The harm in harm reduction
TheStar.com – comment – The harm in harm reduction
April 15, 2008
Tony Gizzie, Community Editorial Board
Not so long ago, when individuals entered an addiction treatment facility, they were taught techniques and life skills in order to thrive once again without their substance of choice. In short, they learned to abstain and change.
Currently, in the Province of Ontario and the City of Toronto, the approach is something quite different. It is called “harm reduction,” a methodology I believe to be ineffective in the long term.
The Centre for Addiction and Mental Health, a provincial agency, defines harm reduction as any program or policy designed to reduce drug-related harm without requiring the cessation of drug use. The policy goes on to say that the primary focus of harm reduction is on people who are already experiencing some harm due to their substance use.
The City of Toronto’s definition goes further and states that harm reduction refers to interventions that seek to reduce the harms associated with substance use for individuals, families and communities. It can include, but does not require, abstinence.
Let’s think about that for a moment. Say someone you know has a life-threatening addiction to drugs or alcohol.
In all likelihood their family life is in shambles and their physical and mental health is poor. Their paycheque, assuming they are still employed, goes to feed their habit.
In the harm-reduction scenario, imagine that person going to their wife or boss and saying, “Hey, good news, I only get high on the weekends, isn’t that great?”
What kind of nonsense is that? Wouldn’t the best way to change be to stop using altogether?
Alcoholics Anonymous, the most successful recovery program in existence, believes that there is no cure, and that abstinence is the only solution.
Members of AA know they can’t have an occasional drink. They learn that staying clean and changing their behaviour leads to the re-creation of their lives and those of their families.
The City of Toronto hands out crack kits. The rationale is that this will reduce unwanted behaviour such as unsafe sex, sharing of drug paraphernalia, and isolation in the community. The city will tell you that handing out these kits won’t encourage any new drug use. This may all be true, but it doesn’t reduce use, either.
In fairness, providing clean needles and a safe place to shoot up for heroin addicts, which is another form of harm reduction, does combat the spread of hepatitis C and HIV. Whether it saves any families, or reduces the number of guns on the street due to drug related crime, is less certain.
I believe one reason that harm reduction is the treatment du jour of these agencies is that their clientele’s rate of success measured in terms of abstinence was not high, and in order to reach the largest number of potential clients as possible they lowered the bar.
Many organizations offer the rationalization that drug use is part of our lives and will not go away. That is probably true, as it is true that most people who use recreational drugs or drink will not become addicted.
But there are those who are addicted and whose lives are in trouble. For them, continued use can and will ultimately prove to be disastrous.
It is a courageous act for an individual to face their problems and attempt to make the changes necessary to break free of their addiction. It’s not an easy transition to make.
We, as a society, should do everything possible to assist them on their road to recovery. Everything, except create the illusion that only going half way down that road is all it takes.
Tony Gizzie is a banker who lives in Oakville.