Harm Reduction Alone is Never Enough

A man struggles with addiction.

One of the many layers of service to those who are using drugs or addicted is harm reduction. What is harm reduction? It’s a group of different services aimed at making drug use less dangerous. These services include:

  • Distributing clean needles to injecting drug users
  • Testing drugs for potency or to determine their actual contents
  • Distributing drug test kits to users
  • Handing out the opioid antidote naloxone so opioid overdoses can be reversed
  • Teaching people how to avoid the transmission of blood-borne diseases when injecting drugs
  • Educating drug users on how to avoid overdoses
  • Running clean, medically supervised rooms where injecting drug users can use their drugs
  • Instructing drinkers and drug users how to avoid the worst risks associated with their substance use

While harm reduction helps people avoid the worst repercussions of their drug use, this method of helping people can be taken too far. This was the conclusion reached by the B.C. Centre on Substance Use in Vancouver (BCCSU).

Vancouver’s Situation

Vancouver policeman in Vancouver’s East Side
Vancouver’s East Side / Photo by Adam Melnyk / Shutterstock.com

Vancouver has been living with a serious drug problem for many years, particularly problems with opioids. In the Downtown Eastside area, North America’s first supervised drug injection site was established in 2003. While this is primarily a place where a person can be assured of receiving immediate medical help if a problem arises while injecting drugs, the secondary purpose of this service is to familiarize drug users with health and recovery services.

The City of Vancouver also runs needle exchange programs where drug users can turn in used needles and get clean ones, preventing the transmission of HIV and Hepatitis C.

In 2017, the Mayor of Vancouver announced that portable drug testing machines would be supplied to injection sites to enable drug users to find out what is in that package of drugs they just bought.

In Vancouver, there are six safe injecting sites and in British Columbia, a total of 20.

But if the focus of a community is too fixed on reducing the harm of drug use, they could overlook helping people focus on recovery from their addictions.

New Report from BCCSU Encourages More Recovery

The purpose of the BCCSU is to prevent drug use and care for those who are using drugs. Their July 2018 report found that harm reduction services were not enough, and that addiction recovery services needed more promotion and support.

Services for homeless drug users

Their news release on this subject cited the case of Josh McDiarmid, an alcohol and cocaine user. He was living on the streets in Vancouver and utilizing all the social services available to him to survive. He visited homeless shelters, meal services, youth resource centers—but no one ever talked to him about recovery. No one ever sat him down and explained that recovery works and he could achieve a better life that way. “I had accepted my death down there,” he said.

All it took for him to make the turn to recovery was a Facebook message from an old friend at a moment when he was sitting at his own rock bottom. The friend, who was in recovery himself, suggested that Josh try it as well. That began his journey to a healthier life.

Harm Reduction Helps But Stops Short of a Solution

The harm reduction philosophy includes acceptance of the fact that people are going to use drugs. This acceptance could be a little too complete. Understandably, an adamant insistence that a person consider rehab every time they arrive at a safe injection site might drive some people away. But still, the goal of sobriety needs to be uppermost in the minds of anyone supporting or counseling those who are addicted.

Couple enjoys bicycling.

Too much reliance on harm reduction can blur the lines and could encourage the acceptance of drug use among a population. It should not be forgotten that no one wants to be an addict. No one wants to inject heroin every day or drink to oblivion every weekend. In his or her natural state, a human being is caring and alert, focused on survival and the future.

Drugs and alcohol ruin the beauty of our innate characters. The senior service that can and should be provided is helping a person return to a state of health without reliance on alcohol or illicit or misused pharmaceutical drugs.



For more than a decade, Karen has been researching and writing about drug trafficking, drug abuse, addiction and recovery. She has also studied and written about policy issues related to drug treatment.