What Is Harm Reduction?
The definition of “harm reduction” in drugs is variable, but generally the term refers to policies that seek to reduce the potential problems associated with drug use, rather than focus exclusively on eliminating drug use altogether. When harm reduction is mentioned, it is usually referring to the safer use of illegal drugs such as heroin. Injecting drugs, like heroin, directly into the blood stream can cause many health issues, including the spread of HIV and other diseases through shared needles. A method of harm reduction for heroin is providing education and clean needles.
For prescription drugs, harm reduction is an especially useful strategy. These drugs may be legal to use under a doctor’s supervision, but they still have high rates of abuse, even in patients who were prescribed them for legitimate reasons. In fact, the FDA reports in its Safe Use Initiative that “up to 50 percent of harm from medication use could be prevented.” To help prevent overdose deaths, and to help prevent addiction and abuse, harm reduction techniques help raise consumer awareness and educate people about how to protect themselves and use these drugs as safely as possible.
Although made in the lab of a large company and officially sold only to patients with doctor prescriptions, pharmaceuticals—especially opioid painkillers—have a dark side. When used improperly, these drugs can have fatal effects. In fact, in 2011, the Centers for Disease Control and Prevention (CDC) reported that overdose deaths from OxyContin alone were greater than all illegal drugs combined. Sadly, the vast majority of overdose deaths due to prescription misuse or misidentification are avoidable. Often both legal and illegal prescription drug users alike are not educated enough on the potential dangers and often have no clue about how to take steps in avoiding those dangers.
Fortunately, there are many resources available that provide general safety tips on reducing the harm that taking prescription drugs can do. The FDA lists ten tips to prevent an accidental overdose in its Consumer Updates on Safe Use report. Below are some of their tips on safely using prescription drugs:
Know exactly what you’re getting: Identify and understand each active ingredient. Many opioid painkillers, for example, contain large amounts of Tylenol (acetaminophen), which can cause a great deal of damage to the liver, especially in people who drink a lot of alcohol or suffer from liver problems.
Administer the medicine properly: Don’t crush, inhale or inject your prescription meds, as this can cause a sudden rush of the drug all at once, drastically increasing the chances of a fatal overdose.
Properly dispose of and store all medicines: Like many patients, there’s a chance that you won’t use every pill that came with your prescription. Properly storing and disposing of these drugs, however, can prevent a host of problems. The FDA offers this useful handout: How to Dispose of Unused Medicines. Proper disposal of unused prescription medications helps reduce harm in a number of ways, such as preventing these chemicals from contaminating the water supply, reducing the temptation to self-medicate or give away the unused drugs to a friend or family member, preventing accidental poisoning from curious children or pets, and preventing any friends, family members or complete strangers from stealing these drugs.
Know whether the pill is delayed or immediate-release: Confusion over immediate-release vs. controlled or delayed-release prescription pills has caused many unnecessary deaths and trips to the hospital. This is especially dangerous out on the street where misidentification can occur, and also for users who choose to chew or inject the pharmacy drugs. There is a huge difference between 20mg of rapid-release oxycodone and 80mg of OxyContin, the latter of which can easily kill someone who hasn’t developed a large tolerance for opioids.
Know the side effects: Reading the associated side effects of prescription medications can be dizzying. Reading up on these side effects and speaking with your doctor, however, can help you better understand what to expect, and when to be concerned. In addition, some of the less severe side effects can be prevented or minimized. Opioid painkillers, for example, often cause dry mouth, which can be prevented by drinking plenty of fluids.
Another common cause of prescription pill overdose is combining medications or combining the prescription drug with another substance such as alcohol or MDMA. Consult with your doctor to identify which medications, supplements, etc. you’re taking to see if they may interact with your prescription drugs. In some cases, some supplements can negate the drug’s therapeutic value. Other times, substances can interact with your medicine and cause more serious problems or increase the chances of an overdose.
Know how long it takes for the drug to take effect: Many users have overdosed from taking too much at once while waiting for the effect to “kick in.” Take note of how quickly the medicine should work, and resist the temptation to misuse the prescription drug and increase your dose because you’re expecting instant results.
Arguments Against Harm Reduction
Not everyone supports the idea of harm reduction. Backers of no-tolerance drug policies and similar groups often criticize harm reduction policies for being too lax on drug use, potentially reducing the negative individual and community impacts while still not addressing the rising rates of abuse, especially for pharmaceuticals.