIV, Hepatitis and other blood borne illnesses. Individuals who inject drugs are also quite often reluctant to seek medical or other care due to the stigma and paranoia associated with their use. The solution for this specific population lies in the time tested, well researched, cost-effective Harm Reduction strategy that is Syringe Exchange.

Syringe Exchange Programs provide individuals who inject drugs with sterile syringes and supplies in exchange for the proper disposal of used syringes. Although this interaction is the primary activity and objective of any Syringe Exchange Program, there are several other valuable services available through many programs. Syringe Exchange Staff develop referral relationships with service providers, resources and treatment programs, including Methadone Maintenance in order to minimize the myriad of existing barriers which exist for those amenable to getting help. These programs also offer referrals for HIV, Hepatitis, STD and other screening, sometimes on site. In addition, Syringe Exchange Programs often incorporate ancillary services such as case management, wound care advice, overdose prevention, volunteer opportunities, peer-delivered services, nutrition assistance and access to personal care items.

For more information about Harm Reduction, including Syringe Exchange and the many years of research which support its effectiveness, the Harm Reduction Coalition’s website is a great place to start. The syringe access page can be found here:

www.harmreduction.org/article.php?list=type&type=49

For information about the New York State Department of Health AIDS Institute’s Harm Reduction Unit, visit their website here:www.health.state.ny.us/diseases/aids/harm_reduction/index.htm

Visit  Project Safe Point, to learn more about our harm reduction program.