Safer Substance Use Begins with Risk Mitigation
We all know that driving can be dangerous. When we get behind the wheel, we take certain precautions to ensure our safety such as strapping our seatbelts on, putting away our phones, wearing sunglasses, and driving the speed limit. By taking these safety measures, we are reducing our risk of harm to ourselves and others while partaking in a dangerous activity. This is called risk mitigation.
Everyday examples of harm reduction include:
- Having working airbags in your car
- Taking an Uber instead of drinking and driving
- Using condoms
- Eating before drinking alcohol
- Using nicotine gum/patches/vapes instead of smoking cigarettes
In the behavioral health field, harm reduction is associated with reducing the risks of substance use so people can engage in a recovery journey as they define it.
Why is abstinence not enough?
When life takes a turn, substance use can be an escape from trauma, mental health challenges, housing instability, and family conflict. With repeated use, our brain’s chemistry is altered, making it harder to stop the use.
A big behavioral change, such as stopping use,
is hard because:
- The behavior meets some kind of need.
- The cycle of guilt and shame when stopping and resuming use.
- Big changes are overwhelming.
- Co-occurring disorders complicate change.
- Drugs alter our brain chemistry.
Recovery is not a one-size-fits all model.
When trying to help, we need to ask:
- What does wellness look like to you?
- Does it look like abstinence?
- Does it look like reduced or safer use?
Once we have those answers, we can work with the person to find the right route for healing.
How does safer substance use support recovery?
While drugs can change the brain, time and treatment can change it as well. Stigma-free risk mitigation practices increase trust to raise the likelihood of sustained recovery as defined by the individual.
Requiring us to put judgment aside, it helps us address the social and environmental conditions that lead to use, along with the use itself, and gets to the root of the issue. Overdose prevention is about meeting people ‘where they are at’.
This can mean:
- Finding ways for safer use like providing access to sterile needles and fentanyl testing strips.
- Distributing naloxone (Narcan) to help prevent overdoses and save lives.
- Connecting people with recovery resources, such as Medication-Assisted Treatment (MAT) and counseling.
By meeting people ‘where they are at’ with realistic expectations about the winding path of recovery, we can support the whole person through individual-centered treatment.
Recovery and wellness look different for everyone. Harm reduction acknowledges that each person’s wellness begins at a different starting point. This life-saving approach releases shame surrounding substance use and enables people to create lasting change.
To learn more:
Meeting People Who Use Drugs Where They Are - An episode of “Changing the Conversation” podcast
