Does Harm Reduction Work?
There are many different types of harm reduction treatments that have been used for years to help prevent individuals who use drugs from the dangerous consequences of these behaviors. While methadone maintenance treatment is considered a type of harm reduction treatment, it is important to ask if these methods work and what they are actually helping to achieve.
What is Harm Reduction?
According to the National Institute on Drug Abuse for Teens, “Harm reduction is an approach that is based on the belief that some people will do risky, dangerous, and sometimes illegal things even if they know it could hurt them or have an outcome they don’t want… Supporters of harm reduction feel that educating and protecting people about how to reduce unwanted outcomes is more realistic and helpful than educating them on why they shouldn’t do it in the first place.” This approach to drug abuse and addiction treatment recognizes that people will abuse drugs no matter what and, therefore, seeks to minimize any harm that could arise from this behavior.
How Does Methadone Maintenance Fit into the Concept of Harm Reduction?
In the case of methadone treatment for heroin and other types of opioid abuse, there are several harmful outcomes that the treatment itself is designed to prevent or minimize. These include:
- Acquiring and transmitting HIV, hepatitis B and C, and other diseases
- Physical problems, such as collapsed veins, liver disease, seizures, abscesses, etc.
- Addiction or the consequences of it (cravings, withdrawal symptoms, etc.)
- Unhealthy or unwanted pregnancies
- Criminal activity and legal problems
- Sexual risk behaviors
As a treatment method, methadone maintenance usually involves a number of steps in which patients are educated about, tested for, and given access to other preventative measures for dangerous outcomes that could be involved with the continued abuse of opioid drugs. Methadone is also dispensed at a specific dosage amount based on the patient’s needs in order to minimize their cravings and withdrawal symptoms.
Part of the concept behind methadone maintenance is that many people cannot stop using opioid drugs and, without methadone, would go back to abusing heroin and other more dangerous opioids. This is a harm reduction approach. In addition, because doctors, nurses, therapists, and other staff members understand that there is still a chance patients will abuse heroin or other opioids in some capacity, these clinics also provide a number of educative services that help patients avoid the more dangerous outcomes of these actions.
Is Harm Reduction Effective?
While harm reduction (and by association, methadone maintenance) is a good concept, many people wonder if it is actually effective. Does harm reduction work to minimize the damage individuals experience from doing drugs or does it only cause people to feel that it is safer and therefore more acceptable for them to participate in this behavior? Critics of harm reduction often “say there should be a ‘zero tolerance’ approach [to drug abuse] and that by trying to reduce harm from using drugs, you are encouraging drug use.”
Despite the voice of detractors, it has been found that harm reduction itself is considerably effective. According to a review from the National Center for Biotechnology Information, “There is sufficient evidence to support the wide-spread adoption of harm reduction interventions and to use harm reduction as an overarching policy approach in relation to illicit drugs.” Harm reduction has been found to help with many of the issues experienced by drug abusers and diminishes the damage caused by this behavior in many instances.
For example, another study from the NCBI states, “There is now compelling evidence that harm reduction approaches to HIV prevention among injecting drug users are effective, safe, and cost-effective.” HIV and other diseases that are commonly contracted through shared needle use have all been shown to be reduced with the implementation of harm reduction methods, which is extremely beneficial because these issues are one of the most prevalent among heroin users. Harm reduction is very helpful in keeping people from contracting these diseases which, overall, leads to a safer and healthier lifestyle for many.
Harm reduction has also been found to be effective in preventing higher mortality rates, overdose rates, and many other issues that commonly plague drug-using individuals. However, further studies may need to be done to understand how effective these methods are in preventing pregnancy-related issues, criminal activity, and other problems.
Is Methadone Maintenance an Effective Harm Reduction Method?
Methadone maintenance is an extremely effective harm reduction method. The program has existed since the 1960s, helping individuals reduce their use of injection drugs and lead healthier, safer lives. According to another NCBI study, “Harm-reduction-based methadone treatment, in which the use of illicit drugs is tolerated, is strongly related to decreased mortality from natural causes and from overdoses. Provision of methadone itself, together with social-medical care, appears more important than the actual methadone dosage.”
The use of methadone to maintain individuals who are unable to stop using drugs does diminish the harm these individuals are likely to experience by a large amount. And although many believe a zero tolerance policy is more beneficial overall, harm reduction takes into account the needs and abilities of drug addicted individuals and provides a more realistic option that still leads to the lessening of many harmful outcomes.
“Access to and use of methadone maintenance programs are strongly related to decreased mortality, both from natural causes and overdoses, which suggests that these programs have an impact on overall sociomedical health” (NCBI). And, according to the Center for Disease Control, methadone maintenance itself has been found to be beneficial in several other outcomes of opioid drug abuse, including:
- Improving the outcome of pregnancies
- Reducing injection drug abuse
- Reducing criminal activity
- Improving family stability
- Improving employment potential and financial situations
- Reducing the potential for disease transmission and other problems with physical health
Does Harm Reduction Work?
Harm reduction does work, and methadone maintenance as one of its methods also works to help opioid abusers minimize and even completely avoid the chance of being harmed further by their drug use. Sometimes, it is important to recognize that people will do what they want, even if there is a potential risk involved, and that the best way to help them is to minimize the risks as much as possible.