5 things I want you to know about harm reduction
5 things I want you to know about harm reduction:
ID: A yellow rectangle with light salmon outlines of crystals as background. On the left hand side is a blue circle with the number one inside as negative space. Next to the number one in maroon letters reads, “Harm reduction is a framework created by and for people who use drugs.”
Harm reduction is a framework created by and for people who use drugs.
I feel the need to scream this from the rooftops all the time because harm reduction has become an often misused buzzword with no reference to its origin or intended application. I want to make sure that we are all staying grounded in an understanding of what harm reduction is when we are talking about it. At its core, harm reduction is a set of strategies and ideas for reducing harm related to substance use. It was created in response to the HIV/AIDS epidemic, and has grown exponentially in the last three decades to meet the multi-layered, intersectional needs of people who use drugs. Though I do believe harm reduction is a framework that could probably solve every single problem you could think of, we need to remember what it is, what and who it's for, and place people with lived experience at the front whenever harm reduction is being talked about, practiced, or researched.
ID: A yellow rectangle with light salmon outlines of crystals as background. On the left hand side is a blue circle with the number two inside as negative space. Next to the number two in maroon letters reads, “Harm reduction is not “enabling” people who use drugs.”
2. Harm reduction is not “enabling” people who use drugs.
It’s way past time that we reframe our thinking around what enabling means. Here’s the truth: people who use drugs are going to do what they want to do, no matter if we are supporting them or not. The hard part of this truth is that without support, and when stigmatized and abandoned by their communities and loved ones, people will put themselves at greater risk when using substances. So, I ask that we start asking ourselves what exactly are we enabling when we practice harm reduction. I say we’re enabling people who use drugs to be held by the community, in all their humanity. We’re enabling people who use drugs to have access to the tools they need to stay healthy, safe, and alive. How is this a bad thing? If abstinence isn’t everyone’s destination, how can we make sure that people are getting what they need, regardless?
ID: A yellow rectangle with light salmon outlines of crystals as background. On the left hand side is a blue circle with the number three inside as negative space. Next to the number three in maroon letters reads, “Practicing harm reduction isn’t easy.”
3. Practicing harm reduction isn’t easy.
Meeting people where they’re at, not where you want them to be takes a lot of self awareness, humility, and patience. If you’re looking for a way to support people who use drugs without connecting to their full humanity and honoring their self determination, this work isn’t for you. If you’re looking for a way to do meaningful work without being witness to all outcomes - including the adverse outcomes - working in harm reduction isn’t for you. We must do this work in community in order to be held through the hard, messy, and heartbreaking moments. We are all people who could, have, or do use substances; there is no divide between ourselves and the people we are here to serve.
ID: A yellow rectangle with light salmon outlines of crystals as background. On the left hand side is a blue circle with the number four inside as negative space. Next to the number four in maroon letters reads, “Harm reduction removes the good/bad binary from our thinking about substances and the people who use them.
4. Harm reduction removes the good/bad binary from our thinking about substances and the people who use them.
This one might be hard for folks to wrap their heads around, because we’ve been told all our lives that drugs are bad.
When we attach a moral value to a substance, we’re missing the big picture - the why behind the use and the needs of the person engaging in use. Dr. Gabor Mate says, “not why the addiction, but why the pain.” Sit with that for a second… Think about the fact that the only gateway drug is trauma. We need to get comfortable with existing in the gray areas, and understanding that there are complexities in everything. Substances as a thing aren’t inherently bad. Capitalism, the racist and classist war on drugs, stigma — these are the things we need to be fighting, not the fact that substances exist or that people use them. *steps off soap box…*
ID: A yellow rectangle with light salmon outlines of crystals as background. On the left hand side is a blue circle with the number five inside as negative space. Next to the number five in maroon letters reads, “You are in community with folks who use substances, whether they trust you enough to let you know it or not.”
5. You are in community with folks who use substances, whether they trust you enough to let you know it or not.
Take some time today to think about whether you’re a safe person for people who use substances. Think about any biases that you may be holding onto, and what you can do to release them. Birthworkers — you’re supporting people who use substances whether you know it or not. Do you have the tools and resources to be the support that they need? Capstone: Advanced Full Spectrum Doula Training will take this conversation deeper in our harm reduction module. Our next US cohort began Sunday, December 11, and there’s still time to join us if you’d like to learn more.
In the meantime, I invite you to work through these journal prompts:
What messaging did you grow up with about drugs and the people who use them? Where did these messages come from?
Think of a time where you felt stigmatized. How could the situation have gone differently to help you feel seen, heard, validated, and cared for?
What are some tools you’ve used in the past to unlearn previously held onto beliefs or biases? Did these tools work? Why or why not?
What are some biases that you currently hold onto in regard to people who use substances? Be honest.
Compassion is at the root of eliminating stigma. What does compassion mean to you? How can you call it in, even in difficult moments?
Some resources:
Find naloxone in your community
End overdose - free overdose reversal training
National harm reduction coalition
Find syringe exchange in your community
Drop your favorite harm reduction resources in the comments below.