For many, the reality that harm reduction and recovery go hand in hand can be challenging to see. The idea that people ought to be engaged, supported and empowered, even while actively using substances and without the requirement of abstinence, can be difficult for many who view abstinence as paramount to recovery. Some people living in recovery may believe that the act of supporting people while in their active substance use and allowing them the right to use can serve as a barrier to people finding recovery – this line of thinking typically comes out in statements such as “we are preventing people from hitting rock bottom, and hitting rock bottom is necessary for people to be ready for recovery.”
The reality, however, is that harm reduction IS part of the recovery continuum and that not only is recovery activation not about hitting rock bottom but that rock bottom in this era of the opioid epidemic means death. Most particularly because of the latter, it is more important than ever that the recovery advocacy movement embraces harm reduction and seeks ways to align on key issues. If we are to ever see a decrease in opioid-related overdose deaths and an increase in political will for real solutions, recovery advocates must expand their view of recovery and truly partner with harm reductionists.
For some people and families living in recovery, this may seem like a daunting task. To help put this into context, it is important to go back to what recovery really means. While many definitions of recovery exist, SAMHSA and key stakeholders gave us the following pretty simple and universal definition of recovery:
Recovery is “a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.”
Now, if we can all move just a little beyond the confines of our own limited personal definitions of recovery that have been framed by the pathways we found it through and instead meet at the place of this definition, it shouldn’t be too difficult to see how harm reduction is absolutely part of recovery.
To drive home why harm reduction is part of the recovery continuum, below are 10 reasons why the recovery advocacy movement needs to embrace harm reduction strategies:
- Needle exchanges save lives. Period. Needle exchange programs put Narcan in the hands of people who most need it.
- Needle exchange programs reduce the spread of HIV without increasing the use of drugs, according to this study.
- The World Health Organization report found that there is reasonable evidence that needle syringe programs can increase recruitment into drug treatment and possibly also into primary health care.
- A 2016 Center for Disease Control Report found a national return on investment of $7.58 for every $1 spent on needle exchange programs
- The needle exchange program in Philadelphia refers more people to treatment than any other agency.
- Recovery is about engagement, not coercion. Recognizing the role of the stages of change and meeting people where they are at goes much further in engaging people in the type of ways that lead to recovery initiation.
- Harm reduction addresses the social determinants of health that are responsible for positive health outcomes and aid in reduced or ceased substance use (i.e. housing, social support, employment, etc)
- Wellness occurs on a continuum and we need services to meet people wherever they are on that continuum
- Harm reduction helps protect the health, dignity, and human rights of individuals who are stigmatized against and often dehumanized in our society.
- Dead people can't recover. There has not been one overdose death in any of the 60 worldwide Safe Consumption Spaces (i.e. Supervised Injection Facilities, Comprehensive User Engagement Sites). Harm reduction gives people the chance to find recovery.