Understanding harm reduction
"The behaviours associated with drugs can be beneficial (intake of medications that prolong life), neutral or damaging. To label positive or negative is judged by many as a purely subjective gesture and subject to controversy. The concept of harm reduction offers, a practical manner to evaluate the repercussions in an objective manner."
Diane Riley, Canadian centre for the fight against alcoholism and drug addiction.
Harm reduction is a social approach destined to reduce the negative consequences linked with a given behaviour, like drug abuse. This approach consists of seeking objectives that are realistic, given priority, and individualized in order to eliminate the risks linked with drug abuse, without rejecting the notion of abstinence.
Origins of harm reduction in Canada
Fast spread of the aids virus among the users of intravenous drugs has become in the course of 1985 to 1990 a major public health problem in most countries. In the face of this problem that menaces to take on an even greater presence, the Canadian government had pronounced itself in 1987 in favour of the harm reduction concept within its national political campaign against drug addictions. The other harms targeted by this approach express themselves in terms of economic costs (In Quebec for instance, we estimate the cost due to absenteeism in the workplace caused by the abuse of illicit drugs to 500 million dollars), in terms of public security and of social distress.
Harm reduction application
There exists an ensemble of strategies aiming to attain health objectives, re-socialization or decriminalization of drug-addicted individuals.
Syringe exchange sites
A good number of intravenous drug users are not ready to abandon the product; this is why the government has given itself the methods to reduce the risk of HIV infection and the hepatitis' by making new syringes accessible to drug addicts. The first syringe exchange program was put in place in Toronto in 1987. Today, there are 650 syringe exchange sites in existence in the province of Quebec alone.
The syringe exchange programs, moreover, reach certain users of intravenous drugs who, otherwise, would never be in contact with other organizations in the hopes of getting help.
Methadone maintenance programs
They consist of, under medical surveillance, providing to heroin users by injection an opiate substitution delivered in the form of syrup: methadone. Different from heroin that users inject themselves directly into the blood stream and in which case the effects only last a couple of hours, methadone is taken orally, and the rate of elimination is much slower allowing the user to feel the effects for at least 24 hours.
Because the users no longer have to search for an illegal and costly product, and because the program imposes a routine of daily visits in a distribution centre, the drug addicts are able to abandon their criminal activities, to renew themselves with the workforce, to obtain an appropriate medical record, and to reduce the spread of infections linked to the sharing of syringes (aids and hepatitis').
Dianova Canada and harm reduction
Within a community framework, the Dianova program proceeds in stages, according to individualized objectives. Taken from the example of the harm reduction model, our approach is humanistic, in other words founded on the needs and the aspirations of people and pragmatic, that is, founded on aptitudes and the interests of all.
It thus acts upon an approach that relies on respect for the people's capacity to improve their quality of life, to acquire an autonomy permitting clear choices in the face of drug consumption.
More specifically, the harm reduction approach aims to diminish the negative consequences stemming from abuse or of misuse of drugs, and distinguishes itself with confidence and tolerance towards everyone. All in all, each person sets their own objectives and their rhythm of change.