Why Harm Reduction?

Written by Milling Around

Originally Published in 2021

“There is often so much negative noise and perception around harm reduction that the real narrative is completely stifled. Harm reduction, by definition, is “...a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use. Harm Reduction is also a movement for social justice built on a belief in, and respect for, the rights of people who use drugs” (National Harm Reduction Coalition, 2022).

Harm reduction takes many forms, with the most recognizable, tangible form being access and use of naloxone (Narcan) and safe injection supplies. Along the same vein (ba dum tiss) are the emerging conversations on the federal and state stage around legalizing safe consumption sites (SCS). These examples of harm reduction are typically in reference to injection drug use, as well as people using opioids (this includes heroin and fentanyl, two substance names you likely have seen before).

The harm reduction movement is so much more than what you consume in local headlines, in Zoom meeting rooms, in dinner conversations. Harm reduction is, at its core, a form of community care. It’s unconditional support, compassion, and dignity. The largest tenet of harm reduction is intangible, invisible - it is expressed through our hearts and minds in the form of deep love for our fellow people.

I’ve lived in Lowell for roughly seven years. When I first came to this city, I was struck by the sheer number of people here, and second by how diverse the local community was. The third was the concentration of unhoused people I saw, mostly downtown, where large groups of folks come together during the day for community and a plethora of services, ranging from food to healthcare. This was new for me, coming from a majority white town of 27,000 people, where substance use and or homelessness were not as “out in the open.” Pause there for a second - why weren’t individuals in the midst of chaotic substance use and experiencing homelessness visible? I know they existed through stories at school, many renditions of the various experiences of my peers, but why couldn’t I see it?

People often have to hide when they are not safe. Overt substance use and homelessness are not safe in our society - I’m not talking about the public and personal safety aspect of when there’s a situation with violence, but situations where people are made unsafe through stigma, internalized hatred, and fear. The practice and ideology of harm reduction is a strong bridge to finding common ground here. If the folks I heard about in my hometown and in Lowell today had spaces to become visible not in a negative, fearful light, but an honest and open-minded one, perhaps we would be able to love and support people more easily. I don’t necessarily know what that looks like as I write this. I’d be curious to hear what examples came to mind as you peel through this piece. I share this brief reflection to model what it means to deeply analyze past and present experiences. I also share this to illustrate how I interpreted my world before I came to peace with what is, with stubborn loyalty.

Harm reduction is a movement that starts within each of us. It starts in those deep corners of our minds where we harbor thoughts and memories of experiences that have told us “reducing” isn’t the way, abstinence is, elimination of the vice is. The important distinction between reducing use and completely abstaining from use lies in the end result - statistically, people are at far greater risk of dying due to (opioid) overdose following a return to use after a period of abstinence than if they continued using at a slower or reduced rate.

The harm reduction movement starts in the parts of our psyche that place our individual welfare far and away from the general welfare, safety, and health of the community at-large. Fully embracing the harm reduction movement requires endless unlearning, rejection of oppressive norms, and, most importantly, coming to peace with what is.

What to do next? Follow @HarmReducionCoalition on Instagram and/or Twitter. Use your internet sleuthing ability to find the pages and the work of individuals doing the work, experiencing the work, providing funding for the work. Pull together a mental collage of quotes, stories, scientific articles, art - and sit with it. Summon that collage on your next walk through your neighborhood, your downtown, when you’re sitting at your job. Come to your own conclusions about what harm reduction means to you, and how it fits into your worldview. Then, we can talk about action steps.